Researchers from the NHS Foundation Trust, University of Cambridge and Cambridge Clinical Laboratories have warned that until a vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) becomes available, antigen and antibody testing should be carried out among oncology nurses as part of routine patient care.
The team’s study of 434 patient-facing oncology staff who worked during the peak of the coronavirus disease 2019 (COVD-19) pandemic in the UK, found that the highest seroprevalence rate for SARS-CoV-2 was among nurses.
David Favara and colleagues say that current UK guidelines recommend that all patients receiving systemic anticancer therapy should be tested for SARS-CoV-2 by PCR (polymerase chain reaction) before starting treatment, with further testing considered at intervals during treatment.
The guidance regarding healthcare workers, on the other hand, only recommends testing in the broadest sense, says the team.
“We propose that there should be a focus on routinely testing oncology nursing staff for both SARS-CoV-2 antigen and antibodies until an effective vaccine comes available,” write the researchers.
A pre-print version of the paper is available on the server medRxiv*, while the article undergoes peer review.
Summary of relationship between role, previous symptoms and antibody results (June 2020 sample collection). All participants were nasopharyngeal swab SARSCOV-2 PCR negative at time of SARS-COV-2 antibody testing.
Cancer patients may be at greater risk of contracting SARS-CoV-2
Since the first cases of SARS-CoV-2 were first identified in Wuhan, China, late last year, the virus has now infected more than 31 million people globally and caused more than 961,000 deaths. Despite researchers’ intense efforts to develop therapies, no effective antiviral treatments or vaccines have yet been developed.
Cancer patients may be at a greater risk of contracting SARS-CoV-2 owing to the multiple hospital visits they need to attend for diagnosis, treatment, and follow-up.
Recent studies have suggested that while anticancer therapy does not increase the mortality risk among cancer patients infected with SARS-CoV-2, it may increase the risk of severe complications following infection.
Guidance is therefore needed to safeguard both patients and oncology staff, say Favara and colleagues.
However, data regarding oncology-specific SARS-CoV-2 infection and immunity rates in the UK are lacking, and the risk of transmission among staff who care for cancer patients is not known.
“To date, no large study has specifically reported and tracked patient-facing oncology staff SARS-CoV-2 exposure,” say Favara and team.
What did the current study involve?
Favara and colleagues recruited 434 patient-facing oncology staff who worked during the peak of the COVID-19 pandemic at three secondary care NHS Foundation Trust hospitals in the UK, namely the Queen Elizabeth Hospital, Peterborough City Hospital, and Cambridge University Hospitals.
Summary of Relationship between day 1 and day 28 positive antibody results (by SARS-CoV-2 antigen target).
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Staff members had nasopharyngeal swabs tested for SARS-CoV-2 by PCR in June 2020 (day 1 samples) and again in July (day 28 samples). They also had their blood tested for SARS-CoV-2-specific antibodies (at the same points) using a laboratory Luminex-based assay and a rapid point-of-care (POC) assay.
Of the 434 participants involved in the study, 58.3% were nurses, 21.2% were doctors, 10.4% were radiographers, and 10.1% were administrators. The overall median age of the study population was 40 years and 82% were female.
Prior to June, 26.3% of participants reported having symptoms indicating potential SARS-CoV-2 infection, and 1.4% had tested positive for infection by PCR.
What did the study find?
On day 1 and day 28 of testing, all participants tested negative for SARS-CoV-2 by PCR.
The Luminex-based assay identified 18.4% of participants as SARS-CoV-2 seropositive on day 1, 42.5% of whom also tested seropositive by PCO.
Luminex-based seropositivity rates were higher among nurses (21.3%) and doctors (17.4%), compared with among administration staff (13.6%) and radiographers (8.9%).
Of 400 participants who also underwent testing on day 28 in July, 13.3% tested seropositive by Luminex, 92·5% of whom had previously tested positive, and 7·5% of whom were newly positive.
Of all the staff groups tested, the seroprevalence rate was highest among nurses, at 16.5%.
“The daily interactions of nurses with multiple patients at close quarters will undoubtedly contribute to these stark statistics,” say Favara and colleagues.
Of the participants who tested seropositive on day 1, 32.5% became seronegative by day 28, suggesting that SARS-CoV-2 antibody seropositivity declines over time.
Nurses should be tested regularly as part of routine patient care
The researchers say that until a vaccine becomes available, the high prevalence of SARS-CoV-2 seropositivity in oncology nurses, along with the high rate of decline in seropositivity over 4 weeks supports regular antigen and antibody testing in this staff group as part of routine patient care.
“This study sets the first seropositivity baseline for UK oncology staff and provides new information to consider incorporating into international guidance on safeguarding patients,” say Favara and team. “We propose that there should be a focus on routinely testing oncology nursing staff for both SARS-CoV-2 antigen and antibodies until an effective vaccine comes available.”
The researchers suggest that since seropositivity can fluctuate within 4 weeks, testing should be carried out at least once a month. Ideally, weekly PCR-testing with fortnightly serology would be performed.
“Increasing availability of lower-cost, high sensitivity, and specificity SARS-CoV-2 testing methods should make this targeted approach viable, would help protect patients and staff and enable containment and tracking of new, asymptomatic infections,” they conclude.
*Important Notice
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
NAIROBI, Kenya (AP) — The body of Ugandan Olympic athlete Rebecca Cheptegei — who died after being set on fire by her partner in Kenya — was received Friday by family and anti-femicide crusaders, ahead of her burial a day later.
