Shilpa Gupta, MD, shares updates from the frontlines and discusses how she is handling the COVID-19 pandemic.
Shilpa Gupta, MD, medical oncologist, Department of Hematology and Oncology, Cleveland Clinic, shares updates from the frontlines and discusses how she is handling the COVID-19 pandemic.
Oncologists at Cleveland Clinic are transitioning over to virtual visits or phone calls whenever possible, depending on the patient, to minimize exposure to public spaces and other people, explains Gupta. When faced with technical challenges during virtual visits phone calls are utilized, adds Gupta. However, many patients find reassurance in seeing the doctor’s face, which is why virtual meetings are conducted whenever possible.
Traffic from visitors in the clinic is also being minimized. To this end, all patients, visitors, and providers are screened at the entry point on a daily basis with a temperature check, says Gupta. Cleveland Clinic has plenty of surgical masks, but N95 masks and other protective gear are in short supply; therefore, this equipment is being reserved for those who are taking care of patients in the intensive care unit.
A few of Gupta’s patients were admitted to local hospitals with pneumonia-like symptoms, but they are still trying to figure out whether the symptoms are related to COVID-19. For patients treated with immunotherapy, it is especially important to see if the symptoms are related to the virus or their treatment. Empirically, patients are receiving treatment with steroids if there is suspicion that their symptoms are being caused by immunotherapy; this likely can’t hurt the patient, even if the symptoms are due to COVID-19, according to Gupta.
Due to the increasing number of admissions at Cleveland Clinic, Gupta is ensuring the patient appointments are well planned. The goal is to avoid administering therapy that has more risk than benefit during the pandemic, says Gupta. To this end, some treatments are being deferred, as long as consent is obtained from the patient and they are stable. Treatment is also being withheld from those who are frail and at risk for hospitalization because of immune-related adverse events; being hospitalized at this time could be extremely harmful, says Gupta. Curative treatments, on the other hand, are not being delayed, adds Gupta.
Clinical trials are pausing enrollment in light of the pandemic. However, for patients who are already enrolled on ongoing trials, investigators are modifying treatment practices to ensure patient safety; these efforts include mailing oral medications to patients when appropriate and allowing patients to get their labs and scans done at a local hospital rather than making the trip to Cleveland Clinic, explains Gupta. Follow-up visits are also being done virtually.
Ultimately, Gupta’s primary piece of advice for healthcare professionals during this time is to put patient safety first and to do no harm. Policies will continue to change as the situation evolves, and healthcare professionals must remain adaptive, concludes Gupta.
Please visit www.OncLive.com to watch the entitreity of the MJH Life Sciences News Network, which provides the latest news across a variety of healthcare specialties, and a number of interviews with experts in the medical field, many of which are focused on the ongoing COVID-19 pandemic.