In December 2019, the emergence of an as yet uncharacterized pneumonia in Wuhan, China heralded the onset of the coronavirus pandemic caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2). The etiology and disease profile, aka Coronavirus Disease-2019 (COVID-19), has been quickly elucidated; though there is considerable lack of understanding of viral transmission. Public health measures to mitigate and contain the outbreak are hampered by scarcity and scaling up testing. The virus is among the most contagious in our lifetimes and thought to be primarily transmitted by droplet infection. Viral transmission also occurs by airborne routes and during asymptomatic periods of infection, which complicates public health measures. This is further compounded by lack of Personal Protective Equipment (PPE) and different strategies for use. These realities place Healthcare Workers (HCWs) at risk providing care to known infected patients and Persons Under Investigation (PUIs) with high suspicion of COVID-19. We propose a hypothesis-driven period sero-prevalence study of SARS-CoV-2 in MaineHealth Cancer Care Network (MHCCN) cancer Healthcare Workers (HCWs) at a sizeable rural health system and academic medical center. Our study is predicated on the lack of sound sero-epidemiological data to define occupational exposure and risk of SARS-CoV-2 infection in our cancer providers. We anticipate brisk recruitment of our cancer HCWs (Aim 1) and roll-out of a sero-antibody (IgG/IgM) test (Aim 2) to determine exposure. Brief clinical and occupational surveys will be completed. This cohort is invaluable to sustain and provide information on the SARS-CoV-2-transmission dynamics that will guide continued response to this pandemic, especially with an anticipated second wave that will inform cancer care in the rural community setting. This project is submitted in response to NOT-CA-20-0421 and is closely integrated and tethered to MaineHealth Lifespan NCORP (1UG1 CA239771-01) the parent grant that was submitted and subsequently awarded under PA-18-591.
We propose a seroprevalence / registration study based on the lack of sound sero-epidemiological data to define the transmission dynamics of SARS-CoV-2 in the rural cancer care environment that is essentially caring for an immuno-compromised patient population. Our period-prevalence cohort of cancer providers addresses a vital gap and is an invaluable cohort to define these transmission dynamics. With an anticipated surge in cases with the upcoming flu season data from our study will inform and improve clinical outcomes to ensure safe care at the patient, provider and system levels.
