Caring for Patients With Cancer in the Face of Self-Vulnerability During the COVID-19 Pandemic—Reply | Oncology | JAMA Oncology | JAMA Network
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Comment & Response
August 27, 2020

Caring for Patients With Cancer in the Face of Self-Vulnerability During the COVID-19 Pandemic—Reply

Author Affiliations
  • 1Barbara and Donald Zucker School of Medicine at Hofstra/Northwell Health, New Hyde Park, New York
JAMA Oncol. 2020;6(10):1640-1641. doi:10.1001/jamaoncol.2020.3333

In Reply I thank Drs Choi and Simone for acknowledging my sentiments and for their response to the commentary.1 It gives me a sense of fulfillment that my article has reached other pregnant women on the front lines of this pandemic who are experiencing similar concerns and uncertainties. Since writing my piece, other articles have been published that describe more in detail the risks of coronavirus disease 2019 (COVID-19) in pregnant women, as Drs Choi and Simone highlight in their comments. As they stated, reports such as the one by Dashraath et al2 can certainly raise the level of concern for women who are battling with the dual responsibilities of being physicians and expectant mothers. Taking respite in guidelines set forth by the Accreditation Council for Graduate Medical Education, US Food and Drug Administration, Centers for Disease Control and Prevention (CDC), and individual institutions, both Dr Choi and I made the difficult yet personal decision of staying true to our vocation by continuing to work and care for patients, while hoping to be an example to our future children.

After experiencing this pandemic firsthand over the last 4 months, I feel confident and less uncertain about many concerns that I initially wrote about. One of my initial primary concerns as a pregnant physician on the front lines was general scarcity of personal protective equipment (PPE) that many studies and media outlets highlighted. An article published in the New England Journal of Medicine3 showcased lack of adequate PPE, such as respirators, gloves, face shields, and gowns, for frontline health care workers in the US during the earlier days of the pandemic. Around the same time, the CDC loosened its guidelines and suggested that health care workers could use scarves or bandanas for protection when there was a shortage of masks.4 Fortunately, my institution did not have to go through these drastic measures and was quickly able to rise up to the challenge by providing its employees with appropriate PPE. Through all these months, I have witnessed how keeping up with the ever-changing institutional guidelines, wearing appropriate PPE, and taking standard precautions as recommended by the CDC can help protect health care workers from contracting the virus. This in turn has reassured me that I made the right decision of pursuing my inner calling to continue working and to stand by my patients, and that I was not placing my unborn child’s or my life at risk.

In the end, I have learned one most important lesson through this experience, something that I hope to pass along to my son: It is human nature to have doubts and be afraid, at times, especially when there is uncertainty of the future; however, it is how we face adversity and react to it is what defines our character. I hope that one day, my son and I can look back at this experience that we faced together and be proud of the fact that, despite the emotions and concerns that this pandemic caused, we persisted by remaining positive and optimistic.

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Article Information

Corresponding Author: Coral Olazagasti, MD, Barbara and Donald Zucker School of Medicine at Hofstra/Northwell Health, 450 Lakeville Rd, New Hyde Park, NY 11042 (colazagasti@northwell.edu).

Published Online: August 27, 2020. doi:10.1001/jamaoncol.2020.3333

Conflict of Interest Disclosures: Dr Seetharamu reported receiving personal fees for serving on advisory boards from Amgen, AstraZeneca, Takeda, and Genentech. No other disclosures were reported.

Additional Contributions: This article reflects the first-person account of Dr Olazagasti. Dr Seetharamu is her mentor at Hofstra/Northwell Health and reviewed the article for agreement with the institution’s guidelines.

References
1.
Olazagasti  C, Seetharamu  N.  Facing a pandemic while pregnant.   JAMA Oncol. 2020;6(7):985-986. doi:10.1001/jamaoncol.2020.1652PubMedGoogle ScholarCrossref
2.
Dashraath  P, Wong  JLJ, Lim  MXK,  et al.  Coronavirus disease 2019 (COVID-19) pandemic and pregnancy.   Am J Obstet Gynecol. 2020;222(6):521-531. doi:10.1016/j.ajog.2020.03.021PubMedGoogle ScholarCrossref
3.
Ranney  ML, Griffeth  V, Jha  AK.  critical supply shortages—the need for ventilators and personal protective equipment during the COVID-19 pandemic.   N Engl J Med. 2020;382(18):e41. doi:10.1056/NEJMp2006141PubMedGoogle Scholar
4.
CDC loosens guidelines to allow medical experts exposed to COVID-19 to keep working. Accessed July 23, 2020. https://www.cnn.com/world/live-news/coronavirus-outbreak-03-19-20-intl-hnk/h_61eeddcaa97731860d3b952f3351c488
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