The COVID-19 pandemic has impacted multiple aspects of oncology, including patient care, research, continuing medical education (CME), and cancer care providers' psychological well-being, according to survey data presented today at the European Society of Medical Oncology (ESMO) Virtual Congress 2020.
"The ongoing SARS-CoV-2 pandemic and ensuing coronavirus disease (COVID-19) is challenging cancer care and services worldwide," report the investigators, led by Guy Jerusalem, MD, PhD, Head of Medical Oncology and Director of the Breast Clinic at the Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium.
In order to evaluate the pandemic's impact on the organization of oncological care, 20 oncologists from 10 of the countries most affected by the pandemic distributed the 95-item survey worldwide. The survey was completed by 109 representatives from oncology centers, 62.4% of which were academic hospitals, in 18 countries.
Various COVID-related precautions were taken at the different centers. COVID-19 swab or gargle tests were systematically performed before day care unit admission in 27.5% of the centers and prior to admission for overnight stay in 58.7% of the centers. A local registry of infected patients was implemented by 64.2% of centers, and 77.1% of centers implemented systematic tracing of infected patients.
Most respondents (60.9%) reported a reduction in clinical activity at their centers during the height of the pandemic. Cancellations or delays were seen most frequently for surgical procedures, affecting care in 44.1% of centers, and for chemotherapy, affecting care in 25.7% of centers. Earlier cessation of palliative care took place in 32.1% of centers. Nearly two-thirds of survey respondents (64.2%) saw undertreatment as a major concern.
Use of telemedicine was very common: during the height of the pandemic, teleconsultations were used for follow-up in 94.5% of centers, for oral therapy in 92.7%, for immunotherapy in 57.8%, and for chemotherapy in 55%. Most survey respondents (around 82%) planned to continue to use telemedicine.
The pandemic has had a distinct impact on professional development and interprofessional communication. Most respondents (82%) reported increased use of virtual tumor boards, and 92% reported virtual oncological team meetings. However, 45% felt that virtual meetings were not an acceptable alternative to live international meetings.
Research has also been impacted by the pandemic. Despite the reported drop in clinical activity during the pandemic's peak, only 28.4% of respondents indicated increased scientific activity during this time. Major violations to or deviations from study protocol were observed in 27.5% of centers, and 37% of centers expect significant reductions in clinical trial activity during this year. However, all clinical trial activities are or will soon be reactivated in 72.5% of centers.
Survey results indicated that there was some level of psychological impact from the pandemic on cancer care professionals; 18% of respondents estimated that their well-being would not recover to previous levels by the end of the year. Most respondents (63%) indicated that they had easily accessible psychological support services, but only 10% used or planned to use these services.
"COVID-19 has a major impact on organization of patient care, well-being of caregivers, continued medical education, and clinical trial activities in oncology," conclude Dr. Jerusalem and colleagues.
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Image credit: National Institute of Allergy and Infectious Diseases