Caring for the Most Vulnerable Amidst the Coronavirus Crisis
Steven A. Pergam, MD, MPH, Medical Director, Infection Prevention at SCCA, and Catherine Liu, MD, Associate Medical Director, Infection Prevention, discuss how the center is addressing vulnerable populations during the COVID-19 crisis. They also explain how they've been able to minimize risk and exposure, as well as some of the key lessons learned after the city was on the forefront of the outbreak.
Featuring:
Steven Pergam, MD, MPH is the Medical Director, Infection Prevention Seattle Cancer Care Alliance
Associate Professor, Department of Medicine, Division of Allergy & Infectious Diseases
University of Washington School of Medicine Physician UW Medicine
Associate Member, Vaccine and Infectious Disease Division and Clinical Research Division
Fred Hutchinson Cancer Research Center Clinical expertise Infectious disease.
Learn more about Steven Pergam, MD, MPH
Catherine Liu, MD | Steven Pergam, MD, MPH
Prior to joining SCCA, Dr. Catherine Liu served as Medical Director of Hospital Epidemiology and Infection Control and the Infectious Diseases Management Program at the University of California, San Francisco. In addition to her administrative roles, she was an Associate Professor of Clinical Medicine and maintained an active teaching role as an attending physician on the Transplant/ Immunocompromised Host Infectious Diseases service and as a faculty member at the UCSF School of Medicine. "I chose medicine as a career because I wanted to make a meaningful impact on people’s lives through direct patient care and by contributing to scientific discovery," Dr. Liu says. Dr. Liu says she is incredibly privileged to have the opportunity to hear patients and families share their stories and care for them during one of their most difficult life experiences. "My goal is to improve patient outcomes and quality of life by prevention and treatment of infections through practical application of the medical literature and participation in clinical research studies," she says. Dr. Liu's clinical and research interests focus on improving outcomes among cancer patients through establishing an 1) antimicrobial stewardship program that aims to promote optimal selection, dose, and duration of antimicrobial therapy and, 2) outpatient parenteral antimicrobial therapy (OPAT) program for those patients with infections requiring IV antimicrobials who are transitioning care from the inpatient to outpatient setting. "In collaboration with a multidisciplinary team of advanced practice providers, pharmacists, and Infection Control, my goal is to prevent the emergence and spread of antimicrobial resistant pathogens and reduce the risk of medication-related toxicity while ensuring patients receive the highest standard of care." Outside of work, Dr. Liu enjoys spending time with her family, exploring the Seattle area, cooking and traveling.Steven Pergam, MD, MPH is the Medical Director, Infection Prevention Seattle Cancer Care Alliance
Associate Professor, Department of Medicine, Division of Allergy & Infectious Diseases
University of Washington School of Medicine Physician UW Medicine
Associate Member, Vaccine and Infectious Disease Division and Clinical Research Division
Fred Hutchinson Cancer Research Center Clinical expertise Infectious disease.
Learn more about Steven Pergam, MD, MPH
Transcription:
Aimee Martin (Host): Welcome to the Oncology Sound Byte, a podcast produced by the Seattle Cancer Care Alliance, designed to offer byte sized audible oncology education from one of the top cancer treatment centers in the nation. Medical professionals can tune in to learn from SCCA’s nationally renowned team of experts representing Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Children’s. We hope you’ll listen and learn while we share disease-specific advancements with the collective goal of improving cancer care and patient outcomes both regionally and beyond.
I’m your host, Aimee Martin a Senior Physician Liaison at Seattle Cancer Care Alliance. For our debut episode, we will focus on a topic we’re all too familiar with; COVID-19. The pandemic has significantly impacted every aspect of our everyday life, even more so, in the healthcare field. In this interview, we will uncover lessons learned when it comes to caring for the most vulnerable amidst the Coronavirus crisis, which first reached the US right here, in the Seattle area.
To help us further discuss this topic, I’d like to introduce Dr. Steven Pergam, SCCA’s Medical Director of Infection Prevention and Dr. Catherine Liu who serves as SCCA’s Associate Medical Director of Infection Prevention. Welcome to the show.
Steven Pergam, MD, MPH (Guest): Thanks for having us.
Catherine Liu, MD (Guest): Thank you.
Host: I wanted to start by asking you both to explain your roles and professional background a bit more. And how you have been able to work as a team in response to this pandemic.
