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2.
J Cancer Res Ther ; 17(2): 551-555, 2021.
Article in English | MEDLINE | ID: covidwho-1268377

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID 19) is a zoonotic viral infection that originated in Wuhan, China, in December 2019. It was declared a pandemic by the World Health Organization shortly thereafter. This pandemic is going to have a lasting impact on the functioning of pathology laboratories due to the frequent handling of potentially infectious samples by the laboratory personnel. To deal with this unprecedented situation, various national and international guidelines have been put forward outlining the precautions to be taken during sample processing from a potentially infectious patient. PURPOSE: Most of these guidelines are centered around laboratories that are a part of designated COVID 19 hospitals. However, proper protocols need to be in place in all laboratories, irrespective of whether they are a part of COVID 19 hospital or not as this would greatly reduce the risk of exposure of laboratory/hospital personnel. As part of a laboratory associated with a rural cancer hospital which is not a dedicated COVID 19 hospital, we aim to present our institute's experience in handling pathology specimens during the COVID 19 era. CONCLUSION: We hope this will address the concerns of small to medium sized laboratories and help them build an effective strategy required for protecting the laboratory personnel from risk of exposure and also ensure smooth and optimum functioning of the laboratory services.


Subject(s)
COVID-19/diagnosis , Clinical Laboratory Services/organization & administration , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Tertiary Care Centers/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Clinical Laboratory Services/standards , Decontamination/methods , Decontamination/standards , Developing Countries , Disinfection/methods , Disinfection/organization & administration , Disinfection/standards , Hospitals, Rural/organization & administration , Hospitals, Rural/standards , Humans , India/epidemiology , Infection Control/standards , Medical Laboratory Personnel/organization & administration , Medical Laboratory Personnel/standards , Pandemics/prevention & control , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Specimen Handling/standards , Tertiary Care Centers/standards , Workforce/organization & administration , Workforce/standards
3.
Cancer Rep (Hoboken) ; 5(2): e1426, 2022 02.
Article in English | MEDLINE | ID: covidwho-1237412

ABSTRACT

BACKGROUND: Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis. AIM: This study described the factors contributing to treatment delays during the pandemic and their impact on disease progression. MATERIALS AND RESULTS: This retrospective cohort study was done in St. Luke's Medical Center, a private tertiary healthcare institution based in Metro Manila, Philippines, composed of two facilities in Quezon City and Global City. Patients with solid malignancy with ongoing systemic cancer treatment prior to the peak of the pandemic were identified. Clinical characteristics and treatment data were compared between those with delayed and continued treatments. Multivariate analysis was done to determine factors for treatment delays and association of delays with disease progression and Covid-19 infection. Of the 111 patients, 33% experienced treatment delays and 67% continued treatment during the pandemic. There was a higher percentage of patients on palliative intent who underwent treatment delay, and 64% of delays were due to logistic difficulties. Treatment delays were significantly associated with disease progression (p < .0001). There was no evidence of association between delay or continuation of treatment and risk of Covid-19 infection. CONCLUSIONS: There was no difference in Covid-19 infection between those who delayed and continued treatment during the pandemic; however, treatment delays were associated with a higher incidence of disease progression. Our findings suggest that the risks of cancer progression due to treatment delays exceed the risks of Covid-19 infection in cancer patients implying that beneficial treatment should not be delayed as much as possible. Logistic hindrances were also identified as the most common cause of treatment delay among Filipino patients, suggesting that efforts should be focused into assistance programs that will mitigate these barriers to ensure continuity of cancer care services during the pandemic.


