IMPACT OF COVID-19 ON CANCER CARE

The Corona Virus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has signicantly changed health care delivery to cancer patients. We have reviewed the available literature on COVID-19 to provide comprehensive information about the impact on the delivery of health care in Cancer Care Facility and adaptations in oncological services. We carried out a literature search in English language using online databases PubMed, Up To Date and Embase with keywords: ‘COVID-19’, ‘coronavirus’ and ‘SARS-CoV-2’, ‘cancer’ from January 2020 to 30th June 2020 focusing on cancer care and different strategies to continue surgical services to cancer patients. Here, we have summarized all currently available information regarding the global impact on the delivery of surgical oncological care and adaptations in Cancer Treatment Protocols due to COVID-19 disease.

Download Full-text

Caring in Cancer Patient during Covid-19 Pandemic: A literature review

JURNAL PENDIDIKAN KEPERAWATAN INDONESIA ◽

10.17509/jpki.v6i1.24635 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Nurul Huda

Keyword(s):

Literature Review ◽

Cancer Patients ◽

Nursing Care ◽

Cancer Care ◽

Care Delivery ◽

Nursing Workforce ◽

Safe Delivery ◽

Oncology Nurse ◽

Corona Virus ◽

The Impact

ABSTRACTDuring this Coronavirus disease-19 (Covid -19) Pandemic, the challenges for appropriate and safe delivery nursing care is becoming main concerns since cancer patients are at high risk to be infected. Oncology nurse must reassure that the patients still get the optimal treatment while in other part they have to keep their patients safe. However, the change of provision of care in order to protect cancer patients must pay more attention. The aim of this paper was to review the literature on both the impact of Covid 19 to the provision of cancer care and nursing workforce. The implications of these findings for cancer patients will also be discussed. The electronic Science direct, Googlescholar and Pubmed databases were used to identify relevant articles. A combination of keywords: cancer, care, Corona virus 19, Covid-19 and Pandemic were used to identify relevant articles. Ten articles were included in the review. The broad issues were the impact of Covid 19 on nursing delivery care and the impact to the workforce. In terms of cancer care delivery, the Oncology teams are adopting new ways to minimise the risk of Covid 19 to the patients and their staff while at the similar times they have to reassure that the patients get the optimum care. Triage patients, adjusting treatment and limitation of visitor’s access to the patients is kind of changes that could do. A serious shortage and the availability of personal protective equipment are the major concern in nursing workforce changes during this pandemic. Planning or resuming cancer treatment and screening to mitigate the risk is the most important way to get the best outcomes. Hence, nurse has been pushed to adapt quickly and give their optimum nursing care to patients as well as protect themselves from cross infectionABSTRAKSelama masa pandemi Coronavirus 19, tantangan terhadap pemberian asuhan keperawatan pada pasien kanker menjadi perhatian utama. Hal ini dikarenakan, pasien kanker adalah pasien dengan resiko tinggi tertular infeksi. Perawat oncology harus memastikan bahwa pasien yang mereka rawat tetap mendapatkan perawatan yang optimal walaupun disisi lain mereka harus menjaga keamanan pasien. Oleh karena itu perubahan cara layanan dalam rangka melindungi pasien harus menjadi fokus tersendiri. Tujuan dari artikel ini adalah melakukan literature review tentang impact Covid 19 terhadap layanan pasien kanker dan lingkungan kerja di unit kerja keperawatan. Aplikasi dari temuan juga didiskusikan di artikel ini. Electronic data base seperti Science Direct, Googlescholar dan Pubmed digunakan untuk mencari artikel yang berhubungan. Kombinasi dari kata kuci : cancer, care, Corona virus 19, Covid-19 and Pandemic digunakan untuk telusur artikel. 10 artikel terseleksi. Isu utama yang didapatkan adalah efek dari Covid 19 terhadap cara pemberian asuhan keperawatan dan perubahan yang terjadi dalam lingkungan tenaga kerja. Dalam hal pemberian asuhan keperawatan diketahui bahwa team oncology mengadopsi cara baru untuk mencegah penyebaran Covid-19 kepada pasien dan staff dengan melakukan triage, menunda atau menyesuaikan treatment dan membatasi akses pengunjung ke pasien. Kekurangan tenaga kerja dan ketersediaan alat pelindung diri menjadi issue utama dalam ketenagakerjaan di area keperawatan selama masa pandemi. Merencanakan atau meresume kembali asuhan yang diberikan dan melakukan screening untuk mitigasi resiko infeksi merupakan salah satu cara yang paling naik untuk pelayanan yang terbaik. Oleh karena itu perawat harus bisa beradatasi secara cepat terhadap perubahan dan memberikan pelayanan keperawatan yang optimum dengan tidak melupakan perlindungan diri terhadap diri mereka sendiri dari infeksi silang.