Dr. Pergam: So, I think one thing that’s really important, these designations of Director and Associate Director are sort of artificial in some ways. I think Dr. Liu and I work very closely as a unified team with the Infection Prevention group to really organize and strategize around trying to do everything we can to protect our patients from developing COVID-19 and if they do, to protect staff from acquiring it. It’s really our goal is to prevent transmission happening in the clinic and as well, really trying to focus on maintaining the ability to continue to treat patients for their cancer. The goal is to continue care, to treat patients as needed for underlying cancer and to protect them as best as possible when they arrive on campus. It’s a team effort. It’s not just Infection Prevention, it’s really everyone at the center that plays important roles.
Dr. Liu: I think that one of the bright moments if you will of this pandemic is that we have really learned how resilient and adaptable we’ve been able to be as a system and our ability to continue to provide oncology care. I think as Steven mentioned, this is really been true in multidisciplinary team effort with infection prevention, our oncologists, environmental care and so many others that have really worked very closely together to ensure the safety of our patients as well as our healthcare workers. We’ve been able to rapidly establish systems to again continue to ensure the safety of our patients and caregivers as well as our healthcare workers during these unprecedented times while continuing to deliver effective and compassionate care for cancer patients.
And I do think that many of the systems that we have put in place, as part of our response to this pandemic will enhance the way that we practice cancer care in the future. One example of this I think is Telehealth. This was really deployed as a way to minimize exposures in the clinic and provide medical care while adhering to the principles of physical distancing and I think that the lessons that we have learned by implementing Telemedicine during this pandemic will better equip cancer centers to provide care to patients in the future particularly those who live far away to enable us to continue care no matter where a patient lives.
Additionally, I think we’ve learned a lot about how to effectively screen and triage our patients with respiratory symptoms. This is an ongoing issue that we face every year particularly with influenza season and I think we’ve learned a lot of very valuable tools about prescreening patients with respiratory symptoms and being able to use some of these same tools with future respiratory viral and influenza seasons to limit exposures and transmission in our cancer center.
Dr. Pergam: I think what’s been really heartening is that the process that we’ve gone through has really put patients first. What we’ve really tried to do is when possible, to really organize systems that are really engaged in identifying at risk patients, being able to monitor them closely, provide early and frequent COVID testing as needed. But we’ve also really prioritized our own staff to make sure that we are testing and identifying people that might potentially have been affected by this that work in our systems. I think any multi-model approach like this in a large healthcare system, really does require sort of a unified vision. And I think that’s been the vision from the beginning is we want to continue to provide really compassionate care for patients that need it at the same time as protecting them from what is really something that was an unexpected pandemic and something that I think will probably one of the largest challenges of our lifetime and taking care of patients.
So, I think it’s been a really – it’s been heartening to see so many people step up and take on these different roles and to help through the process. But I think we’ve learned a lot and I think we’re continuing to learn everyday as things change.
Host: Seattle has been on the forefront of the COVID-19 outbreak. What are some of the key lesson you’ve learned in the cancer care space during this unprecedented time?
Dr. Pergam: Yeah, I think the drive throughs have been really successful. Certainly, we saw what others did in other countries. Korea was a good example where they had developed a drive through, and we’ve partnered with our colleagues at University of Washington Medical Center so that we could all be on a similar process and how that’s been done. So, these basically drive up systems. I actually have done this myself because I think probably Dr. Lui has as well where we’ve had minor symptoms during this process, and we needed to be checked ourselves. So, for employees, we drive up to a station that has been taken over in a garage. We have RN staff come in. They come up to your door wearing appropriate personal protective equipment, ask you a few questions and you get swabbed. And that is all organized through a survey system that you can go into online and quickly fill out, talk about your symptoms and then they can call you to arrange a time to come in and get testing done. It’s been very efficient. It’s very streamlined and quick and has been really an ideal opportunity for our staff to get tested.
The other thing that’s been really helpful is having a virology lab that can quickly process samples. We get answers to these swabs relatively quickly. For the patients, it was a little – it took a little more time. But that’s been really successful as well. And we do something similar where patients who have symptoms we can arrange for an appointment, they can come in at a specific time. They can either drive up or walk up and get tested. And that testing is done using a number of volunteers who work in the clinic who meet them in a separate parking garage and get them tested. And that whole process has been super helpful in allowing us to do pre-appointment screening, to identify patients in the community who are at risk to test them before they come to clinic and even to offer screening for patients who aren’t seen on that regular of a basis to identify who might potentially be positive.
So, I think it’s been not only a resource for our patients but it’s been a resource for the community to use in some ways so we can help identify who is positive and who isn’t and get them to the right care and to follow them closely for additional symptoms they have.
