Coronavirus, COVID-19

WHAT IS IT

In late November, 2019 a new coronavirus strain originating from the Hubei Province of China began to cause respiratory illness in humans of varying severity typically manifesting as fever, cough and shortness of breath with a significant proportion of patients developing pneumonia. The spectrum of severity of the illness ranged from no symptoms whatsoever (asymptomatic) to mild symptoms (in the majority of patients) to severe symptoms warranting hospital admission in about 20% of patients mostly due to breathing difficulty and fever. Of these hospitalized patients a proportion deteriorated and required ICU level care and mechanical ventilation (a machine to help one breathe). Unfortunately, a proportion of such patients died. The infection is spread by respiratory droplets and by contact with surfaces that harbor it.

With time we have also learned that up to 20% of patients may have gastrointestinal symptoms such as nausea, abdominal cramping and diarrhea which may at times precede respiratory symptoms. Heart problems may also occur during the course of severe illness. Those most likely to experience severe symptoms are typically older than 60 and have medical illnesses such as diabetes, high blood pressure, cardiovascular disease, weakened immune system, kidney and liver problems and cancer.

The aforementioned disease caused by Coronavirus is now known as COVID 19 and the virus itself is sometimes referred to as SARS2. The infection has spread rapidly throughout the world and has caused a great deal of illness and loss of life. It currently represents an unprecedented global health crisis the world has not seen before and must face. Moreover, health care resources and delivery is challenged and strained unlike never before.

The disease was categorized as a pandemic on March 11, 2020 by the World Health Organization. As a means to slow the spread of the virus California Governor Newsome issued a “shelter in place” order March 19, 2020 which mandates individuals stay at home unless engaged in certain activities such as health care. This in addition to other measures implemented such as social distancing, frequent hand washing and the regular use of a mask when in public one hopes will slow and ultimately control the spread of the infection.

PREVENTION

  • Follow state and federal mandates which are provided in conjunction with recommendations from the Center for Disease Control (CDC) and the World Health Organization (WHO).
  • “Shelter in place” for as long as ordered which also includes not visiting others nor having them visit you or your immediate family/people whom you live with. Again, ideally your circle of contacts should be as limited as possible at this time.
  • Practice good hand hygiene washing hands with soap and water for 20 seconds or use an alcohol-based hand sanitizer frequently thru out the day.
  • Avoid touching your eyes, nose and mouth.
  • Wear a face mask when in public.
  • Intermittently clean “high touch” surfaces.
  • Practice social distancing (6 feet distance from another person) at all times.

IF INFECTED / EXPOSED

  • There is no available ant-viral therapy or vaccine at this time.
  • If you believe you have been exposed to coronavirus you should quarantine yourself for 2 weeks practicing home isolation in a “sick room” away from all others ideally also using a separate bathroom. Again, most infected people have mild symptoms and recover uneventfully at home without specific treatment.
  • Contact your health care provider about the role of testing.
  • If you develop a fever, cough and/or difficulty breathing contact a healthcare provider ideally via telephone and tell them about your symptoms and concern regarding COVID 19 infection.
  • Do not visit ANY public spaces.
  • Call ahead before visiting your doctor and make them aware of your symptoms. Routine medical visits ideally should be delayed or telemedicine should be utilized.
  • If you must be around others wear a mask covering your nose and mouth (scarf or bandana will suffice).
  • Use tissue to cover mouth and nose if cough or sneeze.
  • Wash hands with soap and water (or hand sanitizer) frequently especially after blowing nose, coughing, or sneezing, going to the bathroom or before eating/preparing food.
  • Avoid touching your eyes, nose and mouth with your hands.
  • Avoid sharing household items such as dishes, cups, linens, towels, etc.
  • Clean ALL “high touch” surface areas frequently in “sick room” and bathroom; others should do the same in common areas outside of your “sick room” and bathroom. “High touch areas” include phones, remote controls, counters, keyboards, etc.
  • Clean and disinfect any area with bodily fluids with soap, water and disinfectant.
  • If you believe you are having a medical emergency call 911 immediately.
  • MONITOR YOUR SYMPTOMS: Common symptoms include fever and cough. However if you experience shortness of breath, chest pressure, confusion or lethargy (difficulty in arousing) please seek emergent medical attention. Ideally, inform your primary doctor however proceed to the closest emergency room or urgent care facility. Follow instructions provided by your health care provider (your doctor or emergency room) and local health department.

COVID 19 & CANCER

Patients with cancer and certain blood disorders may be more susceptible to the current coronavirus infection. They may also have more severe symptoms as a consequence of their diagnosis as well as its therapy (chemotherapy, radiotherapy, bone marrow transplant, cancer surgery, etc.) due to a weakened immune system among other factors.

