ABSTRACT
Purpose: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers.Methods: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era.Results: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by esophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3(18%) centres reported higher morbidity, while rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however 6 (37%) centres reported slightly higher mortality in the active Covid phase.Conclusion: Covid -19 pandemic resulted in significant reduction is new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid -19 exposure.
Subject(s)
COVID-19ABSTRACT
The United Nations (UN) 2030 Agenda for Sustainable Development sets out 17 Sustainable Development Goals (SDGs) to advance sustainable development globally, focusing on vulnerable and at risk regions. India has fully adopted the SDG framework and aligned its development priorities with the Global Goals;however, challenges remain in implementing the multifaceted framework in the context of such a large, culturally and economically diverse population. This has been brought into even starker relief since the advent of the COVID-19 pandemic. Accordingly, building resilience to future risks and recovering economic stability have been identified as key priorities by the Indian government. Here, Pramanik et al discuss the impacts of the COVID-19 lockdown and the Cyclone Amphan aftermath on delta dwellers and their livelihood, potential strategies to support livelihoods and food security in the face of continuing recurrent disruptions, and the consequences of the COVID-19 pandemic coupled with cyclone Amphan likely to affect progress toward achieving the SDGs at the local level.