Overcoming the Emotional Toll of COVID-19 in Oncology

Allyson Ocean, MD

Social distancing, though critical in containing the spread of the novel coronavirus 2019 (COVID-19), has made it challenging to console patients with cancer who are dealing with the ramifications of the outbreak, explained Allyson Ocean, MD, adding that self-care is an important element of delivering proper patient care.

“We’re all dealing with such heavy stress and uncertainty in this situation, and it’s really hard,” said Ocean. “But, we are trained as healthcare providers to delve into these issues. We know how to find resources to make people better. We have to really take care of ourselves, so that we can [best] take care of our patients.”

In an interview with OncLive, Ocean, an associate attending physician, NewYork-Presbyterian Hospital, and associate professor of clinical medicine at Weill Cornell Medicine, discussed the emotional toll the virus has had on patients and practitioners and the importance of self-care and social distancing.

OncLive: Have you or a colleague treated a patient with COVID-19? What was your experience like?

Ocean: My experience with a patient who had COVID-19 was very upsetting and challenging. I didn't even know about it. I saw a gentleman who was about to turn 65 for a completion visit. He had just finished 6 months of chemotherapy for stage III colon cancer. I saw him at the end of February, and we talked about what he has to do to keep the cancer away—–how he has to eat well, exercise, not eat too much red meat, make sure his vitamin D intake is OK, [eat] nuts and all [these] lifestyle changes to increase his chance of cure. He told me he was looking forward to his 65^th birthday. [He was planning on having] a big party to celebrate the fact that he was done with chemotherapy. It was a really special visit, and we hugged. At that time, I really wasn't wearing personal protective equipment (PPE). [At that time], we didn't really know how bad this was going to get.

A few weeks later, his wife let us know that a couple days before she had called us, he had gone to another hospital with a cough and shortness of breath. He had extreme worsening of his condition within 24 hours and passed away. The day he was admitted [to the hospital] was on his 65^th birthday. I was so upset because all I could think about was how much he was looking forward to living well again. It was such a tragedy. It's a tragedy for everybody that has been taken from this virus. That was my experience with a patient who was presumed to have [COVID-19]. We don't actually know if he had [the virus] because it all happened too fast. I know he was tested; it was presumed to be a death related to COVID-19 complications. I'm lucky I didn't have, essentially, any exposure to him. [It’s now] several weeks later and I've been asymptomatic and haven't had any symptoms whatsoever. Since the beginning of March, we've been wearing PPE in our office. I use an N95 mask, and I wear a surgical mask on top of it. I also use gloves for every patient I see. I haven't had any exposure, other than that.

What is the biggest challenge you're facing in practice?

My challenge is trying to cope with the emotional problems patients are experiencing right now, and how to how to help them through it. It’s a very stressful and scary time. It’s hard not being able to comfort people by touching them and hugging them in person. [We have] face-to-face interactions over video, but it's not the same. It’s colder. People want that interaction and, and we don't have that. It’s really sad to see all these patients alone in the hospital alone without anybody from their own family to take care of them. It’s great that we have wonderful providers that are taking care of these patients, but it's just heartbreaking to hear these stories of people dying from COVID-19 in hospitals who can't say goodbye to their loved ones.

What advice would you give to your colleagues?

Everyone is scared, especially the people on the frontlines [who are afraid] of bringing [the virus] home to their family. Some of them have to be separated from their family while they're on the frontlines for months at a time, and that is really challenging. It's such a disruption of our normal lives. We need to figure out a way to work through these stressful times with self-care, whether it’s exercise, journaling, or meeting with a counselor. It could be having a Zoom “dance party” with your friends, whatever it is, just do something to release that stress.

Is there anything else you would like to emphasize?

I just want to tell people to keep on doing what they're doing in terms of social distancing. Don’t go out if you don't have to. There are so many people who are willing to buy groceries for others and deliver things for them. Just call. Call companies, such as FreshDirect or [other] food delivery companies. I bet they would get a delivery time for someone who's dealing with cancer; I have heard that it's very hard to get a delivery time for groceries now. One of my patients told me that he couldn’t get his food delivered. I said, “Call them and tell them what you're dealing with.” I was sure they would give him a time, and they did.

We really have to stay home and social distance. We're going to get through this. It looks like things are already starting to improve. In New York, we’re flattening the curve effectively because we are staying home. This is a horrific time with so much sadness, but as long as you stay home and practice social distancing, things will get better.