Welcome to The C Word – a special edition of The Oncology Journal Club focused entirely on COVID-19, with Special Guest Professor Raina MacIntyre.
As regular listeners will know, our hosts Eva Segelov, Craig Underhill and Hans Prenen have resisted an episode on COVID-19 because like the rest of Australia, they hoped we had escaped the worse of the pandemic. However in the last couple of weeks the situation has become much more difficult in Victoria, and dire in some places, particularly in nursing homes. We felt it was time for a special episode to bring you up to date with the latest literature on COVID-19 and cancer.
“There is confirmation bias going on and false attribution of source of infection,” Professor Raina MacIntyre.
Our format is a little different this week as Eva gets us started with a very special interview with Professor Raina MacIntyre, one of the world leading authorities on pandemics who shares some important insights on COVID-19. Raina and Eva’s discussion is wide-ranging, covering healthcare worker infections, predictions for how long lockdowns will last, vaccines, mask wearing, ‘Super-Spreaders’ and much more.
Regarding healthcare workers who have been infected, Raina presents her own data and analysis, noting; “there is confirmation bias going on and false attribution of source of infection – its a really important issue because its not just about healthcare workers dying or getting ill and facing the long term sequelae of this infection, but its also about the furloughing of huge numbers of healthcare workers who need to be quarantined”.
“We are going to be playing a start-stop, start-stop game with periods of normality and periods of restriction until we can vaccinate people,” Professor Raina MacIntyre
This interview will be of broad interest, not just to those working in healthcare so we encourage you to share this episode with family and friends so we can spread these important messages as widely as possible.
In the second half, Hans gives us the European perspective with papers from Belgium, Italy and Spain. Craig shares some insights from the UK and Eva also gives us some COVID Quick Bites.
“A ‘Super-Spreading’ phenomenon has been observed – some people say that 20% of people are responsible for 80% of the transmissions. In those people, its probably a combination of both host factors as well as environmental factors. The ‘Super-Spreaders’ may also have innate host factors that make them shed virus much, much more than other people and be much more infectious,” Professor Raina MacIntyre
This Week’s Team:
Special Guest: Professor Raina MacIntyre
Professor Raina MacIntyre is NHMRC Principal Research Fellow and Professor of Global Biosecurity. She heads the Biosecurity Program at the Kirby Institute, which conducts research in epidemiology, vaccinology, bioterrorism prevention, mathematical modelling, genetic epidemiology, public health and clinical trials in infectious diseases.
Her research falls under 4 areas: Personal protective equipment, Vaccinology, Epidemic response and emerging infectious diseases, and Bioterrorism prevention. She is a dual-specialist physician with training in epidemiology and modelling. Her research is underpinned by her medical training, vaccine program experience and extensive field outbreak investigation experience.
She is best known for research in the detailed understanding of the transmission dynamics and prevention of infectious diseases, particularly respiratory pathogens such as influenza, tuberculosis, bioterrorism agents and vaccine-preventable infections. She has led the largest body of research internationally on face masks and respirators in health care workers. Her research has been influential in informing guidelines for health workers on PPE.
She is involved in several research studies on COVID-19. She leads Biosecurity in Global Security PLuS and is interested in emerging threats to health security. She also designed and co-convenes a course, Bioterrorism and Health Intelligence, taken by students at UNSW and ASU.
Professor Eva Segelov
Professor Eva Segelov is a Medical Oncologist and is Director of Oncology at Monash University and Monash Health, Melbourne, Victoria, previously Senior Medical Oncologist at St Vincent’s Hospital, St Vincent’s Private Hospital and St Vincent’s Clinic and Associate Professor of Medicine, University of New South Wales.
Eva has an interest in academic clinical trials in GI and breast cancer and has been a member of the AGITG since 2003. She has clinical trials expertise, links with national and international trials groups, and extensive experience with adult medical education.
Professor Hans Prenen
Professor Hans Prenen is a medical oncologist and head of the phase 1 – early clinical trials unit at the Antwerp University Hospital in Belgium. He is a member of several scientific organisations, published many scientific oncology papers in prestigious journals and is regularly invited for lectures at national and international meetings. His interests are clinical trials and translational research with a focus on digestive oncology.