Cheptegei’s family met with dozens of activists Friday who had marched to the Moi Teaching and Referral Hospital’s morgue in the western city of Eldoret while chanting anti-femicide slogans.
She is the fourth female athlete to have been killed by her partner in Kenya in yet another case of gender-based violence in recent years.
Viola Cheptoo, the founder of Tirop Angels – an organization that was formed in honor of athlete Agnes Tirop, who was stabbed to death in 2021, said stakeholders need to ensure this is the last death of an athlete due to gender-based violence.
“We are here to say that enough is enough, we are tired of burying our sisters due to GBV,” she said.
It was a somber mood at the morgue as athletes and family members viewed Cheptegei’s body which sustained 80% of burns after she was doused with gasoline by her partner Dickson Ndiema. Ndiema sustained 30% burns on his body and later succumbed.
Ndiema and Cheptegei were said to have quarreled over a piece of land that the athlete bought in Kenya, according to a report filed by the local chief.
Cheptegei competed in the women’s marathon at the Paris Olympics less than a month before the attack. She finished in 44th place.
Cheptegei’s father, Joseph, said that the body will make a brief stop at their home in the Endebess area before proceeding to Bukwo in eastern Uganda for a night vigil and burial on Saturday.
“We are in the final part of giving my daughter the last respect,” a visibly distraught Joseph said.
He told reporters last week that Ndiema was stalking and threatening Cheptegei and the family had informed police.
Four in 10 women or an estimated 41% of dating or married Kenyan women have experienced physical or sexual violence perpetrated by their current or most recent partner, according to the Kenya Demographic and Health Survey 2022.
TEL AVIV, Israel (AP) — A rare Bronze-Era jar accidentally smashed by a 4-year-old visiting a museum was back on display Wednesday after restoration experts were able to carefully piece the artifact back together.
Last month, a family from northern Israel was visiting the museum when their youngest son tipped over the jar, which smashed into pieces.
Alex Geller, the boy’s father, said his son — the youngest of three — is exceptionally curious, and that the moment he heard the crash, “please let that not be my child” was the first thought that raced through his head.
The jar has been on display at the Hecht Museum in Haifa for 35 years. It was one of the only containers of its size and from that period still complete when it was discovered.
The Bronze Age jar is one of many artifacts exhibited out in the open, part of the Hecht Museum’s vision of letting visitors explore history without glass barriers, said Inbal Rivlin, the director of the museum, which is associated with Haifa University in northern Israel.
It was likely used to hold wine or oil, and dates back to between 2200 and 1500 B.C.
Rivlin and the museum decided to turn the moment, which captured international attention, into a teaching moment, inviting the Geller family back for a special visit and hands-on activity to illustrate the restoration process.
Rivlin added that the incident provided a welcome distraction from the ongoing war in Gaza. “Well, he’s just a kid. So I think that somehow it touches the heart of the people in Israel and around the world,“ said Rivlin.
Roee Shafir, a restoration expert at the museum, said the repairs would be fairly simple, as the pieces were from a single, complete jar. Archaeologists often face the more daunting task of sifting through piles of shards from multiple objects and trying to piece them together.
Experts used 3D technology, hi-resolution videos, and special glue to painstakingly reconstruct the large jar.
Less than two weeks after it broke, the jar went back on display at the museum. The gluing process left small hairline cracks, and a few pieces are missing, but the jar’s impressive size remains.
The only noticeable difference in the exhibit was a new sign reading “please don’t touch.”
VICTORIA – The British Columbia government is partnering with a bear welfare group to reduce the number of bears being euthanized in the province.
Nicholas Scapillati, executive director of Grizzly Bear Foundation, said Monday that it comes after months-long discussions with the province on how to protect bears, with the goal to give the animals a “better and second chance at life in the wild.”
Scapillati said what’s exciting about the project is that the government is open to working with outside experts and the public.
“So, they’ll be working through Indigenous knowledge and scientific understanding, bringing in the latest techniques and training expertise from leading experts,” he said in an interview.
B.C. government data show conservation officers destroyed 603 black bears and 23 grizzly bears in 2023, while 154 black bears were killed by officers in the first six months of this year.
Scapillati said the group will publish a report with recommendations by next spring, while an independent oversight committee will be set up to review all bear encounters with conservation officers to provide advice to the government.
Environment Minister George Heyman said in a statement that they are looking for new ways to ensure conservation officers “have the trust of the communities they serve,” and the panel will make recommendations to enhance officer training and improve policies.
Lesley Fox, with the wildlife protection group The Fur-Bearers, said they’ve been calling for such a committee for decades.
“This move demonstrates the government is listening,” said Fox. “I suspect, because of the impending election, their listening skills are potentially a little sharper than they normally are.”
Fox said the partnership came from “a place of long frustration” as provincial conservation officers kill more than 500 black bears every year on average, and the public is “no longer tolerating this kind of approach.”
“I think that the conservation officer service and the B.C. government are aware they need to change, and certainly the public has been asking for it,” said Fox.
Fox said there’s a lot of optimism about the new partnership, but, as with any government, there will likely be a lot of red tape to get through.
“I think speed is going to be important, whether or not the committee has the ability to make change and make change relatively quickly without having to study an issue to death, ” said Fox.
This report by The Canadian Press was first published Sept. 9, 2024.
