Strategies for covid-19 pandemic phase in oncological rehabilitation

ABSTRACT

Introduction: Cancer, lymphoma and leukemia are life-threatening diseases, ofen with curative therapies, high risk of recurrence and stressful symptoms that require immediate, quality-assured care across the entire supply chain, including rehabilitation. The protection against uncontrolled infection in the Covid-19 pandemic must be focused along the entire route of supply chain. Method(s) Before recommendations and rules issued by national, regional and local authorities were enacted we started organizing a pandemic schedule in rehabilitation in February 2020. A holistic approach is necessary in dealing with this unprecedented event. Terefore we have to roll out preemptive/proactive and reactive strategies to improve recognition of, and response to clinical deterioration in the context of the Covid-19 pandemic. Basis for our considerations was the Epidemiological Bulletins of RKI (Germany) from 2017 (Infuenza Infection) and new from 2020 (Covid-19). The WHO declared Covid-19, a new disease, different from other viruses such as Severe Acute Respiratory Syndrome (SARS), Middle East Resp. Syndrome (MERS) and Infuenza as a "pandemic" on 12th march 2020. Result(s) First we checked invitation letters, contacted leadership, occupier and regional health department. We checked, increased and expanded our protective and diagnostic equipment. We trained employees and patients in extended hygiene measures and created different schedules. All relevant pandemic rules were implemented before they were ofcially initiated. Our pandemic response plan includes infrastructure and equipment, workforce training, planning and support, communication plans, infection control, transport and transfer polices. We adapted rehab therapies for cancer survivors. We developed and implied workfows for every responsible situation. Over a period from February to May 2020, we were able to successfully maintain of high-quality cancer rehabilitation in a reduced number. We also conceived an isolation area in our clinic and used it in collaboration with the regional health department. Conclusion(s) The timely roll-out of universal pandemic rules in rehabilitation, including training and controls, enables the continuation of high-quality cancer rehabilitation and thus will contribute to the stabilization of the supply chain of cancer diseases even in pandemic times. However, all measures should be able to be implemented in isolation from considerations of possible economic consequences.