By Kathleen Wiley, RN, MSN, AOCNS®, and Chelsea Backler, MSN, APRN, AGCNS-BC, AOCNS®
Last updated: March 27, 2020
COVID-19 is a novel coronavirus (a large family of viruses that can cause cold-like illnesses) first identified in Wuhan, China, in December 2019. It is a respiratory illness and can be spread from person to person, possibly through respiratory droplets during close contact. The first case of COVID-19 in the United States was reported on January 21, 2020.
Symptoms and People at Highest Risk
Patients with COVID-19 may have mild to severe respiratory illness with fever, cough, and difficulty breathing, although some report asymptomatic infection. More serious presentations can include severe pneumonia, respiratory failure, and septic shock. Those at highest risk for infection have had prolonged, unprotected close contact with a patient with confirmed COVID-19 or live in or have recently been to areas with sustained transmission. Based on limited data from COVID-19 and other related coronaviruses, older adults and those with underlying medical conditions that make them immunocompromised may be at greatest risk for severe outcomes.
Prevention and Treatment
No vaccine is currently available to protect against COVID-19. The best prevention is to avoid being exposed to the virus and practice good everyday habits:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Stay at home when you are sick.
- Cover coughs and sneezes.
- Clean and disinfect surfaces.
- Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based sanitizer that contains at least 60% alcohol when soap and water are not available.
Because no specific antiviral treatment is available, supportive care of complications is the primary clinical focus. Not all patients will require medical supportive care.
Oncology Nursing Implications and COVID-19
The COVID-19 pandemic represents an unprecedented time in medicine. The situation is evolving rapidly, and recommendations are likely to change as more evidence emerges specific to oncology nursing practice, patients with cancer, and COVID-19.
Some key considerations for nursing practice:
- Staff may need additional training to screen patients for COVID-19 symptoms.
- Consider postponing routine follow-up visits for patients not on active treatment or using telemedicine.
- Home infusion may be a possibility for certain patients.
- At this time, treatment delays are not widely recommended for all patients, but may be considered by the interprofessional team on a case-by-case basis.
- Review and update any policies and procedures regarding isolation of infected patients.
- If a patient on active treatment is diagnosed with COVID-19, follow standard clinical management recommendations for infection modifications.
- Patients should be educated about COVID-19 symptoms and instructed to call if they develop a new fever, cough, or shortness of breath.
Personal protective equipment (PPE) and availability during the outbreak is a top concern for nurses both in oncology and across the healthcare system. Learn what PPE is required for COVID-19 and how to address shortages.