Subject(s)
Antineoplastic Agents/therapeutic use , COVID-19/epidemiology , Neoplasms/drug therapy , Time-to-Treatment/statistics & numerical data , Adult , Aged , COVID-19/immunology , COVID-19/prevention & control , COVID-19/transmission , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Disease Progression , Female , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/immunology , Pandemics/prevention & control , Philippines/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
4.
Gynecol Oncol ; 162(1): 12-17, 2021 07.
Article in English | MEDLINE | ID: covidwho-1213578

ABSTRACT

OBJECTIVE: To compare gynecologic oncology surgical treatment modifications and delays during the first wave of the COVID-19 pandemic between a publicly funded Canadian versus a privately funded American cancer center. METHODS: This is a retrospective cohort study of all planned gynecologic oncology surgeries at University Health Network (UHN) in Toronto, Canada and Brigham and Women's Hospital (BWH) in Boston, USA, between March 22,020 and July 302,020. Surgical treatment delays and modifications at both centers were compared to standard recommendations. Multivariable logistic regression was performed to adjust for confounders. RESULTS: A total of 450 surgical gynecologic oncology patients were included; 215 at UHN and 235 at BWH. There was a significant difference in median time from decision-to-treat to treatment (23 vs 15 days, p < 0.01) between UHN and BWH and a significant difference in treatment delays (32.56% vs 18.29%; p < 0.01) and modifications (8.37% vs 0.85%; p < 0.01), respectively. On multivariable analysis adjusting for age, race, treatment site and surgical priority status, treatment at UHN was an independent predictor of treatment modification (OR = 9.43,95% CI 1.81-49.05, p < 0.01). Treatment delays were higher at UHN (OR = 1.96,95% CI 1.14-3.36 p = 0.03) and for uterine disease (OR = 2.43, 95% CI 1.11-5.33, p = 0.03). CONCLUSION: During the first wave of COVID-19 pandemic, gynecologic oncology patients treated at a publicly funded Canadian center were 9.43 times more likely to have a surgical treatment modification and 1.96 times more likely to have a surgical delay compared to an equal volume privately funded center in the United States.


Subject(s)
Elective Surgical Procedures/statistics & numerical data , Genital Neoplasms, Female/surgery , Hospitals, Private/statistics & numerical data , Hospitals, Public/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Canada/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/statistics & numerical data , Communicable Disease Control/standards , Female , Genital Neoplasms, Female/diagnosis , Gynecologic Surgical Procedures/statistics & numerical data , Gynecology/economics , Gynecology/organization & administration , Gynecology/standards , Gynecology/statistics & numerical data , Hospitals, Private/economics , Hospitals, Private/organization & administration , Hospitals, Private/standards , Hospitals, Public/economics , Hospitals, Public/organization & administration , Hospitals, Public/standards , Humans , Medical Oncology/economics , Medical Oncology/organization & administration , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Middle Aged , Pandemics/prevention & control , Retrospective Studies , Tertiary Care Centers/economics , Tertiary Care Centers/organization & administration , Tertiary Care Centers/standards , Tertiary Care Centers/statistics & numerical data , Time Factors , Triage/statistics & numerical data , United States/epidemiology , Young Adult
5.
J Surg Oncol ; 124(1): 7-15, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1148837

ABSTRACT

BACKGROUND: The effects of the coronavirus disease 2019 (COVID-19) pandemic on surgical oncology practice are not yet quantified. The aim of this study was to measure the immediate impact of COVID-19 on surgical oncology practice volume. METHODS: A retrospective study of patients treated at an NCI-Comprehensive Cancer Center was performed. "Pre-COVID" era was defined as January-February 2020 and "COVID" as March-April 2020. Primary outcomes were clinic visits and operative volume by surgical oncology subspecialty. RESULTS: Abouyt 907 new patient visits, 3897 follow-up visits, and 644 operations occurred during the study period. All subspecialties experienced significant decreases in new patient visits during COVID, though soft tissue oncology (Mel/Sarc), gynecologic oncology (Gyn/Onc), and endocrine were disproportionately affected. Telehealth visits increased to 11.4% of all visits by April. Mel/Sarc, Gyn/Onc, and Breast experienced significant operative volume decreases during COVID (25.8%, p = 0.012, 43.6% p < 0.001, and 41.9%, p < 0.001, respectively), while endocrine had no change and gastrointestinal oncology had a slight increase (p = 0.823) in the number of cases performed. CONCLUSIONS: The effects of the COVID-19 pandemic are wide-ranging within surgical oncology subspecialties. The addition of telehealth is a viable avenue for cancer patient care and should be considered in surgical oncology practice.


