Clean to the Touch: No COVID-19 in Radiation Oncology Clinic

A quality improvement study conducted at a large New Jersey tertiary care COVID-19 referral center showed that following strict prevention and disinfection protocols can be effective in keeping facilities free of the virus.

Based on the analysis of 128 environmental samples collected from a variety of services throughout the radiation oncology department at Rutgers Cancer Institute of New Jersey, a team of investigators determined their clinic had zero traces of the SARS-CoV-2 virus.

“The results of this study suggest that following strict prevention protocols and routine cleaning and disinfecting seem adequate for limiting surface contamination with SARS-CoV-2,” said the team by Bruce G. Haffty, M.D., chair of radiation oncology and associate vice chancellor for cancer programs.

Being able to demonstrate that radiation oncology centers can successfully keep the virus out is critical, he said, because many patients are making substantial decisions about needed medical care based on their fears of the virus. In fact, he pointed out, many patients have deferred or canceled scheduled follow-up appointments, leading numerous radiation oncology clinics to see a significant drop-off in patient volume during the pandemic.

“Although re-scheduling follow-up visits or converting selected follow-up visits and consultations to telemedicine is good practice during the pandemic, some patients or clinicians may delay or decline important cancer therapies that can substantially affect quality of life and cancer outcomes,” Haffty said. “We believe that appropriate patient care should not be delayed because of the pandemic.”

In an effort to assuage patient fears, Haffty’s team tested their facility during the height of the pandemic in New Jersey. They collected samples every Monday, Wednesday, and Friday for a total of six days between May 1, 2020, and May 13, 2020. Samples fells into three categories: patient areas (80 swabs), staff areas (19 swabs), and department equipment (29 swabs). Of all the samples, 15 were taken from objects touched by patients who were positive for infection.

Their swabbing efforts, which focused on surfaces that were at high risk for contamination due to patient contact and frequent use, followed World Health Organization protocols, and samples were collected at 4:30 p.m. prior to the 5 p.m.-scheduled disinfection and cleaning services. The team also went a step further and tested the immobilization mask of a COVID-19-positive patient – with RT-PCR analysis – daily for five radiation treatments.

According to their analysis, none of the samples came back positive for any SARS-CoV-2 RNA.

Haffty’s team did acknowledge that their study had some limitations, however.

In addition to not collecting air samples, the team was unable to test 100 percent of surfaces. Consequently, they said, their study could have reduced sensitivity, pointing to the need for additional surface and air studies in varied environments that could improve the overall understanding of the role of environment factors in spreading COVID-19.