Impact of the covid-19 pandemic on lung cancer referraland treatment

Background: UK restrictions during covid-19 impacted lung cancer care including referrals into secondary care. Aim(s): (1) document pattern of referrals to this semi-rural Trust, (2) evidence any later presentation of disease, and(3) report impact on treatment. Method(s): Data was collected retrospectively and analysed for pre-covid, lockdown/restriction period, and post-relaxation of rules. Non-parametric data were analysed by chi square (X2) analysis for trend. Result(s): Fall in referrals pivoted on the initial UK peak in 2020 with a slow recovery in two week wait referrals post-lockdown (43%, previously 60%). Table 1 shows distribution in disease stage negatively skewed (all >2.46) with themajority at stage 4. Trend showed no statistical difference in stage with X2 (df 6, n=792, = 3.831, p=.6995) andsimilarly when re-analysing earlier stages. Treatment outcome shows non-significant trends to increased palliativecare (28 to 35%) and radiotherapy (10 to 18%), with less chemotherapy (25 to 21%) or surgery (26 to 15%). Conclusion(s): Locally, lung cancer diagnosis numbers have been maintained, with a similar stage at presentation but a change in referral pattern favouring emergency/upgraded presentation may signal reduced access to primary care.

Refugee protection in the covid-19 crisis and beyond: The capacity and limits of international law

The current pandemic and concomitant framework of crisis has led to unprecedented restrictions on global movement, and hence on the ability of refugees to seek protection. These measures have been implemented as a matter of urgency on account of the immediacy of the public health challenge, yet risk violating international refugee and human rights law. This experience provides an opportunity to reflect on an equally compelling, although less imminent, threat, namely displacement linked to the impacts of climate change. This article considers these twin challenges and reflects on the capacity and limits of international law to address both crises, while balancing the competing rights and interests at stake. It argues that a key challenge for international law and policy is how to harness the sense of urgency generated by COVID-19 for the long-term ‘climate crisis’, without resorting to emergency mechanisms of reactive, short-term, restrictive, and exceptional measures. © 2021, University of New South Wales Law Journal. All rights reserved.