Download Full-text

Spotlight on International Quality: COVID-19 and Its Impact on Quality Improvement in Cancer Care

JCO Global Oncology ◽

10.1200/go.21.00281 ◽

2021 ◽

pp. 1513-1521

Author(s):

Douglas W. Blayney ◽

Giovanni Bariani ◽

Devika Das ◽

Shaheenah Dawood ◽

Michael Gnant ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

United Arab Emirates ◽

Health Care Providers ◽

Cancer Care ◽

Care Delivery ◽

Global Scale ◽

The Philippines ◽

Care Providers ◽

The Impact

This report from ASCO's International Quality Steering Group summarizes early learnings on how the COVID-19 pandemic and its stresses have disproportionately affected cancer care delivery and its delivery systems across the world. This article shares perspectives from eight different countries, including Austria, Brazil, Ghana, Honduras, Ireland, the Philippines, South Africa, and the United Arab Emirates, which provide insight to their unique issues, challenges, and barriers to quality improvement in cancer care during the pandemic. These perspectives shed light on some key recommendations applicable on a global scale and focus on access to care, importance of expanding and developing new treatments for both COVID-19 and cancer, access to telemedicine, collecting and using COVID-19 and cancer registry data, establishing measures and guidelines to further enhance quality of care, and expanding communication among governments, health care systems, and health care providers. The impact of the COVID-19 pandemic on cancer care and quality improvement has been and will continue to be felt across the globe, but this report aims to share these experiences and learnings and to assist ASCO's international members and our global fight against the pandemic and cancer.

Download Full-text

The COVID-19 Pandemic: Role of Supportive Care in Cancer Patients

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.s1.259-261 ◽

2021 ◽

Vol 5 (S1) ◽

pp. 259-261

Author(s):

Wasimul Hoda ◽

Sachidanand Jee Bharati ◽

Abvinav Kumar ◽

Sanjay Kumar ◽

Chandrashekhar Choudhari ◽

...

Keyword(s):

Supportive Care ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Care ◽

Virus Disease ◽

Healthcare Resources ◽

Corona Virus ◽

Difficult Time ◽

Basic Minimum

Cancer care is adversely affected by the corona virus disease 2019 (COVID-19). Due to increasing number of COVID-19 cases, all healthcare resources are diverted to take care of COIVD-19 patients. This is the most difficult time for cancer patients because cancer treatment is getting delayed or interrupted due to COVID-19. In this tough time, the supportive care can be continued with basic minimum resources and can provide a big relief to cancer patients.

Download Full-text

Risk Factors and Clinical Outcomes of Cancer Patients with Clostridium difficile Associated Diarrhea Co-infected with a Second Enteropathogen

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.881 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S362-S363

Author(s):

Harika Yalamanchili ◽

Andrew Chao ◽

Eduardo Yepez Guevara ◽

Samuel L Aitken ◽

Micah Bhatti ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Cancer Patients ◽