Dr. Liu: I think the other key benefit of drive through testing is that it’s allowed us to limit potential exposures in the clinic so that rather than bringing sick individuals into the clinic, we have an offsite location where they can be tested safely. So, that’s been a real advantage of that system as well.
Host: How is SCCA managing cancer patients who test positive for COVID-19?
Dr. Liu: We have developed a series of guidelines and protocols for management of patients who have tested positive for COVID-19. I think really the first step is for the oncologists to determine whether the patient’s treatment should be continued or whether there are aspects of their treatment that should be delayed in the context of their positive test result and to consider the risks and benefits of proceeding with or delaying therapy. So, decisions are made regarding whether their treatment and visits are essential or nonessential. For those patients who are deemed to have ongoing requirements for care at the clinic, a physical visit at the clinic or who require essential care such as a blood transfusion; we have protocols in place so that patients can be seen in a safe environment and this really does involve very close coordination of care between our infection prevention teams, the treating teams and the entire operational unit so that patients can be safely escorted to the appropriate place to be evaluated. We have and encourage patients to wear a mask when they come into the clinic and have developed a pathway by which these patients can be escorted separate from other patients in the area up to the clinic location where they are to be seen.
We’re trying to minimize the number of individuals that need to enter a patient’s room at any given time. And for those who do need to evaluate the patient to ensure that appropriate personal protective equipment or PPE is used at all times.
Host: As the nation begins the recovery process, what does returning to “normal” look like here at the Seattle Cancer Care Alliance?
Dr. Pergam: Well I think in a lot of ways, it will be shifts. Right? I mean there is a complete understanding that there’s been challenges in the midst and high level pandemic periods. Things like surgical procedures have been put aside for certain individuals when they weren’t deemed to be urgent. And so, I think a lot of that will change and we will start to see a lot more people coming back and working more intently to get a lot of those patients who have been in wings waiting a bit back to care. But I think it’s hard to predict the future. I think we don’t have a crystal ball and so, there is some concerns with low level infection in our community, the estimates are anywhere from 3-5% maybe even less in Seattle that might be positive if you were to look by antibody testing to suggest that they had been infected at some point. That means there’s a lot of people in the community that are still at risk.
And so as the community begins to open up, when we begin to bring more patients on campus, I think we’re going to have to be super diligent at watching carefully to assure that infected patients aren’t coming onto campus. So, one of our jobs and one of the things that we’re really dedicated towards is to maintaining high vigilance, high level testing and awareness of community patterns so that we can be nimble in how we respond to that. At the same time, we do really want to expand the offerings we have for patients so it’s a balance and I think nobody has the right solution. I think this is a lot of the decisions that are being made are based on models that are suggesting specific future outcomes but until we actually reach that point, we’re actually dealing with it face to face and I think we have to sort of be prepared for many different scenarios that might be out there.
Host: What can healthcare workers do to help protect their patients during this time?
Dr. Liu: There are a number of key strategies that I think are really important as a healthcare worker for you to be able to protect your patients, yourself and others around you. And I think these really go back to the basic principles of infection prevention. First, practice frequent hand hygiene. I think the importance of meticulous hand hygiene cannot be overstated as really the cornerstone of infection prevention during this pandemic. Second, stay home when you are sick. While I think there has been a lot of discussion recently about the possibilities of asymptomatic or pre-symptomatic transmission; we do know that the primary mode of transmission is really through close contact with symptomatic individuals. So, staying home when you are sick is really key to protecting your patients.
The other key step that I think has really emerged in the discussions around this pandemic is practicing physical distancing, maintaining a six foot distance from others whenever possible. At our center, we’ve been encouraging our staff to stagger their break times in order to minimize the number of people in our break room at any given time and again, really trying to practice physical distancing to limit exposures. And then I think it is always important to use the appropriate personal protective equipment when you’re managing patients with respiratory symptoms. I think this may vary somewhat at each center in terms of the type of masks that are available. But generally it does involve use of a surgical mask with some kind of face shield protection to prevent droplet transmission.
The other discussion that has emerged in recent weeks based on a recent CDC recommendation is regarding this role of pre-symptomatic or asymptomatic transmission which again, while we do know that symptomatic transmission is really the primary mode of transmission, there are emerging data to support that there may be transmission that occurs in the context of early or unrecognized symptoms and so use of a cloth face covering when in public settings particularly when you are unable to maintain a six foot physical distance may help to prevent you, if you do have an asymptomatic or pre-symptomatic infection from giving it to others.
