ABSTRACT
The first confirmed case of coronavirus disease 2019 (COVID-19) in Latin America was reported on February 25th,2020, in Brazil. As COVID19 disease incidence escalated in the country, management of cancer patients requiredimmediate action and oncology clinics were urged to establish a contingency plan. We were the first oncology clinicin Brazil to install a COVID-19 Management Committee to elaborate and implement best practices to assist canceroutpatients as well as to provide a safe environment for clinical staff and other employees at the outpatient clinics.We started monitoring our staff and employees on March 13th, a day after we installed a contingency plan forCOVID-19 management and WHO declared COVID-19 a pandemic. So far, out of 1,022 staff and employees of ourgroup, we have registered 12.3% suspected and 3.8% confirmed COVID-19 cases, and only 1 case severe enoughto require hospitalization. As COVID-19 testing is not widely available, not all patients were tested and/or we did nothave access to results, as tests might have been conducted somewhere other than the clinic. Out of 98 patients withsuspected COVID-19 being monitored by SCIA (ranging from 29 to 90yo), 68% were tested and 43% of these werepositive. As for the monitored population (n=98), 62.6% were undergoing treatment, 31.8% tested positive, and9.9% died due to COVID-19 (31% of the confirmed cases, matching literature data). All deaths by COVID-19 (n=9)occurred in patients above 68yo, and 77% (n=6) were undergoing cancer treatment. To the best of our knowledge, this is the first report of COVID-19 incidence in cancer patients in Brazil. The challenges of cancer treatment in themidst of a global pandemic highlight the importance of a rapid response by institutions, where organizationalstructure, strategic planning, agility in guidelines implementation, and alternative ways to protect and support clinicalstaff, employees, and patients may be the keys to mitigate pandemic effects.