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Controlling Crisis

a meeting of people wearing masks

As news of COVID-19 emerged, Moffitt Cancer Center began initiating its previously existing pandemic plan in earnest.

When the COVID-19 pandemic hit, Moffitt Cancer Center leaders began planning for the worst and hoping for the best

By Sara Bondell

At Moffitt Cancer Center, someone is always planning. Appointment schedules, treatment plans, surgery calendars, upcoming events. There are plans for building new spaces and a plan if a major hurricane hits the state.

But a pandemic plan, while in place, was never at the front of anyone's mind.

Until COVID-19 hit.

"Once it was clear COVID-19 was in the U.S. and that it could get quite serious, we knew we needed to get a group together and start planning," said Robert Keenan, MD, Vice President, Quality and Chief Medical Officer.

The Cancer Center activated its incident command center, a general emergency management team traditionally used during hurricanes. The group, composed of almost two dozen subgroups and led by Infection Control and the Infectious Diseases Program, would now focus on COVID-19.

They were able to adapt 2014 Ebola plans and other resource materials to fit the current needs and established a COVID-19 response plan for managing infected patients and daily operations.

Proactive Measures

To avoid a personal protective equipment shortage, Moffitt Cancer Center began taking inventory of what it already had and started looking for ways to get additional supplies.

It added 39 vendors and entered into 20 new agreements with current vendors for product substitutions. The number of N95 masks at the Cancer Center has increased by more than 500% and the number of gloves has increased by 325% compared to the same time period in 2019.

The Cancer Center nurses found ways to consolidate treatment to reduce the waste of isolation gowns, decreasing the number of gowns used by 8% compared to the same time last year.

The Cancer Center did not run out of any personal protective equipment during the pandemic. At the lowest point, there was about one week's worth of supplies for certain sized masks and gloves.

While no cancer surgery is truly elective, surgeons identified which procedures could be delayed, like the removal of nonaggressive tumors and secondary reconstructive surgeries. About 30% of these nonurgent surgeries were postponed during the four-week height of the pandemic and have now been rescheduled or performed.

Clinics determined which upcoming appointments could be pushed back and which ones could be converted to virtual visits. Before COVID-19, there were 76 Moffitt Cancer Center providers performing virtual visits. A month later, there were almost 200, and telemedicine grew more than 5,000% during the pandemic.

Moffitt Cancer Center also put into place a no-visitor policy, added screening checkpoints at entrances and ramped up cleaning efforts around the hospital. On-site conferences and meetings were canceled, and international travel was prohibited for team members.

The University of South Florida helped Moffitt Cancer Center during the pandemic by running a COVID-19 clinic which provided support and helped monitor symptoms for outpatients with COVID; the Cancer Center sent several patients through this virtual clinic. The critical care physicians at Moffitt Cancer Center are USF pulmonologists, and several of the infectious disease physicians working at the Cancer Center are USF physicians, all of whom are involved with direct patient care.

On the research side, only one researcher was allowed in each lab on campus and studies requiring in-person visits were suspended. There was not, however, a major disruption in clinical trials. Fifteen were suspended, but more than 200 trials were open during the pandemic.

Testing

After securing necessary equipment and prioritizing patient care, the next challenge was testing. At the beginning of the pandemic, Moffitt Cancer Center did not have an in-house COVID-19 test. All samples were sent to a lab in Salt Lake City, Utah, which could take up to two weeks for results.

With an immediate need for an in-house test, the Cancer Center's labs validated their own. The COVID-19 screening clinic can now give some patients same-day results, with the chance of receiving a false negative result less than 1 in 1,000.

Since the beginning of the pandemic through Oct. 11, Moffitt Cancer Center ran slightly more than 16,000 COVID-19 tests. Currently the Cancer Center is conducting an average of 3,300 tests per month.

nurses wearing masks walking down a hallway

Team members on the frontline of care worked diligently to ensure the health and safety of Moffitt Cancer Center patients during the COVID-19 pandemic.

Preparing for Another Wave

Many are predicting another wave of the virus and planning has already begun. That includes stocking up on personal protective equipment and using data collected from the first wave to help identify the start of a potential new peak earlier.

There are hundreds of thousands of masks and gloves already ordered and on their way to the Cancer Center.

"The fact that we have been through the first wave makes us more knowledgeable on how to prepare," said Keenan. "We can do a lot of planning, but no one will know if the next wave will be similar, worse or better." Another wave hitting during flu season can also complicate things.

Long-Term Impact

While it is still uncertain what the world post-COVID-19 will look like, one thing is for sure: Things will never be the same.

"There is no question that COVID-19 jolted us into a new way of thinking and there's a lot of people asking, what will this new normal be?" said Keenan.

The new normal could include social distancing for the next year and a large majority of the workforce continuing to work from home. About half of Moffitt Cancer Center's 7,000+ team members worked remotely during the pandemic.

COVID-19 also forced the Cancer Center to create a more robust telemedicine program, forever changing the ways patients can access care. The Cancer Center can now use the technology in the future to deliver care to patients who are too sick to come in for appointments or live far away.

Chart: Personal Protective Equipment by the Numbers


COVID-19 Frontline Response Fund

Hospitals are facing major challenges with the COVID-19 pandemic, and Moffitt Cancer Center is no exception. As our patients continue to seek lifesaving care, the Cancer Center is doing everything possible to protect the immunocompromised, as well as our own health care team. This includes strengthening our safety measures, harnessing technology and expanding our research beyond cancer to better understand this virus.

The COVID-19 Frontline Response Fund was created by the Moffitt Cancer Center Foundation to advance three critical areas -- patient support, telemedicine and research. As our nurses, physicians and researchers are assisting to combat this pandemic, Moffitt Cancer Center wants to ensure our patients and team members have the extra support needed in these uncertain times.

To donate or learn more, visit the COVID-19 Frontline Response Fund.