Coronavirus and the Cancer Patient

By Peter C. Raich, MD, FACP

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Solve the Last Mile Problem

Over a very short time we have received a large amount of information about this new pandemic infection we are now facing: coronavirus also known as COVID-19. We’ve been told that it is important to wash one’s hands frequently and thoroughly, cough and sneeze into a tissue or into inner elbow, not shake hands, and frequently clean and disinfect surfaces touched by others. These all are good and important pieces of advice that we should all follow. But are there added risks faced by persons living with cancer, those undergoing treatments for cancer and those recovering from cancer? We need to acknowledge that, because of an impaired immune system caused by the cancer and especially by most cancer treatments, such individuals are at increased risk for infections, including viruses such as coronavirus. These infections are more likely to be life-threatening and are made worse by coexisting heart or lung disease, diabetes or age over sixty years.

So, what can you as an individual with cancer do to best protect yourself and to decrease the risk of getting infected with coronavirus? In the absence of an effective testing program, it is most important to practice thoughtful “social distancing.” What that means is to avoid all crowds and to keep any contact with other people at an absolute minimum. This sounds extreme, but it’s the best way to currently reduce the risk of exposure to anyone possibly infected with the virus. This means staying home and interacting only with few close family members and caregivers. This step is especially important since we currently have a spotty and unpredictable testing program in the US. If any contacts show signs of a cold or flu-like illness, they should wear a face mask and immediately contact their health care provider to be screened for coronavirus infection. If positive, they should not have further contact with the cancer patient, who in turn should also be tested for coronavirus. Individuals with cancer should avoid restaurants and grocery stores, keep several weeks’ supply of crucial medications and food, and preferably have food supplies delivered to their homes.

Despite these cautions and stricter measures to avoid contact and risk of exposure, we need to remain calm and rational while being prepared. We all need to stay informed about measures proposed by federal and state governments and about specific conditions in our communities. Stay in contact with your oncologist and primary health provider, but avoid office, hospital and emergency department visits, unless specifically instructed by your doctors. If you develop symptoms of coronavirus infection, such as dry cough, fever or worsening shortness of breath, start wearing a face mask and contact the doctors most involved in your care for instructions. If your doctors cannot be reached, contact your local urgent care or emergency care department for specific directions of where to go to be checked. Once you have such symptoms, wearing a face mask will reduce the risk of you passing on the virus to someone near you.

Having access to current and reliable information about the coronavirus pandemic is crucial to allaying misplaced fears and to staying healthy during this difficult time.  I recommend these trusted information sources:

  1. https://www.coronavirus.gov is a CDC website developed in conjunction with Dr. Anthony Fauci, Director of NIAID/NIH, a foremost expert on viral infections. Review especially the section on “People at High Risk.”
  2. https:/www.coronavirus.jhu.edu by the Johns Hopkins University Coronavirus Resource Center is compiled and updated by experts in global public health, infectious disease, and emergency preparedness.

On March 13, 2020 the U.S. declared a national emergency related to the coronavirus. Soon after, the U.S. Centers for Medicare and Medicaid Services (CMS) authorized payments for remote telehealth services to Medicare, Medicaid and CHIP patients, encouraging private health plans to do the same. Since then, healthcare providers have been encouraging all patients, whenever possible, to receive care remotely rather than coming for care to healthcare facilities where they are likely to be exposed to the coronavirus or other infectious diseases.

Here are some things that you can do (consistent with your patient rights under HIPAA) to prepare for telehealth visits with busy healthcare providers who may be unfamiliar with you and your health history:

  1. Get your key health information together and send it electronically to a provider just before, or at the time of, a telehealth visit.
  2. Ask the provider to send you electronically a care plan including a summary of recommendations within two days after the visit.
  3. Record the telehealth visit and save the audio or video file for future reference and for sharing with family caregivers and other healthcare providers.

If you are a patient or a family caregiver, download the RK360 App the from Apple and GooglePlay Stores, and get ready for telehealth so you:

    1. Own and exclusively control access to your encrypted RK360™ Cloud Record
    2. Populate your Cloud Record from Apple-connected EHRs including the VA
    3. Upload labs, allergy, meds, problem, vaccinations, care plans
    4. Avoid medical mistakes by sending actionable pre-visit data to every provider
    5. Coordinate care by requesting post-visit care plans and bills from every provider
    6. Protect Record contents against hackers, power outages and ransomware
    7. Exchange data in person and remotely with lowest- to highest-tech providers
    8. From 1 phone, manage yours and up to 6 family members’ Cloud Records.

If you are a healthcare provider interested in a low-cost telehealth solution, contact us for more information.

Peter C. Raich, MD, FACP is a Medical Oncologist/Hematologist who has researched and written about informed decision-making in cancer care and treatment.  He is Chief Medical Officer of Prosocial Applications and Professor Emeritus, U. of Colorado Denver

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