Dr Craig Underhill
Dr Craig Underhill completed his Bachelor of Medicine and Surgery in 1987 at Melbourne University. He completed medical oncology training in Melbourne and worked as the Senior Clinical Research Registrar at Guy’s Hospital, London.
In 1998 arrived in Albury-Wodonga and established a medical oncology practice and clinical trials unit which has developed expertise and infrastructure to ensure the initiation of high quality trials. The research Unit lead by Dr Underhill has twice been awarded NSW Premier’s Award for Innovation in Cancer Clinical Trials, the inaugural award in 2009 and then again in 2012.
Dr Underhill chaired a working party that was instrumental in securing $65 million in federal funding for The Albury Wodonga Regional Cancer Centre which opened in September 2016.
Dr Underhill is the VCCC Regional Oncology Lead and advocates for the increased access to clinical trials for regional Victorians and leads the VCCC teletrials program.
Rachael Babin is Editor-in-Chief of The Oncology Newsletter and Publisher of www.oncologynews.com.au. For regular oncology updates for healthcare professionals, please subscribe to The Oncology Newsletter.
This Week’s Papers:
The COVID-19 Guildines:
Segelov, Eva., Underhill, Craig., Prenen, Hans., MacIntyre C. Raina., et al. Practical Considerations for Treating Patients With Cancer in the COVID-19 Pandemic. JCO Oncology Practice. Published online May 13, 2020. Access online here.
- Steensels D, et al. Hospital-Wide SARS-CoV-2 Antibody Screening in 3056 Staff in a Tertiary Center in Belgium [published online ahead of print, 2020 Jun 15]. JAMA. 2020;324(2):195-197. doi:10.1001/jama.2020.11160. Access online here.
- García IS, et al. SARS-CoV-2 infection among healthcare workers in a hospital in Madrid, Spain [published online ahead of print, 2020 Jul 20]. J Hosp Infect. 2020;S0195-6701(20)30351-0. doi:10.1016/j.jhin.2020.07.020 Access online here.
- Porru S, Carta A, Monaco MGL, et al. Health Surveillance and Response to SARS-CoV-2 Mass Testing in Health Workers of a Large Italian Hospital in Verona, Veneto. Int J Environ Res Public Health. 2020;17(14):E5104. Published 2020 Jul 15. doi:10.3390/ijerph17145104. Access online here.
- Russell, Beth et al. Factors Affecting COVID-19 Outcomes in Cancer Patients: A First Report From Guy’s Cancer Center in London. Oncol., 22 July 2020 | Access online here.
- Maringe, Camille et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. The Lancet Oncology, Published:July 20, 2020DOI: Access online here..
- Sud, Amit et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. The Lancet Oncology. Published:July 20, 2020DOI: Access online here..
- Poggio, Francesca. Assessing the Impact of the COVID-19 Outbreak on the Attitudes and Practice of Italian Oncologists Toward Breast Cancer Care and Related Research Activities. JCO Oncology Practice. Published online June 23, 2020. Access online here.
- Waterhouse, David, M et al. Early Impact of COVID-19 on the Conduct of Oncology Clinical Trials and Long-Term Opportunities for Transformation: Findings From an American Society of Clinical Oncology Survey. JCO Oncology Practice 16, no. 7 (July 01, 2020) 417-421. Access online here.
- Gyawali B, Poudyal BS, Eisenhauer EA. Covid-19 Pandemic—An Opportunity to Reduce and Eliminate Low-Value Practices in Oncology? JAMA Oncol. Published online July 02, 2020. doi:10.1001/jamaoncol.2020.2404 Access online here.
- Curigliano, Giuseppe. Cancer Patients and Risk of Mortality for COVID-19. Cancer Cell. Published:July 25, 2020 DOI: Access online here.
- Marandino, Laura et al. COVID-19 Emergency and the Need to Speed Up the Adoption of Electronic Patient-Reported Outcomes in Cancer Clinical Practice. JCO Oncology Practice 16, no. 6 (June 01, 2020) 295-298. Published online May 01, 2020. DOI: 10.1200/OP.20.00237. Access online here.
Please forgive Eva’s sound quality in places – she is recording remotely from lockdown in Victoria in less than ideal circumstances.
With thanks to Eva Segelov, Craig Underhill, Hans Prenen, Raina McIntyre and Graham Knowles.