Dr. Sandeep “Bobby” Reddy joined me on my podcast for the American Journal of Managed Care to discuss the clinical care of cancer patients in the age of COVID. Dr. Reddy is an oncologist at the UCLA School of Medicine and the Chief Medical Officer of NantHealth, a healthcare cloud-based information technology company that converges science and technology through a single integrated clinical platform.
What follows is a modified version of the transcript of the interview. It has been abbreviated and edited for readability. Some sections have been omitted altogether (e.g. growth factor use, and participation in clinical trials) but can be found on the podcast recording.
Scroll down to view a 5 min video of Dr. Reddy discussing the most important things you should know about getting cancer care in the age of COVID.
BR: It’s an interesting question, however, despite so many cases and so much time that’s elapsed, the answer, unfortunately, is we don’t really know.
What we do know is that cancer patients are at higher risk of mortality if they do contract the virus. And that is true for patients who are actively being treated and as well as patients who have recovered from treatment.
There is data from both China and Italy that shows a very significantly increased risk of death in cancer patients and post-cancer patients. The thought is that because of the immune compromise, they will develop a more severe form of the disease and end up having hospitalizations, ICU stays, and ultimately an increased risk of mortality.
We would surmise that those same factors would also lead to an increased risk of contracting COVID. However, we haven’t actually seen that epidemiologically.
So far, it seems like the cancer population is being affected at about the same rate as the general population. That could be because cancer patients are taking even greater precautions to avoid contracting the disease.
And, perhaps, the people around them, their caregivers, and other members of the community are also behaving appropriately in terms of social distancing, wearing masks, and the other protective measures that we can take.
BR: That raises an interesting point about the use of masks and this big debate that we’re having in the country. Remember, masks don’t actually protect the wearer. This is a great misconception. The purpose of the mask is to protect everyone else.
If we as a society wore masks, meaning everyone, maybe for a month, we would probably have zero COVID. This is because the virus would not be able to spread and infect new people.
When you cover your face with the mask, it effectively reduces transmission by about 99%. This is true, no matter which mask you wear.
The N95 mask is a tight-fitting mask that reduces the likelihood of any viral particles getting to a wearer. However, the critical reason that we should all wear masks is to prevent transmission.
If you cough or sneeze or even breathe very heavily, all of the virus particles that will be expressed from your mouth or nose will be trapped by the mask. So, somebody else who’s nearby will not contract the virus.
Even if a tiny fraction of viral particles does get out there, that’s probably below the threshold that’s going to cause a very severe infection. So the type of mask is more or less irrelevant. The key is covering the face.