Systematic Testing of Environmental Surfaces in a Radiation Oncology Clinic Shows no Detectable SARS-CoV-2

A Rutgers Cancer Institute of New Jersey study shows environmental surface testing at the center’s Radiation Oncology Department located within Robert Wood Johnson University Hospital, an RWJBarnabas Health facility, during the height of the COVID-19 pandemic in the state showed no detectable SARS-CoV2 – the virus that causes COVID-19. The work led by radiation oncology resident Imraan Jan, DO, at Rutgers Robert Wood Johnson Medical School, and Bruce G. Haffty, MD, associate vice chancellor for cancer programs and chair, radiation oncology at Rutgers Cancer Institute, is published in the August 27 online edition of JAMA Oncology (doi: 10.1001/jamaoncol.2020.3552).

In the early period of the global pandemic, it was hypothesized that SARS-CoV2 spread among people via droplets that come from the nose and mouth or through contact with contaminated objects and surfaces. During that period, there were some studies confirming how the virus contaminated surfaces in health care settings that routinely treated patients with SARS-CoV2 but not many pertaining to clinics that were not routinely treating patients with the virus.

“Considering cancer patients are already immunocompromised, it was deemed that this population may be at risk for increased disease and death if they were diagnosed with COVID-19 as compared to the general population. Since it was not beneficial to completely stop cancer treatment for select patients during this early period, practitioners needed to understand more about COVID-19 transmission in places like outpatient cancer clinics where the virus was not routinely treated. By assessing the presence or absence of SARS-CoV2 in this setting, important health information can be given to patients, families and providers so that they can weigh the benefit versus risk of receiving cancer treatment,” shares Dr. Haffty, who is the senior and corresponding author of the work.

For a six day period over two weeks from May 1 to May 13, 2020, during the peak daily rate of COVID-19 diagnosis in New Jersey, environmental swabbing took place in the Radiation Oncology Department prior to daily scheduled cleaning and disinfection services. Areas included chairs, door handles, sinks, toilets, computers and select department equipment. Swabbing was conducted in accordance with World Health Organization protocols, and targeted areas were identified based on frequency of use and patient contact.

Analysis of the 128 samples collected were separated into three categories: patient areas (80), staff areas (19), and department equipment (29). Included in this were 15 samples taken from objects used by a patient with confirmed COVID-19, including an immobilization mask. Out of the 128 samples taken, none were positive for SARS-CoV2.

“Radiation oncology clinics are often housed in hospital settings that can have a high prevalence of COVID-19 patients, thus elevating fears of infection and causing cancer patients who are deemed to need radiation treatment to cancel or defer appointments,” notes Haffty, who is also chair of radiation oncology at Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School. “The results of this study suggest that strict prevention protocols and routine cleaning and disinfecting appear adequate for limiting SARS-CoV2 surface contamination.”

The authors note study limitations include a lack of air samples taken due to the study’s focus on surface contamination. Also, due to the nature of swabbing ability, entire surfaces could not be swabbed for analysis. The authors recommend additional air and surface studies in varied environments be conducted in order to gain a better understanding of the role environmental factors play in the spread of COVID-19.

This work was funded in part by a National Cancer Institute Cancer Center Support Grant (P30CA072720). Additional details including author contributions, exemptions and conflicts of interest can be found at: doi: 10.1001/jamaoncol.2020.3552.

Source: Rutgers Cancer Institute of New Jersey

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