Minimizing transmission of COVID-19 while delivering optimal cancer care in a National Cancer Centre

Chiang, Jianbang; Yang, Valerie Shiwen; Han, Shuting; Zhuang, Qingyuan; Ooi, Gideon; Sin, Iris Huili; Chua, Gail Wan Ying; Tan, Si Ying; Chia, Claramae Shulyn; Tan, Veronique Kiak-Mien; Neo, Patricia Soek Hui; Kwek, Jin Wei; Yap, Swee Peng; Kanesvaran, Ravindran; Lim, Soon Thye; Hwang, William Ying Khee; Tham, Chee Kian

The COVID-19 pandemic has disrupted current models of healthcare and adaptations will likely continue. With the gradual easing of lockdown measures worldwide, cancer centres must be prepared to implement novel means to prevent repeated waves of infection. There are two limitations unique to oncology – a higher susceptibility of patients to COVID-19 and the multidisciplinary approach required of cancer management. We describe the measures implemented in the largest cancer centre in Singapore to continue optimal cancer care in spite of the ongoing pandemic, with no nosocomial infections reported in our centre to date. We adopted a multipronged approach, with an overall committee supervising the entire COVID-19 management effort. A screening clinic was setup to triage patients prior to entry to the centre. Each Oncology Division within the cancer centre designed solutions tailored to the specific needs of their discipline. We explore in detail the screening criteria and workflow of the screening clinic, as well as modifications by individual divisions to reduce infection risk to patients and healthcare professionals. This approach can be modelled by other cancer centres during this prolonged COVID-19 pandemic.