The Prince Charles Hospital (TPCH) reports the rapid and comprehensive transition to an almost completely ’Virtual adult cystic fibrosis centre (ACFC)’ within a short period of time following the emergence of COVID-19 infections in Australia and first cases identified in Queensland.
This program highlights the multi-disciplinary innovations around outpatient care, management of pulmonary exacerbations, an on-line home exercise program through Facebook, medication provision, influenza vaccination, clinical trials and maintenance of the flow of information to the CF community.
It has also embedded COVID-19-driven innovations into clinical practice and these continue to evolve. Furthermore, the ACFC multidisciplinary team and the CF community have contributed substantially to the Queensland effort to contain COVID-19 by providing the ACFC ward with its state-of-the-art ventilation facilities for COVID-19 individuals and their families. Finally, the ACFC nursing staff with their intimate understanding of infection control practices have seamlessly taken on the running of the ACFC ward whilst seconded to COVID-19 in an exemplary fashion, under the leadership of a Clinical Nurse Consultant (CNC) and Coordinator of the CF service.
Responding to COVID-19—the experience of an adult cystic fibrosis centre
Summary
Aim
To develop and report the considerations and strategies introduced to counter the threat of COVID-19 infection in a geographically dispersed CF population living in Queensland, Australia. Relatively few COVID-19 infections had been described globally in people with cystic fibrosis (CF) in the early months of the COVID-19 pandemic, but people with CF and especially those with severe disease were theoretically at high risk of death. The challenges faced included the geographically dispersed CF population with 60% of the ACFC patient population living >200 km distant from TPCH, the complexity of the disease itself combined with a substantial and understandable level of anxiety in the CF community around COVID-19.
Benefits
The ACFC has been able to introduce innovations that we have now embedded into routine clinical care. The substantial increase in capacity for telehealth consultations using new videoconferencing platforms and ability to home monitor critically important objective measures such as lung function has transformed the CF service.
An additional major benefit has been the opportunity to videoconference into the patient’s home or workplace, which reduces the disruption to normal life and infinitely reduces the risks of cross-infection for CF patients who are high aerosol producers even with normal respiration.
Background
With potentially the most geographically dispersed cystic fibrosis population in the world, the Adult Cystic Fibrosis Centre (ACFC) at The Princes Charles Hospital cares for adult cystic fibrosis patients residing as far afield as the Northern Territory and Northern New South Wales. The ACFC had a limited telehealth program in place as the pandemic hit, and with the looming influenza season, the need to maintain clinical trials activity, the challenges of trans-state jurisdictions and keeping the CF population well-informed on rapidly changing clinical practices, the ACFC had to rapidly adapt.