Reference no: EM132676561

Bruce is a 47-year-old man, who decides he needs to visit his doctor due to some gastrointestinal symptoms. At first it just started out as a bit of abdominal pain and cramping, followed by diarrhea so at first Bruce just thought he had a stomach bug. But weeks went by and the diarrhea just increased in frequency, and instead of feeling better, he started to feel really fatigued. This has been going on for 8 months before his wife finally convinced him to make an appointment with a doctor, who then referred him to a gastroenterologist. A couple of months later when he finally goes to his specialist appointment, Bruce admits after questioning that he has had bleeding with his stool but he didn't want to tell the doctor as he was embarrassed and didn't want to get checked for hemorrhoids. The gastroenterologist also asks many questions about Bruce's diet and his weight and discovers that Bruce has lost 15 kg in the past year despite eating a lot of hot chips and mashed potatoes - the only thing Bruce feels doesn't make his diarrhea worse. The gastroenterologist then tells Bruce he would like to perform a colonoscopy to investigate further.

After the colonoscopy, the surgeon tells Bruce that they found a number of polyps in his bowel which is not necessarily a cause for concern as many polyps are benign, but they will have to wait on the results of the biopsies to make sure none of them were malignant. A week later the surgeon calls Bruce, unfortunately it is bad news - the biopsy shows evidence that the growth is malignant and anaplastic and that they can't rule out metastatic growths. Bruce is called back in for follow-up tests, and they find that there is an abnormal growth in his liver also.

Bruce is now sent to an oncologist, who recommends that he has surgery to remove any remaining polyps, a small portion of his bowel, and the abnormal growth from his liver. Based on the advice from his oncologist, Bruce also decides to undergo chemotherapy treatment. Whilst doing some routine checks after his treatment, Bruce is informed he has neutropenia.

Question

Discuss two measures that may minimize Bruce's chances of contracting coronavirus. In your answer, identify two different links in the chain of infection that can be broken, and explain how they are broken.