Oncology nursing supportive care during the COVID-19 pandemic: reality and challenges

The social construct of our global society has been significantly impacted by the SARS-CoV-2 Coronavirus (COVID-19) virus. The health risks of SARS-CoV-2 and its associated disease COVID-19 are better understood, and public health agencies, physicians, government, and health advocates continue to facilitate public access to this information. For many countries, the pandemic has resulted in failing economies, with many facing financial hardship, job loss, and nutrition insecurity. Most importantly, healthcare systems worldwide have made significant adjustments in order to care for patients diagnosed with the virus, as well as maintaining health and preventing disease within our worldwide community. As of December 11, 2020, the Johns Hopkins University of Medicine Coronavirus Resource Center [1] which has been tasked with providing updated daily statistics regarding the international response to COVID-19 reported the following sobering statistics from 191 countries/regions: Global Cases more than 69 million; Global Deaths 1.5 million plus; US Confirmed Cases more than 15 million; US Deaths more than 292,000. The World Health Organization [2], US-based Centers for Disease Control [3], and local public health organizations worldwide have issued guidelines to inform individuals of the signs and symptoms of COVID-19, as well as identify those who are at higher risk for serious illness. Older adults, those with underlying conditions such as heart and lung disease and diabetes, patients with cancer, certain racial and ethnic minority groups, and people with disabilities and developmental and behavior disorders are among those who must take extra precautions to avoid contracting the virus. Responsible government officials have been providing detailed information, guidelines, and resources for all citizens regarding the COVID-19 virus, as well as sharing new mitigation developments, and making accurate testing available. Equally important is alerting the public with frequent and timely updates of vaccine development, of which 3 have completed clinical trial enrollment to date. Data evaluation, with potential application submissions to the US Food and Drug Administration for emergency use authorization, is in progress for these vaccine candidates. The hope and expectation are that when COVID-19 vaccines become available, their validity is accepted by the general public, and will ultimately be administered worldwide. Only then can we truly anticipate that the pandemic will be controlled and prevented, with society achieving a state of normality. Patients with cancer who may be receiving a variety of treatments are at a higher risk of developing severe infections and have increased mortality, especially if they are immunocompromised and diagnosed with COVID-19 [4]. Caring for patients during the pandemic has required that changes to every aspect of what constituted standard of care be reevaluated and adapted to accommodate for the specific precautions and guidelines outlined by institutions and public health agencies. Both oncology medical and nursing professional organizations (ASCO, ONS, MASCC/ESMO, ISNCC, AMA, ANA, AACR, NCCN) have published position papers on COVID-19, in addition to a wealth of papers by clinicians that offer analyses of the impact of the virus on patient outcomes, socio-economic and socio-political factors that influence psychological morbidity [5, 6], and issues related to cancer survivorship [7]. COVID-19 symptom presentation is quite similar to symptoms experienced by patients with cancer by virtue of diagnosis, or those receiving treatment. It has therefore become increasingly important during patient education sessions with patients and caregivers to review treatment side effects and COVID-19 symptoms, with specific instructions including contact information, as to when to contact either their nurse or physician. Oncologists have equated clinical decisions regarding treatment options, while taking into account hospital resources * Rebecca A. Clark-Snow rclark_snow@yahoo.com