Dr. Pergam: I would also comment that one thing that I think all providers can do is to spend time with their patients and review these details. I think one thing that all centers should be thinking about is focusing on some patient forward education. So, it’s not just protecting yourself and preventing yourself from infecting others but really getting into the weeds about the importance that social distancing, handwashing, and the use of masks in public spaces regarding patients and their caregivers, those who live in their household; household transmission is incredibly important and so educating caregivers and household occupants that live with cancer patients is important and taking time to remind patients about how important these steps are for themselves can help them getting infected in the first place.
You can certainly do things yourself to protect you and your staff, but I think it’s really important that all centers take the time to educate patients about the things that they can do. They are really some straightforward steps and it may not be easy for everyone, but something as simple as saying let’s get you three months of your prescription on hand so that you can potentially not have to go to the pharmacy on a regular basis. Small steps that can be really important. So, I think there’s a lot of things that people can do to protect themselves but to educate your patients and to take the time during these visits to remind them about these important steps I think is really critical.
Host: Thank you so much for joining us today Drs. Liu and Pergam and thanks to our listeners for tuning in to the Oncology Sound Byte. For more information about today’s topic and other relevant healthcare provider news from SCCA, please visit our provider blog page, www.seattlecca.org/providerblog and subscribe to our e-newsletter for access to future episodes and clinical updates. You can also find the Oncology Sound Byte on your favorite podcast app plus if you like what you’re hearing, be sure to leave us a review. Until next time, thanks for listening and take good care.
Aimee Martin (Host): Welcome to the Oncology Sound Byte, a podcast produced by the Seattle Cancer Care Alliance, designed to offer byte sized audible oncology education from one of the top cancer treatment centers in the nation. Medical professionals can tune in to learn from SCCA’s nationally renowned team of experts representing Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Children’s. We hope you’ll listen and learn while we share disease-specific advancements with the collective goal of improving cancer care and patient outcomes both regionally and beyond.
I’m your host, Aimee Martin a Senior Physician Liaison at Seattle Cancer Care Alliance. For our debut episode, we will focus on a topic we’re all too familiar with; COVID-19. The pandemic has significantly impacted every aspect of our everyday life, even more so, in the healthcare field. In this interview, we will uncover lessons learned when it comes to caring for the most vulnerable amidst the Coronavirus crisis, which first reached the US right here, in the Seattle area.
To help us further discuss this topic, I’d like to introduce Dr. Steven Pergam, SCCA’s Medical Director of Infection Prevention and Dr. Catherine Liu who serves as SCCA’s Associate Medical Director of Infection Prevention. Welcome to the show.
Steven Pergam, MD, MPH (Guest): Thanks for having us.
Catherine Liu, MD (Guest): Thank you.
Host: I wanted to start by asking you both to explain your roles and professional background a bit more. And how you have been able to work as a team in response to this pandemic.
Dr. Pergam: So, I think one thing that’s really important, these designations of Director and Associate Director are sort of artificial in some ways. I think Dr. Liu and I work very closely as a unified team with the Infection Prevention group to really organize and strategize around trying to do everything we can to protect our patients from developing COVID-19 and if they do, to protect staff from acquiring it. It’s really our goal is to prevent transmission happening in the clinic and as well, really trying to focus on maintaining the ability to continue to treat patients for their cancer. The goal is to continue care, to treat patients as needed for underlying cancer and to protect them as best as possible when they arrive on campus. It’s a team effort. It’s not just Infection Prevention, it’s really everyone at the center that plays important roles.
Dr. Liu: I think that one of the bright moments if you will of this pandemic is that we have really learned how resilient and adaptable we’ve been able to be as a system and our ability to continue to provide oncology care. I think as Steven mentioned, this is really been true in multidisciplinary team effort with infection prevention, our oncologists, environmental care and so many others that have really worked very closely together to ensure the safety of our patients as well as our healthcare workers. We’ve been able to rapidly establish systems to again continue to ensure the safety of our patients and caregivers as well as our healthcare workers during these unprecedented times while continuing to deliver effective and compassionate care for cancer patients.
And I do think that many of the systems that we have put in place, as part of our response to this pandemic will enhance the way that we practice cancer care in the future. One example of this I think is Telehealth. This was really deployed as a way to minimize exposures in the clinic and provide medical care while adhering to the principles of physical distancing and I think that the lessons that we have learned by implementing Telemedicine during this pandemic will better equip cancer centers to provide care to patients in the future particularly those who live far away to enable us to continue care no matter where a patient lives.
