Lehigh County Health & Medicine Fall/Winter 2020 - 17

L C M E D S O C .O R G

obtaining the cancer care they need. Dr. Lewis
says: " I reassure them that ongoing research
and active case capture of cancer patients with
COVID-19 is more reassuring than we initially
feared. I also show them that we are assiduously
tracking their own immunity; virtually every
in-person visit is accompanied by a complete
blood count that measures their lymphocyte
count, which is key to viral defense. " Dr. Tweed
adds, " I take extra time to explain practices within
the clinic or for infusion therapy or radiologic
exam scenarios to reassure patients when they
express concern or question the safety of medical
care during the pandemic. "

factors. Masks do not have to be medical-grade " This allowed us to understand better the virus,
for the public to benefit bidirectionally from its infectivity and frequency in the population. It
wearing them, but I am fortunate to have an N95 also allowed the baby to grow stronger and have
that excludes the majority of particulate matter. " her vaccinations. We have relaxed this isolation
now and are seeing family. But if I or a family
Beyond their patients and themselves, though, member were to have a sick contact, we would
oncologists are rightfully concerned about their reinstate the restrictions. "
families, too. Dr. Tweed worries: " I have been
concerned about bringing the virus home to
Dr. Tweed agrees. " Should I have exposure to
my family. Very much so. " Dr. Everett is also a known COVID patient without having worn
concerned: " I have a 5-month-old daughter at proper PPE, or should I have COVID-related
home whom I work hard to protect. "
symptoms, I would consider isolation based on
the specific scenario. " Dr. Lewis's family has a
Dr. Lewis's family has a routine: " My wife plan: " Neither of us has yet tested positive, so we
is a frontline urgent care pediatrician so I haven't sequestered, but would do so if one or the
Such reassurance is vital, according to Dr. worry she is more at-risk than I am. We have a other became ill. In the hopefully unlikely event
Everett, because: " Recent data have demonstrated decontamination routine - going immediately that we fell sick simultaneously, we would need
that there have been fewer cancers detected to the laundry room and washing our scrubs to rely on local family to take care of our kids. "
because people are deferring their screening exams on high heat. Then we shower before we make
(mammogram, colonoscopy, etc.) during this any physical contact with our kids, 9 and 12
Physicians throughout the world are taking
time. " Dr. Tweed agrees: " We will see delayed years old, who both respect the process we go similar measures to ensure their own health and
clinical presentations, leading to more advanced through as a dual-physician couple. "
the safety of their families and patients, while
cancer presentation in some instances. "
recognizing the unique burdens the pandemic
Dr. Everett's routine is similar. " Lots of hand has imposed, including an aspect which concerns
Dr. Lewis worries about a bimodal peak. hygiene. Social distancing from non-household Dr. Everett. " One underappreciated aspect of the
" There was just a study in the UK concluding that family members. Change clothes if coming from pandemic has been the economic impact on our
'Substantial increases in the number of avoidable outside of my house, ask about symptoms or sick patients. With the closing of many businesses,
cancer deaths in England are to be expected as a contacts. I also don't want to take the virus to and the downturn of the economy, many patients
result of diagnostic delays due to the COVID-19 work and to my patients, who are ALL high risk. " can no longer afford transportation, medications,
pandemic in the United Kingdom. Urgent policy
co-pays or other things necessary for them to
interventions are necessary, particularly the need
Dr. Tweed changes immediately and doesn't seek healthcare. Unfortunately, the economic
to manage the backlog within routine diagnostic wear work shoes into her home. " I have started burden of the pandemic will be long-lived after
services to mitigate the expected impact of the wearing scrubs and other machine-washable the virus itself is less of a threat. "
COVID-19 pandemic on patients with cancer.' " clothing, to allow work clothes to be promptly
(https://www.thelancet.com/journals/lanonc/ thrown into a washer. I wear my hair back at
Dr. Lewis tries to see some positives. " The silver
article/PIIS1470-2045(20)30388-0/fulltext)
work, minimal to no jewelry, to avoid the low lining of the pandemic may be that care will be
likelihood of transmission from surface contact. more patient-centered, especially telehealth and
How are they protecting themselves? " Con- I sanitize items brought back into the home home health, after COVID-19 has passed, after
tinuing hand hygiene, wearing a mask at all upon entry: phone, work badge, etc. I do not we have learned what absolutely needs to be
times. Minimal physical contact with patients, hug/kiss/physically contact family until I have done in clinic and what can be done remotely. "
social distancing in exam rooms. Eating lunch taken these 'reentry measures' or after I have
in my office as opposed to the breakroom or a showered when I return home from a higher
Dr. Tweed summed it up nicely. " We really
restaurant, " says Dr. Everett.
risk environment/exposure scenario. We socially are all in this together. That's not just a social
distance and limit excursions to stores or public media tagline. Wear a mask. Wash hands.
Masking is key, says Dr. Tweed: " Always, locations. We have embraced more family time Socially distance. This helps your family, your
always wear a surgical mask. N95 if patient has and hiking/outdoor activities and really enjoyed neighbor, your community, your world. If you're
any concerning symptom or exposure history, or that aspect of recent months. "
struggling with mental health, as is common
for prolonged non-distanced encounters. Hand
in this isolated and stressful time, reach out for
washing and sanitizer frequently. Sanitize surfaces
None of the three oncologists interviewed has help - speak openly with your loved ones and
in exam room and office frequently. " Dr. Lewis felt the need to isolate themselves from family, with your physician.
agrees: " Masking, washing my hands and social although Dr. Everett's nuclear family self-isolated
distancing are the three biggest personal protective for eight weeks after the birth of their daughter.
" We are here for this. We are here for you. "
FALL / WINTER 2020 | Lehigh County Health & Medicine 17


http://www.LCMEDSOC.ORG https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30388-0/fulltext https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30388-0/fulltext

Lehigh County Health & Medicine Fall/Winter 2020

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