ABSTRACT
Background: The pandemic has presented professional and personal challenges for the MO workforce. CAMO sought to examine the temporal effects of C19 on MOs and care practices across Canada. Methods: Three serial multiple-choice, web-based surveys were conducted in 2020 – from Mar 30th to April 4th (S1), May 6th to May 15th (S2) and Dec 10th to 18th (S3). The surveys were distributed by email to MOs identified through CAMO and the Royal College of Physicians and Surgeons directory (n=618). Participation was voluntary with no compensation. Descriptive analyses with frequency distributions are reported. Results: The timing for S1 and S3 coincided with the 1st and 2nd C19 waves in Canada. Response rates decreased slightly: 26% S1, 25% S2 and 20% S3. Per table, demographics were similar across surveys: majority of respondents were from a comprehensive cancer centre and in practice for < 15 years. Concerns regarding PPE access and C19 personal risk decreased over time. A high rate of telemedicine was observed in S1 but this notably decreased by S3, despite the 2nd wave. A similar decreasing trend was observed in the proportion of altered chemotherapy plans due to C19. Similar levels of anxiety, depression, lack of focus and concerns for personal wellness were maintained over time. In S3, respondents noted delayed cancer diagnoses and oncologist burnout as the top 2 post-pandemic challenges, and 87% believed their workload would increase. [Formula presented] Conclusions: As the pandemic continues, positive trends can be observed in concerns around PPE access and C19 risk. A high level of telemedicine adoption was observed early in the pandemic but is decreasing, and chemotherapy plans remained unchanged for most patients. Concerns regarding personal wellness remained high across all 3 surveys. Proactive strategies to support physician wellness, mitigate burnout and manage MO workload are needed. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
ABSTRACT
Background: The first case of COVID-19 (SARS-CoV-2, C19) was reported to Health Canada on Jan 25th, 2020.By March 18th, states of emergency were declared across multiple provinces. The pandemic has presentedprofessional and personal challenges for the medical oncology workforce and cancer care. Under the auspices ofthe Canadian Association of Medical Oncology (CAMO), we sought to examine the temporal effects of C19 onmedical oncologists and care practices across Canada. Methods: Two serial multiple-choice, web-based national surveys were conducted in 2020from March 30th toApril 4th (S1) and May 6th to May 15 , 2020 (S2). The surveys were distributed by email to medical oncologistsidentified through CAMO and the Royal College of Physicians and Surgeons Medical Oncology directory (n=618).Participation was voluntary with no compensation. Descriptive analyses with frequency distributions are reported. Results: A total of 157 completed responses were received for S1 and 159 responses for S2 (25% response rate).Demographics were similar between S1/S2: from comprehensive cancer centre (87%/86%), greater than 15 years inpractice (41%/46%), CAMO member (60%/65%). Moderate to extreme concern of C19 exposure decreased overtime for self (79%/54%), for family (82%/65%), and for patient (pt) (71%/54%). Routine use of PPE increased(67%/100%) with less concern around PPE access (69%/28%). Frequent anxiety (54%/32%) and depression(19%/14%) lessened while frequent lack of interest (18%/17%) and lack of focus (33%/31%) were unchanged. Useof telemedicine for >50% of pts remained high (82%/86%), and confidence in adequate health care access for ptsincreased (39%/59%). Centre accrual activity to clinical trials increased (46%/67%). Change in chemotherapy for>20% of pts was reported infrequently (33%/23%). Cancer prognosis and treatment benefit remained the primarydeterminant in treatment decision-making (rank score: 7.50/7.95) while resource access (6.19/5.68) and pt risk ofC19 (6.05/5.72) became less important. Conclusions: As the pandemic curve flattens and Canadian medical oncologists adjust to a new normal, positivetrends can be observed in concerns around C19 exposure, frequency of anxiety and depression, concerns aboutPPE access, confidence in health care access, and accrual to clinical trials. Chemotherapy plans remainedunchanged for the majority of pts. A high rate of early adoption of telemedicine was observed and maintained. Serialfollow-up is valuable to understand changing perceptions and practices.
ABSTRACT
Background: The covid-19 pandemic has presented unprecedented professional and personal challenges for the oncology community. Under the auspices of the Canadian Association of Medical Oncologists, we conducted an online national survey to better understand the impact of the pandemic on the medical oncology community in Canada. Methods: An English-language multiple-choice survey, including questions about demographics, covid-19 risk, use of personal protective equipment (ppe), personal challenges, and chemotherapy management was distributed to Canadian medical oncologists. The survey was open from 30 March to 4 April 2020, and attracted 159 responses. Results: More than 70% of medical oncologists expressed moderate-to-extreme concern about personally contracting covid-19 and about family members or patients (or both) contracting covid-19 from them. Despite that high level of concern, considerable variability in the use of ppe in direct cancer care was reported at the time of this survey, with 33% of respondents indicating no routine ppe use at their institutions and 69% indicating uncertainty about access to adequate ppe. Of the respondents, 54% were experiencing feelings of nervousness or anxiety on most days, and 52% were having feelings of depression or hopelessness on at least some days. Concern about aging parents or family and individual wellness represented the top personal challenges identified. The management of cancer patients has been affected, with adoption of telemedicine reported by 82% of respondents, and cessation of clinical trial accrual reported by 54%. The 3 factors deemed most important for treatment decision-making wereâ cancer prognosis and anticipated benefit from treatment,â risk of treatment toxicity during scarce health care access, andâ patient risk of contracting covid-19. Conclusions: This report describes the results of the first national survey assessing the impact of the covid-19 on Canadian medical oncologists and how they deliver systemic anticancer therapies. We hope that these data will provide a framework to address the challenges identified.