ABSTRACT
The 2019 novel coronavirus (COVID-19) pandemic has created significant challenges to the delivery of care for patients with advanced head and neck cancer requiring multimodality therapy. Performing major head and neck ablative surgery and reconstruction is a particular concern given the extended duration and aerosolizing nature of these cases. In this manuscript, we describe our surgical approach to provide timely reconstructive care and minimize infectious risk to the providers, patients, and families.
Subject(s)
Coronavirus Infections/epidemiology , Disease Transmission, Infectious/prevention & control , Head and Neck Neoplasms/surgery , Outcome Assessment, Health Care , Pandemics/statistics & numerical data , Plastic Surgery Procedures/methods , Pneumonia, Viral/epidemiology , Academic Medical Centers , COVID-19 , Clinical Decision-Making , Coronavirus Infections/prevention & control , Female , Head and Neck Neoplasms/pathology , Humans , Interdisciplinary Communication , Male , Neck Dissection/methods , Occupational Health , Pandemics/prevention & control , Patient Safety , Patient Selection , Pennsylvania , Pneumonia, Viral/prevention & control , Postoperative Care/methods , Preoperative Care/methods , Risk Assessment , Surgical Flaps/transplantationABSTRACT
BACKGROUND: In the context of COVID-19, cancer survivors represent a particularly vulnerable population that may be "doubly hit" by both costs of cancer treatment and financial strain imposed by the pandemic. METHODS: We performed a review of the literature pertaining to cancer, financial toxicity, and economic challenges. RESULTS: Multiple societies have put forth recommendations to modify delivery of cancer care in order to minimize patient exposure to the virus. Cancer survivors, especially patients with head and neck cancer, have been disproportionately affected by rising unemployment levels and economic recessions in the past, both of which are linked to higher cancer mortality. Patients who rely on employer-provided insurance and do not qualify for Medicaid may lose access to life-saving treatments. CONCLUSIONS: It is essential to implement interventions and policy changes in order to mitigate the effects of this pandemic but also to ensure this becomes a nonissue during the next one.