Although not ideal we believe some cancer treatments can be safely delayed, while others simply cannot. This decision is made on a case by case basis by your physician specialist at OC Blood & Cancer Care and your multidisciplinary treatment team. However, whenever possible and when felt warranted, we will make a concerted effort to begin, maintain and complete prescribed therapy on schedule. For those we continue on cancer treatment multiple safeguards have been put in place to protect you, our staff and providers (see our OUR SAFETY ACTION PLAN).

Some routine follow-up visits and tests such as scans and laboratory tests may be safely delayed or conducted through telemedicine (preferred in our opinion). If you take oral cancer drugs, you may be able to have prescribed treatments sent directly to you, so you don’t have to go to a pharmacy or come into the office oral drug dispensary. Flushes of port-a-cath devices may also be safely delayed at times.

We encourage helping your immune system by maintaining a low stress level. This can be accomplished by lifestyle modifications ensuring healthy balanced nutrition, daily moderate physical exercise, mindfulness/meditation and adequate sleep pattern.

OUR SAFETY ACTION PLAN

At OC Blood & Cancer Care we have always prioritized the health and safety of our patients, staff and providers which is more critical and pertinent now more than ever given the current COVID-19 coronavirus pandemic. The following are key strategies implemented in this regard:

  • The physicians, staff and administrators regularly meet and confer (or “huddle”) regarding COVID-19 related safety matters and strategy to protect patients, staff and providers.
  • Our clinic sites in Fountain Valley, CA and Laguna Hills, CA remain open and fully functional.
  • Patients are screened for travel history, symptoms and fever at three points: 1) communication about scheduling a visit 2) entry into the either office building on the day of visit 3) again, in our office prior to being taken into an exam room or the infusion center.
  • Staff and providers typically wear masks.
  • Until further notice only patients receiving therapy in the infusion center are permitted (friends and family are not permitted).
  • Whenever possible, we are offering telemedicine visits as an option for new and pre-existing patients. Please see telemedicine tab.
  • Until further notice, we are requesting that no visitors enter the clinic, with the exception of caregivers who assist patients with transport, translation, etc. and those delivering essential drugs and supplies.
  • Our offices are cleaned and sanitized throughout the day to reduce the risk of infection. Unnecessary items, such as magazines and newspapers, have been removed.
  • We have secured a large amount of supplies, including masks and other forms of protective equipment, and will continue our efforts to obtain and maintain necessary inventory.
  • Please be assured that we have developed and continue to update contingency staffing plans and schedules to ensure we have a ready workforce capable of delivering high quality care to our patients.
  • Our pharmacy continues to function without interruption as does our laboratory and clinical research activities.
  • Where possible, staff members are working remotely from home, with access to all necessary tools to serve our patients and practice locations.
  • We continue to provide access 24 hours 7 days a week (during office hours which have been reduced at both sites from 9 AM to 3 PM and afterhours by our physician specialists).
  • Until further notice the valet service is closed.

TELEMEDICINE

  • Telemedicine is a growing option for patients to receive real-time care without having to actually visit an office or medical center. Specifically, it permits the clinician to evaluate, examine, consult and provide diagnostic and treatment recommendations via an audio/video platform using a telephone, smart TV, designated kiosk or personal computer. This care delivery format is not suitable for all situations and it should be discussed with our office/your doctor; however, in the context of the current COVID-19 pandemic it is option we are making widely available for patients.
  • For your safety, OC Blood & Cancer Care is now providing telemedicine appointments through ZOOM, a video platform (see instructions below). Available for new and existing patients, this safe way of evaluating patients and devising a treatment plan will ensure that you can access uninterrupted state of the care for patients with cancer and blood disorders who would prefer not to be evaluated in person. To make an appointment, please call (714) 378-7330 in Fountain Valley, CA or (949) 380-2670 in Laguna Hills, CA.

PERSONAL MESSAGE

Again, we are continuing to monitor this rapidly changing and unprecedented situation the world and our immediate community are facing. We are in frequent contact with hospitals in our region as well as local and federal agencies. We understand the “unknown” or uncertainty creates fear and anxiety which further confounds those feelings surrounding a diagnosis of cancer or blood disorders.

At OC Blood & Cancer Care our patients, our physicians and staff are our highest priority. While all of us are adjusting to the current circumstances we are facing during this unprecedented time, we believe that the care and compassion we provide to our patients is as more important today than it has ever been. We remain totally dedicated to continuing to safely and responsibly serve you and our community with exceptional, world class, state of the art care that is close to home.

With the COVID-19 pandemic global crisis rapidly evolving, we are striving to ensure that our physicians, nurses and support staff have constant real time access to the information, resources and support they need to ensure their health and the health of our patients. All decisions we are making are being guided by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the California Department of Health, our affiliated hospital system (Memorial Care) and our team “huddles”.

Again, we remain guided by our mission and our core values as we provide care to our patients and ensure our clinics remain safe and healthy for all. We know better days are ahead and we will overcome this generation defining medical crises together!

Sincerely,
The providers and staff at OC Blood & Cancer Care