As we all are aware that COVID-19 is the novel Corona virus infection that started in last month of 2019 and has now been declared a pandemic by the World Health Organization. Bats are the natural hosts of this virus, however the recent studies in ‘Nature Medicine’ a scientific journal, have shown that the journey of this virus to man was facilitated by its transmission through scaly ant eater or the pangolins. The virus has changed its character (mutated) over time to adapt and evolve. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. The emerging data shows that Covid-19 causes symptoms varying from mild to severe, the latter necessitating a hospital admission and breathing assistance through ventilators. The symptoms start within 5-14 days of a person’s exposure and the affected person needs to be in isolation for another 14 days after being cured so that he/she is not infective to others.

Cancer, as we know is chronic disease and causes a high rate of mortality, second only to heart disease worldwide. Cancer is a relentless disease that continues to grow unless checked in a particular time frame. In such a situation, cancer patients receiving radiation therapy (time-bound) need to be attended to and continue their treatment. Since stopping treatment is not an option, all due care for the patients, attendant’s and medical professionals is required to prevent the COVID-19 infection and stop its transmission amongst this group of patients.

According to Dr. Tejinder Kataria, Chairperson Radiation Oncology, Cancer Institute, Medanta – The Medicity, “Patients on Radiotherapy treatment are not as immune- compromised as the patients who receive chemotherapy. Their blood tests are done once or twice weekly and if required, support with colony-stimulating medicines is given to support them through the treatment in a normal course. They are also supported with a high protein diet and enough fluids during their radiation treatment. They are given detailed instructions for personal hygiene during the course of their visit to the hospital. These protocols have to be adhered to, strictly during the whole course of treatment. The same protocol with a few additional precautions, as outlined below are expected to help us to continue treatment during the COVID pandemic.”

Universal precautions that include meticulous hand-hygiene, masks, gloves and hospital scrubs are provided for the medical professionals to prevent them from the infection. The patients and their attendants as well as the hospital staff is screened at the entrance with a thermal sensor and also queried about their history of fever, body aches, cold, cough or respiratory symptoms besides the history of travel in last 15 days. If such a history exists the visitor is asked to remain outside the treatment premises and visit the Infections Disease (ID) specialist for further instructions. Since Medanta the Medicity is a multi-speciality hospital with a full department of Infectious Diseases (ID),and we have already established are infection control corridors for COVID-19 cases ,patients undergoing Radiation Therapy are entering the hospital and moving to the treatment area through a separate entrance(hence a green corridor already exists).

 The patients are asked to bring only one attendant with them to the hospital and both are asked to wear masks as well as sanitize their hands as soon as they enter the premises for treatment. Except for patients of Head & neck or brain tumours when the patient has to wear an Orfit cast, all other patients are asked to keep a mask on their face during treatment. A separation of 3 feet is maintained between two persons in the waiting hall.

The reception staff are separated from the patients by setting up a Q-manager to create 3 feet distance. “The executive staff have to provide a letter, for the patients, to Civic authorities to permit travel to patients & their attendants during the lockdown. The staff has similarly been assisted by giving letters to travel to & from their residence, if required”, she added.

To keep the safety norms in place, the waiting areas have been cleared off magazines, books and newspapers to prevent cross-usage. We already have established cleaning practices for each patient accessory after each application, hence they are being continued by the house-keeping staff. The door-knobs, handles, computer monitors, bannisters, floors, shiny surfaces are cleaned every 4 hours with 1% solution of sodium hypochlorite (bleach) by the housekeeping staff. All the access doors, that can be kept open are left open, to minimize the human contact.

The world has recorded bubonic plagues and influenza pandemics in earlier centuries. The difference now, is the availability of digital tools that disseminate the knowledge in a few hours all over the world. This tool can be harnessed to learn & adopt behaviours that can reduce the COVID-19 infection, its mortality as well as keep assisting our patients where and when they need medical care. The digital world has opened up new awareness for us to also offer distant learning to our students through video conferencing and using Tele-medicine we are offering consults to patients from the comfort of their home.