Before COVID-19 led to a stay-at-home order and social distancing, Willamette Valley Cancer institute and Research Center was already preparing for the impact of a potential health crisis. To protect high-risk patients from illness, the cancer center made significant changes to its day-to-day operations and increased protection of clinic staff by creating an innovative process to sterilize and reuse N-95 respirators.
Radiation oncologist Dr. Emily Dunn and the practice’s medical physicist team constructed a special box where N-95 masks can be decontaminated using UVC lights.
“UVA, UVB and UVC are ultraviolet rays that come from the sun and UVC is filtered by the ozone,” says Dr. Dunn. “UVC is a weak form of radiation that we can harness through artificial sources like mercury bulbs in our clinic, and that form of radiation can be used to cause damage to virus and bacterial particles.”
N-95 respirators are one example of personal protective equipment (PPE) that is used to protect the wearer from airborne particles. A substantial body of research already showed that the N-95 masks, designed for one-time use, can be reused in a crisis. In March, the Centers for Disease Control authorized reuse of the masks because of shortages driven by the COVID-19 pandemic.
How does the decontamination process work?
The N-95 masks are hung on a rack between two towers of UVC-emitting bulbs and encased in a box with aluminum flashing, to ensure that the entire surface of each mask is exposed to the rays. It’s a highly controlled environment to ensure the radiation is dosed properly and used safely and should not be attempted outside the clinic setting.
“This process can decontaminate an N-95 mask for reuse by the same health care provider. We think the potential to ease the clinic’s stress and our ability to keep our health care workers safe, which then provides an ability to keep our patients safe, is really invaluable right now,” Dr. Dunn says.
Blood cancer drug showing promise in treating COVID-19
Last fall, Dr. Jeff Sharman, WVCI’s director of research and medical director of hematology research for The US Oncology Network, led a clinical trial that earned FDA approval for a blood cancer drug called Calquence (acalabrutinib). That drug is now showing early promise for treating patients with COVID-19 who are on ventilators. Early clinical data suggests Calquence could play a role in decreasing inflammation and reducing the severity of COVID-19 induced respiratory distress.
AstraZeneca, the drug’s maker, is now beginning a large randomized, controlled clinical trial. Part one of the trial will evaluate the addition of Calquence to best supportive care versus best supportive care alone in patients hospitalized with COVID-19 who are not in an intensive care unit (ICU). Part two of the trial will evaluate the addition of Calquence to best supportive care in a portion of patients within the ICU.
Learn more here.
Changing clinic protocols to protect patients
Willamette Valley Cancer Institute has made significant changes within its clinics in Eugene and Corvallis in response to COVID-19.
“We feel a huge obligation to our patients to make sure that our clinics are a safe place for them to receive the cancer treatment they need, especially during this health crisis,” says WVCI practice director Debbie Piccolo.
In addition to limiting visitors and guests to protect patients from additional exposure, temperature checks are required of anyone entering the building. The number of chairs in the waiting rooms, the lab and the infusion room have been reduced to provide six feet of social distancing.
“Our infusion nurses, our lab techs and our radiation therapists are all in full personal protective equipment every day, which is a gown, mask, gloves and goggles,” Piccolo says.
Staff members who can work from home are doing so, and many patients are seeing their doctors through telemedicine visits. WVCI is incredibly grateful to community members who have donated handmade cloth masks that are made available to all patients who enter the clinics.
Taking these precautions is the new normal for WVCI, as the practice continues to assess the current state of the health crisis and what may lay ahead in the weeks, months and even years to come.
“We are going to do everything in our power to make sure that none of our patients get sick and that none of them get sick because they came here,” Piccolo says.