Radiation Therapists' role in COVID-19 testing: Detecting asymptomatic carriers during Ontario's Omicron BA.2 wave

In November 2021, the highly transmissible Omicron BA.2 variant led to a surge in demand for COVID-19 testing within Ontario's cancer care system, overwhelming established testing clinics and delaying radiation therapy (RT) start dates. To address this, a small team of Radiation Therapists (RTTs) was trained to conduct nasopharyngeal swabs (NPS) on the same day as CT simulation for eligible patients.

This single-centre quality improvement project, approved by the institution, involved collecting data on patient demographics, RTT swab clinic throughput, and test outcomes via a retrospective chart review. An online questionnaire gathered insights from RTTs about their experiences, and training procedures were documented.

An urgent medical delegation was obtained from the hospital's Office of Medical Directives, and eight RTTs were trained to perform NPS. Over 4.5 months, 402 new RT patients were swabbed. The positivity rate for asymptomatic patients was 2%. None of the patients with negative NPS results developed symptoms or tested positive during the Omicron incubation period. Initiation of the RTT swab clinic significantly reduced the decision-to-treat to treat time (p = 0.01). All involved RTTs felt the initiative enhanced patient and staff safety.

RTTs successfully and safely performed NPS on the same day as CT simulation, helping identify asymptomatic COVID-19 patients before starting RT. This approach minimized exposures to asymptomatic cases, prevented treatment delays, and reduced the radiobiological risks associated with COVID-related RT interruptions.