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COVID-19 containment measures adopted by Italian Paediatric Oncology and Haematology Association (AIEOP) centres to prevent the virus spread among healthcare providers

2020; Elsevier BV; Volume: 47; Linguagem: Inglês

10.1016/j.ejon.2020.101791

1532-2122

Matteo Amicucci, Marta Canesi, Elena Rostagno, Anna Bergadano, Clara Badino, Debora Botta, Diana Fenicia, A Longo, Simone Macchi, Celeste Ricciardi, Moreno Crotti Partel,

Respiratory Support and Mechanisms

Sars-CoV-2 (COVID-19) is a new virus that has spread rapidly worldwide. Italy has been heavily affected by this pandemic (Lambertini et al., 2020Lambertini M. Toss A. Passaro A. Criscitiello C. Cremolini C. Cardone C. Loupakis F. Viscardi G. Meattini I. Dieci M.V. Ferrara R. Giusti R. Maio M.D. Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists' perspective.ESMO Open. 2020; 5https://doi.org/10.1136/esmoopen-2020-000759Abstract Full Text Full Text PDF Scopus (141) Google Scholar). Cancer patients who contract COVID-19 infection seem to be at a major risk to severe illness and poor prognosis (Kotecha, 2020Kotecha R.S. Challenges posed by COVID-19 to children with cancer.Lancet Oncol. 2020; 21https://doi.org/10.1016/S1470-2045(20)30205-9Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar). Although children seem less vulnerable to the disease, they are not immune to it. The paediatric onco-haematology population is more at risk of contracting the virus because of its fragility due to immunosuppression (Hrusak et al., 2020Hrusak O. Kalina T. Wolf J. Balduzzi A. Provenzi M. Rizzari C. Rives S. del Pozo Carlavilla M. Alonso M.E.V. Domínguez-Pinilla N. Bourquin J.-P. Schmiegelow K. Attarbaschi A. Grillner P. Mellgren K. van der Werff ten Bosch J. Pieters R. Brozou T. Borkhardt A. et al.Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment.Eur. J. Canc. 2020; 132: 11-16https://doi.org/10.1016/j.ejca.2020.03.021Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar). The Italian Ministry of Health issued recommendations about patients affected by malignancies, both for adults and children (della Salute, 2020della Salute Ministero Raccomandazioni per la gestione dei pazienti oncologici e onco-ematologici.in: corso di emergenza da COVID-19. 2020, March 10http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenutiNuovoCoronavirus.jsp?lingua=italiano&id=5373&area=nuovoCoronavirus&menu=vuotoGoogle Scholar). Furthermore, in order to support the clinicians, the Italian Paediatric Oncology and Haematology Association (AIEOP) issued a document containing national recommendations tailored on paediatric patients with cancer (AIEOP, 2020AIEOP Comunicato relativo all'epidemia da SARS-CoV-2/COVID-19. AIEOP, 2020, March 20https://www.aieop.org/web/comunicato-aieop/Google Scholar). The AIEOP network includes 48 Italian centres sharing standards of treatment, clinical trials protocols and research projects. In order to provide the measures adopted in different haemato-oncology paediatric centres belonging to the AIEOP network, a nurse-led national survey has been conducted. This survey aims to highlight preventive and control measures to manage COVID-19 infection in AIEOP centres. In this short letter we try to exploit the survey results showing what measures are adopted to prevent the spread of the virus among the operators of the AIEOP centres also considering what is reported in the national AIEOP press release (Table 1).Table 1COVID-19 containment measures adopted by Italian Paediatric Oncology and Haematology Association (AIEOP) centres to prevent the virus spread among healthcare providers (multi-response questions, n = 36).Implementation AreaContainment measure adopted (healthcare providers)naMulti-response questions.%Personal protective equipment (PPE) Related BehavioursAlcohol-based hand rub available in the common areas2363.9Chlorine-based disinfectants provision to clean surfaces and environments3083.3Wearing mask as an essential criterion to enter the facilities2261.1Wearing gloves as an essential criterion to enter the facilities513.9Use of thermal scanner for those workers who enter the facilities12.8Body temperature measured or self-reported at the beginning of every work shift2055.6Work OrganizationStaff meetings suspended2980.6Events determining gathering in the workplace suspended or reorganized (i.e. nurses' handover, rest breaks at work)2261.1Hospital cafeteria closed to professionals1541.7Hospital canteen closed to professional925Healthcare holidays or any kind of work permit suspended1233.3Smart work solutions activated (when possible)1644.4Pediatric onco-haematology staff moved to COVID-19 units1952.8FinancialSalary increase or supplementary payments for the frontline medical staff00TrainingE-learning about PPE1233.3E-learning about the pandemic1336.1Health RelatedHome isolation period if positive swabs and no symptoms2877.8No home isolation period and/or no swabs performed to those healthcare providers without symptoms, even in case of previous direct contact with a COVID-19 confirmed case719.4Home isolation period and/or swabs performed if no symptoms but direct contact with a COVID-19 confirmed case1130.6Home isolation period if healthcare providers presented symptoms1644.4Dedicated phone number to answer COVID-19 related questions from healthcare staff2261.1DiagnosticSwabs performed to the entire staff822.2Swabs performed to those healthcare providers who were in contact with a COVID-19 confirmed case, without wearing PPE2055.6Swabs performed to those healthcare providers who presented symptoms (fever and respiratory symptoms)1438.9Others (e.g. serological tests)411.1a Multi-response questions. Open table in a new tab All the implemented measures are consistent with the AIEOP national recommendations. Sixty-six percent of the responding centres reported a shortage of PPE and difficulties in supply: this was reported about masks (FFP3 66.7%; FFP2 55.6%, surgical 47.2%) and alcohol-hand rub (52.8%). Interestingly, the majority (83.3%) felt safe in their own work environment and considered their work conditions good enough. The rest of the responders (16.7%) did not answer the question. Staff absenteeism has been analysed and only 16.6% of the responders registered an increased rate: this was related to providers' illness, the need to care for a relative, fear, or lack of transportation to get the workplace. Medical staff have been asked to report the clinical management of cancer children found positive to COVID-19. The survey showed that in 36.1% of the centres, paediatric oncologists have visited the positive covid cancer children in the dedicated covid units or at home; in 19.1% of the centres, paediatric oncologists have not visited themselves the positive covid cancer children. Lastly, 13.8% of the medical staff used phone or telemedicine for consulting with patients. Despite the non-rigid and uniform management in all centres, only 14 positive onco-haematological children were reported and 35 people including doctors, nurses and other staff confirmed that the measures implemented have been satisfactory. Given the limited literature available, this survey represents an excellent vision of how an unexpected emergency situation could be faced and could be a reference in case of similar events in the future. None declared.