Clinical Symptoms ◽

Care Facility ◽

Health Care Facility ◽

Exact Test ◽

Increased Risk ◽

Clostridium Difficile Associated Diarrhea ◽

The Impact

Abstract Background Cancer patients are at an increased risk for C. difficile infection (CDI) which is often identified along with other enteropathogens. The impact of co-infections on outcomes has not been established in this population. We compared the risk factors and clinical characteristics of patients with CDI monoinfection (CDIM) and patients coinfected with bacterial (CDIB) or viral (CDIV) enteropathogens. Methods Adult patients presenting with primary or recurrent CDI (n = 88) identified on a two-step GI multiplex assay (Biofire) followed by toxin A/B EIA, were classified into CDIM (n = 66), CDIB (n = 12), and CDIV (n = 10) groups. Demographic and clinical data were collected and risk factors and outcomes compared by Fisher’s exact test, ANOVA, and the Kruskal–Wallis test. CDI severity was determined using Zar’s criteria, presence of bacteremia, and ICU stay. Results During the study period, 2,017 diarrheal samples were submitted to the microbiology laboratory. An enteric pathogen was identified in 311 (15%) patients. CDI was identified in 88 cases of which 22 (25%) had a second pathogen. CDIM was found in 66 (21%), CDIB in 12 (4%), and CDIV in 10 (3%) subjects. The most common co-pathogens identified were diarrheagenic E. coli in the CDIB group (9/12, 75%) and norovirus in the CDIV group (8/10, 80%). Groups were similar in terms of demographics, number of recurrences, health care acquisition, co-morbidities, disease severity, serum creatinine at presentation, presence of toxin by EIA, and mortality. Patients with CDIM were more likely to have a recent hospitalization than the CDIB group (44/66 67% vs.. 3/12 25%, P = 0.01). Clinical symptoms at presentation were similar for the three groups except for nausea which was more common in the CDIV group when compared with CDIM (8/10, 80% vs. 25/66, 38%; P = 0.02). The use of proton pump inhibitors was similar in the three groups. There was however, a higher proportion of patients taking GABA-like drugs within 90 days among the CDIB patients (10/12, 83%) than the group with CDIM (26/66, 40%) P = 0.01. Conclusion In CDI cancer patients, co-infection with other enteropathogens is common. Patients with CDIB were less likely to have a recent admission to a health care facility. The use of GABA-like drugs was associated with a higher risk of bacterial co-infection. Disclosures All authors: No reported disclosures.

Download Full-text

Cancer Care in the Wake of a Cyberattack: How to Prepare and What to Expect

JCO Oncology Practice ◽

10.1200/op.21.00116 ◽

2021 ◽

pp. OP.21.00116

Author(s):

Steven Ades ◽

Diego Adrianzen Herrera ◽

Tim Lahey ◽

Alissa A. Thomas ◽

Sakshi Jasra ◽

...

Keyword(s):

Health Care ◽

Cancer Care ◽

Health Care Organizations ◽

Care Delivery ◽

Diagnostic Testing ◽

Local Treatment ◽

Transitions Of Care ◽

Treatment Modalities ◽

The University ◽

The Impact

PURPOSE: Cyberattacks targeting health care organizations are becoming more frequent and affect all aspects of care delivery. Cancer care is particularly susceptible to major disruptions because of the potential of immediate and long-term consequences for patients who often rely on timely diagnostic testing and regular administration of systemic therapy in addition to other local treatment modalities to cure or control their diseases. On October 28, 2020, a cyberattack was launched on the University of Vermont Health Network with wide-ranging consequences for oncology, including loss of access to all network intranet servers, e-mail communications, and the electronic medical record (EMR). METHODS: This review details the immediate challenges faced by hematology and oncology during the cyberattack. The impact and response on inpatient, outpatient, and special patient populations are described. Steps that other academic- and community-based oncology practices can take to lessen the brunt of such an assault are suggested. RESULTS: The two areas of immediate impact after the cyberattack were communications and lack of EMR access. The oncology-specific impact included loss of the individualized EMR chemotherapy plan templates and electronic safeguards built into multistep treatment preparation and delivery. With loss of access to schedules, basic patient information, encrypted communications platforms and radiology, and laboratory and pharmacy services, clinical outpatient care delivery was reduced by 40%. The infusion visit volume dropped by 52% in the first week and new patients could not access necessary services for timely diagnostic evaluation, requiring the creation of command centers to oversee ethical and transparent triage and allocation of systemic therapies and address new patient referrals. This included appropriate transfer of patients to alternate sites to minimize delays. Inpatient care including transitions of care was particularly challenging and addressing patient populations whose survival might be affected by delays in care. CONCLUSION: Oncology health care leaders and providers should be aware of the potential impact of a cyberattack on cancer care delivery and preventively develop processes to mitigate the impact.

