HJAR May/Jun 2021

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2021 17 What percentage of Arkansans with cancer does CARTI treat? CARTI treats 35% of new cancer patients inArkansas and touches more than 60% of all cancer patients in Arkansas. If a cancer patient, upon entering CARTI for chemo infusions, has fatigue, no fever but a wet, productive cough, would that patient be allowed to receive treatments at that time without a COVID-19 test? Would the answer differ if the patient had no known exposure to a person testing positive for COVID-19 and the fatigue was related to the chemo treatments? It would depend if the symptoms were new onset or chronic. Assuming the fatigue and cough are new, we would generally test the patient at that time. We have the ability to do this on-site with results in less than one hour. While we wait for the results, the patient would be placed in an isolation room so they do not have to worry with leaving and coming back, should their test be nega- tive. The answer would be the same for pa- tients who have a known exposure. If the patient’s COVID test comes back positive, we would confer with the patient’s physician to decide whether they are healthy enough to still receive treatment or if we need to reschedule the patient and follow CDC quarantine guidelines. Physicians may choose to delay treatment and have the pa- tient wait the necessary two weeks, because their body needs an immune response to fight COVID, and the chemotherapy could possibly lower their ability to do that. If the physician deems it more important to re- ceive treatment, then we will administer that under strict isolation protocols, which in- clude having the patient access the building through a dedicated entrance, being held in an isolation room for their treatment, hav- ing all teammembers wear added PPE and the room undergoing added terminal clean protocols. Of the COVID positive patients we’ve still treated, 50% of those have been patients with brain tumors who would possibly have a negative outcome if their treatment were delayed. If the above question is answered: “No, they would not be allowed treatment without a negative COVID-19 test,” is a rapid COVID-19 test available on-site? We have PCR testing available that is more accurate than the antigen testing. We can have results in less than one hour. If a cancer patient getting chemo infusions at CARTI has tested positive for COVID-19, are they allowed to continue cancer treat- ment at CARTI? And if not, are other ar- rangements made for the patient to con- tinue chemo? Basically, does COVID-19 trump cancer? Due to the immunocompromised state of our patients, our physicians typically choose not to treat a patient who is actively COVID positive, because their body needs an immune response to fight COVID, and the chemotherapy could possibly lower their ability to do that. There are instances where we will treat COVID positive patients if the physician deems it more important to receive treat- ment. In these instances, we will administer treatment under strict isolation protocols, which include having the patient access the building through a dedicated entrance, being held in an isolation room for their treatment, having all team members wear added PPE, and the room undergoing added terminal clean protocols. Were cancer patients, in general, encour- aged to receive COVID-19 vaccinations? Yes, our physicians have been strong pro- ponents of the vaccine and have encour- aged our patients who qualify to take the vaccine. CARTI is now offering the vaccine to our patients. Has CARTI’s staff been encouraged to have stage-4 cancer patients sign DNRs at a higher rate during this pandemic? There has been no change in our practice; patients are still able to make this decision on their own. When were cancer patients in Arkansas eligible to receive the COVID-19 vaccine? Cancer patients were eligible to receive the vaccine inArkansas effective March 16, 2021, when we moved into stage 1-C, as de- fined by theArkansas Department of Health. Were/are all cancer patients encouraged to get the vaccine? Is there a reason one might be discouraged from getting the vaccine — a particular point in treatment perhaps? Patients who have an extremely low im- mune response might not benefit from re- ceiving the vaccine at that time and may be advised to wait until immune status is suf- ficient to build an immune response. What percentage of CARTI’s staff and patients have received the COVID-19 vaccine? What are the top reasons you are currently hearing for not being inoculated? CARTI team members have been very receptive to receiving the vaccine. We cur- rently have a 70% participation rate with staff. We are still analyzing data on patients, but most have already received the vaccine. The main reasons we hear frompatients and team members who choose not to get the vaccine have been that they’re waiting on full FDAapproval and are fearful of the vac- cine due to unfortunate misinformation. In your experience, are cancer patients having enhanced adverse effects from the COVID-19 vaccines? We have not seen a significant difference in the effects of the vaccine on our cancer patients versus the general population in their age group. Cancer & COVID Q&A with Traci Niece, Director of Infection Control, CARTI Traci Niece, RN, is the director of infection control at CARTI, where she has worked since 2014. She received an associate of science degree in nursing from the University of Arkansas at Little Rock in Little Rock, Arkansas.