“A Sad Lesson”: Learning From the COVID-19 Pandemic and Maintaining Cancer Care

Aug 04, 2020

In late 2019, ASCO partnered with the Russian Society of Clinical Oncology (RUSSCO) to hold the first International Palliative Care Workshop (IPCW) in Russia. One of the faculty members for that workshop was Marina Chernykh, MD, PhD, director of the Radiological Center of the Moscow region in Podolsk, Russia, who discussed her experience with that event in ASCO Connection’s March 2020 issue.

More recently, Dr. Chernykh has been on the front lines of COVID-19 as both a health care provider and a patient. In the following interview she discusses her experience and how she kept cancer care moving forward during the pandemic.

In your clinic, are you seeing only patients with COVID-19, only patients with cancer, or both?

MC: I am a physician-in-chief in the PET-Technology Podolsk private medical center. Our team delivers radiotherapy and chemotherapy treatment predominantly to patients with cancer, and our diagnostic radiology services are available to all patients. Following the orders of the Moscow regional government, COVID-19 preventive requirements, [including] a set of measures against the spread of infection, were taken in our center. All the patients with possible coronavirus infection were immediately redirected to a specialized hospital—only patients with cancer were admitted to our clinic.

We are seeing and treating almost our ordinary amount of patients with cancer, excluding some patients whose cases are not that acute (for example, those with basal cell skin cancer and primary prostate cancer). Patients with cancer from several clinics that had been converted to COVID-19 [facilities] were admitted to our center. We did our best to avoid any delays of appointments.

What safety measures are in place in your clinic to protect both patients and staff?

MC: As I mentioned above, a set of measures against the spread of infection was taken in our center. These measures are:

  • Distinguishing patient flows
  • Introduction of an epidemiological warrant form
  • Employees were switched to weekly rotational work basis
  • Use of personal protective equipment
  • Social distancing of 1.5 meters (approximately 5 feet)
  • Visitors were banned
  • Temperature control at the entrances to the clinic
  • Environmental cleaning and sanitizing

Are patients routinely tested for coronavirus, or only patients who present with certain symptoms or meet certain criteria?

MC: Our patients are not routinely tested for coronavirus. According the Moscow regional government, COVID-19 preventive measures [require that] patients with respiratory symptoms or/and fever be redirected to a specialized hospital for appropriate diagnostics. If a negative test result is obtained, the patient is returned to scheduled treatment or diagnostics.

Before the pandemic, were you doing telemedicine appointments? Has that changed?

MC: We fully utilize telemedicine, and during the coronavirus pandemic its role grew. Activities such as multidisciplinary teams and cross-clinical interaction have been moved online.

Are you and your colleagues dealing with burnout? If so, how do you try to mitigate it?

MC: The work volume had increased, regimens have changed, and dramatic restrictions of our ordinary lifestyles have taken place. It would be a mistake to neglect these facts. Things that help us to withstand burnout and be productive are positive social climate, comfortable workplace environment, and, above all, high personal motivation to adhere to deontological [duty-based ethics] terms.

When you were ill with COVID-19, were you isolated at home or in the hospital?

MC: The course of the disease was not severe, and my hospitalization was not required, so I was isolated at home. The work process organization of the center allowed me to complete my functions remotely: online team briefings every morning, remote access to every radiotherapy plan for consulting and approval. My science and educational activities did not stop, either, thanks to 21st-century technologies.

How did you manage being sick and working virtually? Do you have any advice for others who are sick and still treating patients virtually?

MC: First of all, be healthy. In my point of view, it can help one to avoid serious complications, recover faster, and keep one’s productivity even during illness. Second, build your team yourself so you can trust the members of the team as you trust yourself. And in the third place, [take advantage of] modern technologies. Everything is possible if you are motivated enough.

Did having COVID-19 impact the way you treat patients?

MC: Should it? The only thing that changed is the way of communication. For safety concerns I cannot interact with my patients face-to-face as it used to be.

What do you think the long-term impacts of this pandemic may be on the health care system?

MC: The pandemic is a real challenge for society: it touches all spheres of life and the health care system in particular. It is a quality check for all of us, from health care administrators to nurses. We were too relaxed and not ready for a worldwide spread of infection. Many clinics were converted to provide coronavirus treatment, which led to delay of appropriate medical help to patients with other medical issues. I see the system is now stabilized; here in Russia, several huge hospitals were built to take patients with infectious diseases so the others can now work in their ordinary regimens, and it is positive. The state health care guarantees care for patients with cancer, and special federal oncology programs have continued to be implemented. I hope the economic disturbance [of the pandemic] will not affect oncology care.

The pandemic also showed the real role of doctors to society and to themselves. All patients who died due to lack of knowledge of how to treat COVID-19, all the doctors who suffered and died helping people, and all the patients whose scheduled treatment had been delayed are a sad lesson for us, and we will not fall into the same trap again.

Dr. Chernykh will be a faculty member at the RUSSCO Russian Cancer Congress on November 11-13, 2020, along with 2020-2021 ASCO president Lori J. Pierce, MD, FASTRO, FASCO. Both Dr. Chernykh and Dr. Pierce will participate in a joint session with the American Society for Radiation Oncology (ASTRO).

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