Id |
Subject |
Object |
Predicate |
Lexical cue |
T50 |
0-18 |
Sentence |
denotes |
How do we respond? |
T51 |
19-61 |
Sentence |
denotes |
Develop a COVID 19 policy for cancer care: |
T52 |
62-191 |
Sentence |
denotes |
Establish an oncology multidisciplinary committee to create, review and rapidly update a clinical policy suitable to our setting. |
T53 |
192-324 |
Sentence |
denotes |
Provide cancer patients with a cover note that enables seamless movement if they get stopped by law enforcement agents on the roads. |
T54 |
325-387 |
Sentence |
denotes |
Strategise to reduce clinic visits and accelerate remote care: |
T55 |
388-613 |
Sentence |
denotes |
Because cancer patients and caregivers are expectedly anxious whether they are symptomatic or not, and their genuine desire for improved survival; they will require information, counselling, symptomatic control and treatment. |
T56 |
614-705 |
Sentence |
denotes |
Traditionally this is achieved through hospital visits but can be achieved by telemedicine. |
T57 |
706-770 |
Sentence |
denotes |
It is a matter of urgency that we accelerate remote cancer care. |
T58 |
771-859 |
Sentence |
denotes |
Oncology centres should within 72 hours transit to delivering 30-50% of services online. |
T59 |
860-914 |
Sentence |
denotes |
Empower patients and caregivers through communication: |
T60 |
915-1018 |
Sentence |
denotes |
Leverage on digital technologies to ensure we continue to communicate, to patients and with each other. |
T61 |
1019-1255 |
Sentence |
denotes |
Bulk text messaging, email and or voice calls can ensure we provide patients with clear communication about how the hospital is responding to and preventing COVID-19 infection and how the infection will affect cancer care going forward. |
T62 |
1256-1320 |
Sentence |
denotes |
This will keep them abreast of happenings and allay their fears. |
T63 |
1321-1478 |
Sentence |
denotes |
For example, establish a clinical call centre manned by administrative and clinical staff knowledgeable in the provision of cancer care and support services. |
T64 |
1479-1631 |
Sentence |
denotes |
This category of responders must be trained in client service and people relations as the bulk of the calls would be from agitated and worried patients. |
T65 |
1632-1741 |
Sentence |
denotes |
This is so that the staff do not react in untoward ways to the emotion-laden calls they are bound to receive. |
T66 |
1742-1785 |
Sentence |
denotes |
Leverage existing digital health platforms: |
T67 |
1786-1989 |
Sentence |
denotes |
Cancer centres should integrate existing digital health platforms to limit patients and oncology professional’s physical interaction, a strategy that several oncology centres in the USA are adopting [9]. |
T68 |
1990-2091 |
Sentence |
denotes |
Digital platforms such as www.oncopadi.com already exist and were designed for low-resource settings. |
T69 |
2092-2219 |
Sentence |
denotes |
They can provide telemedicine services, consultations, symptom control and counselling to cancer patients and their caregivers. |
T70 |
2220-2579 |
Sentence |
denotes |
To facilitate the use of telehealth solutions across all contexts, a global directory of telehealth platforms is also being compiled by digital health experts which outlines multiple platforms (many are free) to support care delivery during the COVID-19 outbreak: https://docs.google.com/spreadsheets/d/1XMsJJIduO6yI_GEo1Vy_b_SXoz9YwbgtEL63-siNS_Q/edit#gid=0. |
T71 |
2580-2591 |
Sentence |
denotes |
Administer: |
T72 |
2592-2707 |
Sentence |
denotes |
Continue providing only emergencies and essential services such as radiotherapy under established safety protocols. |
T73 |
2708-2794 |
Sentence |
denotes |
Switch: from systemic therapy to oral chemotherapy, and monitor side effects remotely. |
T74 |
2795-2958 |
Sentence |
denotes |
This should be discussed and agreed upon by a multidisciplinary team and communicated with patients only if the pandemic stops patients from visiting the hospital. |
T75 |
2959-3012 |
Sentence |
denotes |
This may be a better option than no treatment at all. |
T76 |
3013-3119 |
Sentence |
denotes |
Practice: the World Health Organization’s advice on reducing coronavirus transmission for the public [10]. |
T77 |
3121-3172 |
Sentence |
denotes |
Palliative cancer care during the COVID-19 outbreak |
T78 |
3173-3311 |
Sentence |
denotes |
Palliation is an ethical obligation and we should strive for good symptom control and comfort care for cancer patients in a pandemic [11]. |
T79 |
3312-3685 |
Sentence |
denotes |
To support palliative and supportive care of people with cancer, these proposed four areas (4S) for palliating a pandemic [11] can be used to guide a response but need to be adapted and considered in the context of the availability of resources and expertise in the context of low-resource settings: “Stuff” (i.e. stockpile of medications, equipment to deliver medications) |
T80 |
3686-3906 |
Sentence |
denotes |
“Staff” (identifying and consulting with clinicians with palliative care expertise, deliver focused education sessions to frontline staff for symptom management and supporting end-of-life care for patients with COVID-19) |
T81 |
3907-4071 |
Sentence |
denotes |
“Space” (e.g. identify wards and nonclinical areas in all health care facilities that would be appropriate to accommodate large numbers of patients expected to die) |
T82 |
4072-4286 |
Sentence |
denotes |
“Systems” (e.g. develop systems for direct consultation of palliative care expertise for staff in hospitals, create a triage system to identify patients with cancer in need of specialist palliative care management) |
T83 |
4287-4353 |
Sentence |
denotes |
Bereavement needs to be considered in the context of COVID-19 too. |
T84 |
4354-4445 |
Sentence |
denotes |
Globally we are seeing increasing numbers of unexpected and premature deaths from COVID-19. |
T85 |
4446-4584 |
Sentence |
denotes |
Families will need support with bereavement where they may have been expecting a longer trajectory of illness for a loved one with cancer. |
T86 |
4585-4691 |
Sentence |
denotes |
Furthermore, traditional cultural rituals and ceremonies may be prohibited in line with social distancing. |
T87 |
4692-4890 |
Sentence |
denotes |
We need talk to spiritual leaders to understand what can occur and provide guidance to the families of those who die to discuss how and when they might be able to hold services for their loved ones. |
T88 |
4891-4952 |
Sentence |
denotes |
A time like this is a true test of leadership and our values. |
T89 |
4953-5117 |
Sentence |
denotes |
As leaders we must make clinical and economical decisions in line with the ethical rationing of resources and the global call to flatten the curve of the infection. |