Additionally, I think we’ve learned a lot about how to effectively screen and triage our patients with respiratory symptoms. This is an ongoing issue that we face every year particularly with influenza season and I think we’ve learned a lot of very valuable tools about prescreening patients with respiratory symptoms and being able to use some of these same tools with future respiratory viral and influenza seasons to limit exposures and transmission in our cancer center.
Dr. Pergam: I think what’s been really heartening is that the process that we’ve gone through has really put patients first. What we’ve really tried to do is when possible, to really organize systems that are really engaged in identifying at risk patients, being able to monitor them closely, provide early and frequent COVID testing as needed. But we’ve also really prioritized our own staff to make sure that we are testing and identifying people that might potentially have been affected by this that work in our systems. I think any multi-model approach like this in a large healthcare system, really does require sort of a unified vision. And I think that’s been the vision from the beginning is we want to continue to provide really compassionate care for patients that need it at the same time as protecting them from what is really something that was an unexpected pandemic and something that I think will probably one of the largest challenges of our lifetime and taking care of patients.
So, I think it’s been a really – it’s been heartening to see so many people step up and take on these different roles and to help through the process. But I think we’ve learned a lot and I think we’re continuing to learn everyday as things change.
Host: Seattle has been on the forefront of the COVID-19 outbreak. What are some of the key lesson you’ve learned in the cancer care space during this unprecedented time?
Dr. Pergam: Yeah, I think the drive throughs have been really successful. Certainly, we saw what others did in other countries. Korea was a good example where they had developed a drive through, and we’ve partnered with our colleagues at University of Washington Medical Center so that we could all be on a similar process and how that’s been done. So, these basically drive up systems. I actually have done this myself because I think probably Dr. Lui has as well where we’ve had minor symptoms during this process, and we needed to be checked ourselves. So, for employees, we drive up to a station that has been taken over in a garage. We have RN staff come in. They come up to your door wearing appropriate personal protective equipment, ask you a few questions and you get swabbed. And that is all organized through a survey system that you can go into online and quickly fill out, talk about your symptoms and then they can call you to arrange a time to come in and get testing done. It’s been very efficient. It’s very streamlined and quick and has been really an ideal opportunity for our staff to get tested.
The other thing that’s been really helpful is having a virology lab that can quickly process samples. We get answers to these swabs relatively quickly. For the patients, it was a little – it took a little more time. But that’s been really successful as well. And we do something similar where patients who have symptoms we can arrange for an appointment, they can come in at a specific time. They can either drive up or walk up and get tested. And that testing is done using a number of volunteers who work in the clinic who meet them in a separate parking garage and get them tested. And that whole process has been super helpful in allowing us to do pre-appointment screening, to identify patients in the community who are at risk to test them before they come to clinic and even to offer screening for patients who aren’t seen on that regular of a basis to identify who might potentially be positive.
So, I think it’s been not only a resource for our patients but it’s been a resource for the community to use in some ways so we can help identify who is positive and who isn’t and get them to the right care and to follow them closely for additional symptoms they have.
Dr. Liu: I think the other key benefit of drive through testing is that it’s allowed us to limit potential exposures in the clinic so that rather than bringing sick individuals into the clinic, we have an offsite location where they can be tested safely. So, that’s been a real advantage of that system as well.
Host: How is SCCA managing cancer patients who test positive for COVID-19?
Dr. Liu: We have developed a series of guidelines and protocols for management of patients who have tested positive for COVID-19. I think really the first step is for the oncologists to determine whether the patient’s treatment should be continued or whether there are aspects of their treatment that should be delayed in the context of their positive test result and to consider the risks and benefits of proceeding with or delaying therapy. So, decisions are made regarding whether their treatment and visits are essential or nonessential. For those patients who are deemed to have ongoing requirements for care at the clinic, a physical visit at the clinic or who require essential care such as a blood transfusion; we have protocols in place so that patients can be seen in a safe environment and this really does involve very close coordination of care between our infection prevention teams, the treating teams and the entire operational unit so that patients can be safely escorted to the appropriate place to be evaluated. We have and encourage patients to wear a mask when they come into the clinic and have developed a pathway by which these patients can be escorted separate from other patients in the area up to the clinic location where they are to be seen.
We’re trying to minimize the number of individuals that need to enter a patient’s room at any given time. And for those who do need to evaluate the patient to ensure that appropriate personal protective equipment or PPE is used at all times.
Host: As the nation begins the recovery process, what does returning to “normal” look like here at the Seattle Cancer Care Alliance?
