Cancer patients need extra care

Should we worry about low immunity in cancer patients in the Covid-19 situation?

The infectivity rate is more or less similar for the normal population as compared to those affected by cancer. Once infected, the chance of falling sick is more among those who are on treatment for cancer. For example, patients who have lung cancer, the elderly, those with comorbidities are more prone to have severe illness with Covid-19. We suggest that anyone with cancer having symptoms of Covid-19 must seek medical help immediately.

Teleconsultation for cancer patients during Covid-19: What is feasible, what is not?

There are strict legal norms that we need to follow for teleconsultation, we have guidelines from the government and the ministry of health. Cancer drugs cannot be prescribed online. Patients who have cancer have ailments like anyone would have. When hospitals were fully functional, we used to see them in person because it would help us pick out a sinister symptom while patients may not recognise it. With teleconsultation, we can help them with simple things. We encourage patients to try teleconsultation prior to getting out of home for simple ailments. If something sinister emerges from the teleconsultation, we would ask them to visit the hospital.

Depression in cancer patients

It is true that close to 60 per cent of patients with a diagnosis of cancer struggle with depression whether they show the symptoms of it or not. From the treating team side, we try to be in conversation with our patients giving care and confidence. We are trying to set up a separate counselling area for patients and family members to be able to speak to a counsellor.

Handling in-patients

We have a triage system with a Covid-19 task force where, as soon as the patient enters, we screen based on standard operating procedure. If there are no Covid-19 symptoms, doctors will evaluate and provide services. If there is any Covid-19 related symptom, we will get testing and further management from a designated hospital. For the safety of in-patients, like in most hospitals, we have created a sort of pseudo lockdown to restrict the movement of multiple caregivers. Only one caregiver is allowed to stay with the in-patient. Food and other requirements will be handed over to the attendant staying with the patient. Nobody goes outside, and nobody comes inside.

Online training programmes to assess basic critical conditions

It’s very pertinent that caregivers are alerted to danger signals as many Covid-19 patients are now being kept under home quarantine if they are stable. We educate the attendants about checking the temperature with a thermometer at home and consult doctors in case of persistent or new fever.

Symptoms like increased cough, breathlessness (increased respiratory rate and effort) or lack of appetite should be flagged immediately. It would be helpful if these are integrated into an app like the Aarogya Setu, to keep a track of the patients and have a daily record.

In case of such issues, we tele-consult the patients and call for a physical visit as required.