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Review
. 2023 Jan;6(1):e1669.
doi: 10.1002/cnr2.1669. Epub 2022 Jul 1.

The COVID-19 infection control response at a large stand-alone comprehensive cancer center in Los Angeles County

Hannah Battey  1 , Brenna Doran  1 , Annemarie Flood  1   2 , Juliet Nussbaum  1 , Tyler Seto  2 , Suwannee Srisatidnarakul  1 , Bernard Tegtmeier  2   3 , Sanjeet Dadwal  3
Affiliations
Review

The COVID-19 infection control response at a large stand-alone comprehensive cancer center in Los Angeles County

Hannah Battey et al. Cancer Rep (Hoboken). 2023 Jan.

Abstract

Background: The City of Hope National Medical Center (COH) is the only stand-alone comprehensive cancer center in Los Angeles, a county that was deemed a COVID-19 pandemic epicenter at the height of the 2020 winter surge. The immunocompromised patient population frequently experienced delays in infection control guidelines from local and government bodies due to minimal data available in comparison to the general population. This required COH to make swift, informed decisions for the best interest of the patient population.

Aim: Here, we review the comprehensive COVID-19 infection control response conducted at COH within the context of a high-risk patient population, predominately comprised of patients with hematologic malignancies.

Methods and results: This infection control response focused on prevention of COVID-19 transmission on campus, COVID-19 testing, and isolation management. These efforts consisted of COVID-19 screening, limitation of personnel on campus, source control, contact tracing, COVID-19 vaccination, establishment of in-house testing and implementation and management of COVID-19 testing. Between January 2020 and September 2021, COH implemented a robust in-house testing program, completed well over 1000 contact traces, ensured COVID-19 vaccinations were distributed to all eligible staff and patients, and established an algorithm for COVID-19 infection resolution, all without compromising the number of hematopoietic stem cell transplants (HCTs) performed, surgical volume, or healthcare-associated standardized infection ratios (SIR).

Conclusion: Institutional collaboration and attention to infection control was pivotal to minimizing the burden of the COVID-19 pandemic.

Keywords: cancer prevention; epidemiology and prevention; hematological cancer; medical oncology.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
COVID‐19 positivity rate for patients and employees tested at City of Hope in comparison to the Los Angeles County positivity rate between March 2020 and September 2021. The positivity rate was calculated as the percentage of all COVID‐19 tests that were positive in 7‐day average increments, using the date of specimen collection. LA County data includes reported cases from healthcare institutions and laboratories within the defined county lines. This data is publicly available
FIGURE 2
FIGURE 2
The number of employee contact traces completed between March 2020 and September 2021, classified as exposure versus no exposure. An exposure was defined based on CDC guidelines (proximity/time‐based assessment of interaction with the COVID‐19 index case). All contact traces were performed by the COH IP Department
FIGURE 3
FIGURE 3
Average time in hours from laboratory receival to result for patient and employee COVID‐19 testing compared alongside the number of daily COVID‐19 tests collected. The time to result and COVID‐19 testing numbers were averaged in 7‐day increments. These data include both internal and external laboratory tests for Duarte main campus
FIGURE 4
FIGURE 4
Number of hematopoietic stem cell transplants (HCTs) performed at COH between 2017 and 2020, broken down by autologous and allogeneic
FIGURE 5
FIGURE 5
The number of inpatient and outpatient surgical and endoscopic procedures performed on COH Duarte campus between January 2019 and September 2021. The linear trendline associated with the total number of inpatient and outpatient surgeries illustrates a steady increase in surgeries over time
See this image and copyright information in PMC

References

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