Dr. Pergam: Well I think in a lot of ways, it will be shifts. Right? I mean there is a complete understanding that there’s been challenges in the midst and high level pandemic periods. Things like surgical procedures have been put aside for certain individuals when they weren’t deemed to be urgent. And so, I think a lot of that will change and we will start to see a lot more people coming back and working more intently to get a lot of those patients who have been in wings waiting a bit back to care. But I think it’s hard to predict the future. I think we don’t have a crystal ball and so, there is some concerns with low level infection in our community, the estimates are anywhere from 3-5% maybe even less in Seattle that might be positive if you were to look by antibody testing to suggest that they had been infected at some point. That means there’s a lot of people in the community that are still at risk.
And so as the community begins to open up, when we begin to bring more patients on campus, I think we’re going to have to be super diligent at watching carefully to assure that infected patients aren’t coming onto campus. So, one of our jobs and one of the things that we’re really dedicated towards is to maintaining high vigilance, high level testing and awareness of community patterns so that we can be nimble in how we respond to that. At the same time, we do really want to expand the offerings we have for patients so it’s a balance and I think nobody has the right solution. I think this is a lot of the decisions that are being made are based on models that are suggesting specific future outcomes but until we actually reach that point, we’re actually dealing with it face to face and I think we have to sort of be prepared for many different scenarios that might be out there.
Host: What can healthcare workers do to help protect their patients during this time?
Dr. Liu: There are a number of key strategies that I think are really important as a healthcare worker for you to be able to protect your patients, yourself and others around you. And I think these really go back to the basic principles of infection prevention. First, practice frequent hand hygiene. I think the importance of meticulous hand hygiene cannot be overstated as really the cornerstone of infection prevention during this pandemic. Second, stay home when you are sick. While I think there has been a lot of discussion recently about the possibilities of asymptomatic or pre-symptomatic transmission; we do know that the primary mode of transmission is really through close contact with symptomatic individuals. So, staying home when you are sick is really key to protecting your patients.
The other key step that I think has really emerged in the discussions around this pandemic is practicing physical distancing, maintaining a six foot distance from others whenever possible. At our center, we’ve been encouraging our staff to stagger their break times in order to minimize the number of people in our break room at any given time and again, really trying to practice physical distancing to limit exposures. And then I think it is always important to use the appropriate personal protective equipment when you’re managing patients with respiratory symptoms. I think this may vary somewhat at each center in terms of the type of masks that are available. But generally it does involve use of a surgical mask with some kind of face shield protection to prevent droplet transmission.
The other discussion that has emerged in recent weeks based on a recent CDC recommendation is regarding this role of pre-symptomatic or asymptomatic transmission which again, while we do know that symptomatic transmission is really the primary mode of transmission, there are emerging data to support that there may be transmission that occurs in the context of early or unrecognized symptoms and so use of a cloth face covering when in public settings particularly when you are unable to maintain a six foot physical distance may help to prevent you, if you do have an asymptomatic or pre-symptomatic infection from giving it to others.
Dr. Pergam: I would also comment that one thing that I think all providers can do is to spend time with their patients and review these details. I think one thing that all centers should be thinking about is focusing on some patient forward education. So, it’s not just protecting yourself and preventing yourself from infecting others but really getting into the weeds about the importance that social distancing, handwashing, and the use of masks in public spaces regarding patients and their caregivers, those who live in their household; household transmission is incredibly important and so educating caregivers and household occupants that live with cancer patients is important and taking time to remind patients about how important these steps are for themselves can help them getting infected in the first place.
You can certainly do things yourself to protect you and your staff, but I think it’s really important that all centers take the time to educate patients about the things that they can do. They are really some straightforward steps and it may not be easy for everyone, but something as simple as saying let’s get you three months of your prescription on hand so that you can potentially not have to go to the pharmacy on a regular basis. Small steps that can be really important. So, I think there’s a lot of things that people can do to protect themselves but to educate your patients and to take the time during these visits to remind them about these important steps I think is really critical.
Host: Thank you so much for joining us today Drs. Liu and Pergam and thanks to our listeners for tuning in to the Oncology Sound Byte. For more information about today’s topic and other relevant healthcare provider news from SCCA, please visit our provider blog page, www.seattlecca.org/providerblog and subscribe to our e-newsletter for access to future episodes and clinical updates. You can also find the Oncology Sound Byte on your favorite podcast app plus if you like what you’re hearing, be sure to leave us a review. Until next time, thanks for listening and take good care.