Download Full-text

Socio-Cultural and Economic Impact of Corona Virus on Cancer Patients, Caregivers and Survivors

Asian Pacific Journal of Cancer Care ◽

10.31557/apjcc.2020.5.s1.171-173 ◽

2020 ◽

Vol 5 (S1) ◽

pp. 171-173

Author(s):

Wasimul Hoda ◽

Sachidanand Jee Bharati ◽

Abhinav Kumar ◽

Priyanka Choudhary ◽

Abhishek Shankar

Keyword(s):

Mental Health ◽

Health Care ◽

Cancer Patients ◽

Health Care Workers ◽

Virus Disease ◽

Economic Aspects ◽

Healthcare Resources ◽

Corona Virus ◽

Care Workers ◽

To Come

Corona Virus Disease -19 (COVID-19) pandemic has a widespread impact on social, cultural and economic aspects of life. It has affected cancer patients in a big way because with onset of COVID-19 pandemic, the healthcare resources were diverted to handle Corona virus infection. The cancer patient, their caregivers and healthcare professional are in dilemma of whether to continue the treatment or stop it for some time till COVID-19 infection settled down. The long-lasting effect of COVID-19 pandemic on socio-economic and mental health of cancer patients and health care workers will emerge in times to come. It is important that a tight balance be made between cancer treatment and its interruption due to COVID-19.

Download Full-text

Patient concerns and disruptions in cancer care during the COVID-19 pandemic.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18716 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18716-e18716

Author(s):

Erica E. Fortune ◽

Jemeille Ackourey ◽

Thomas William LeBlanc ◽

Heather Badt ◽

Alexandra Katherine Zaleta

Keyword(s):

Health Care ◽

Cancer Patients ◽

Cancer Care ◽

Care Quality ◽

Supportive Services ◽

Substantial Impact ◽

Cancer Relapse ◽

Medical Needs ◽

The Impact ◽

First Time

e18716 Background: The COVID-19 pandemic has uniquely impacted the lives of people with cancer, but the specifics of these impacts are not fully understood. We examined: 1) the impact of COVID-19 on cancer-related health care, and 2) patients’ most prominent COVID-related concerns. Methods: From Sept-Dec 2020, 502 cancer patients completed an online survey about disruptions in cancer-related health care (types and causes of disruptions and length of health care delays). COVID-related concerns (e.g., accessing basic and medical needs, financial concerns, psychosocial impact) were assessed via 25 items rated not at all to extremely concerning, or not applicable. Group differences were examined with Pearson Chi-Square. Sample: 75% women, 82% White, age range 20-88 years (M = 60, SD = 12.1); 61% in remission, 16% experiencing cancer relapse, 13% experiencing cancer for the first time; current stage: 40% metastatic, 25% localized, 35% no stage/don’t know; time since diagnosis range 0-36 years (M = 8.8, SD = 7.0); primary cancer diagnoses: 29% breast, 27% blood cancers, 6% prostate, 5% lung, 5% colorectal, and 28% other; 47% currently in treatment. 49% were tested for COVID-19, 3% tested positive. Results: 40% (n = 200) reported a disruption in cancer-related health care: of these, 34% reported disruption in imaging services, 30% lab service, 26% routine screening, 25% supportive services, 12% treatment session (including 46% chemotherapy, 13% radiation, 13% hormone therapy, 4% surgery), and 14% other disruption, with 10% reporting delay in cancer diagnosis. Nearly half with care delays reported a delay of 2-3 months (18%) or 3+ months (30%), with 3+ months delays occurring most often for routine screenings (40%) and supportive services (37%). Primary causes for disruptions included clinicians recommending the delay (46%) and patient fear of contracting COVID-19 via in person care (31%). The top 3 areas of COVID-19-related concerns ( somewhat to extremely concerned) were: 1) others not following safety recommendations e.g., wearing masks (85%), 2) getting COVID-19 due to a weakened immune system (76%), and 3) worrying about loved ones’ health (73%). Those in remission less frequently experienced delay in care (35%) than those with first time cancer (50%) or relapse (51%, χ2= 10.5, p < .05), and those in current treatment more frequently experienced delay in care (44%) than those not in treatment (36%, χ2= 3.5, p < .10). Conclusions: Findings highlight the substantial impact of COVID-19 on cancer care, across various forms of care needs and health services. Patients experiencing cancer for the first time, a cancer relapse, or those undergoing treatment reported high levels of delays, with many delays in excess of 3 months. Given the unique impact of COVID-19 to cancer patients, these results highlight opportunities for care service delivery improvements as the health care community navigates competing priorities of patient safety and care quality.

Download Full-text