Subject(s)
COVID-19/complications , Cancer Care Facilities/standards , Neoplasms/surgery , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2/isolation & purification , Surgical Oncology/statistics & numerical data , Telemedicine/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Female , Follow-Up Studies , Humans , Male , Middle Aged , National Cancer Institute (U.S.) , Neoplasms/pathology , Neoplasms/virology , New England/epidemiology , Retrospective Studies , United States
6.
JCO Glob Oncol ; 6: 1428-1438, 2020 09.
Article in English | MEDLINE | ID: covidwho-1088630

ABSTRACT

PURPOSE: The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS: We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS: A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION: The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.


Subject(s)
Cancer Care Facilities/statistics & numerical data , Coronavirus Infections/prevention & control , Health Services Accessibility/statistics & numerical data , Medical Oncology/statistics & numerical data , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , COVID-19 , Cancer Care Facilities/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross-Sectional Studies , Global Burden of Disease , Health Services Accessibility/standards , Humans , Infection Control/standards , International Cooperation , Medical Oncology/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2 , Surveys and Questionnaires/statistics & numerical data
8.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Article in English | MEDLINE | ID: covidwho-814636

ABSTRACT

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Subject(s)
Anxiety/epidemiology , Burnout, Professional/epidemiology , Caregivers/psychology , Coronavirus Infections/psychology , Neoplasms/psychology , Pneumonia, Viral/psychology , Adult , Aged , Anxiety/diagnosis , Anxiety/psychology , Betacoronavirus/pathogenicity , Burnout, Professional/diagnosis , Burnout, Professional/psychology , COVID-19 , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross-Sectional Studies , Fear/psychology , Female , Health Personnel/psychology , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Humans , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Medical Oncology/organization & administration , Medical Oncology/standards , Middle Aged , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Prevalence , SARS-CoV-2 , Singapore/epidemiology , Workload/psychology
9.
Br J Radiol ; 93(1114): 20200679, 2020 Oct 01.
Article in English | MEDLINE | ID: covidwho-740384

ABSTRACT

Italy has one of the highest COVID-19 clinical burdens in the world and Lombardy region accounts for more than half of the deaths of the country. Since COVID-19 is a novel disease, early impactful decisions are often based on experience of referral centres.We report the re-organisation which our institute (IEO, European Institute of Oncology), a cancer referral centre in Lombardy, went through to make our breast-imaging division pandemic-proof. Using personal-protective-equipment and innovative protocols, we provided essential breast-imaging procedures during COVID-19 pandemic without compromising cancer outcomes.The emergency management and infection-control-measures implemented in our division protected both the patients and the staff, making this experience useful for other radiology departments dealing with the pandemic.


Subject(s)
Breast Neoplasms/diagnostic imaging , Cancer Care Facilities/organization & administration , Coronavirus Infections/epidemiology , Infection Control/methods , Pandemics , Pneumonia, Viral/epidemiology , Radiology Department, Hospital/organization & administration , Betacoronavirus , COVID-19 , Cancer Care Facilities/standards , Clinical Protocols , Coronavirus Infections/transmission , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Female , Humans , Italy/epidemiology , Personal Protective Equipment , Pneumonia, Viral/transmission , Radiology Department, Hospital/standards , SARS-CoV-2
11.
Future Oncol ; 16(28): 2191-2195, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-732936

ABSTRACT

Background: Telemedicine is seen as a savior during the COVID-19 pandemic. Materials & methods: This study is a descriptive cross-sectional study conducted with cancer patients who were interviewed via telemedicine from a tertiary care comprehensive oncology center. Results: A total of 421 patients were included in the study and 118 of them (28.0%) were >65 years old. Communication was provided most frequently by voice call (n = 213; 50.5%). The majority of the patients contacted by telemedicine had breast cancer (n = 270; 64.1%). For 135 patients (32.1%) no further examination or intervention was required and the previously planned follow-up visit was postponed by the clinician. Conclusion: This study showed that telemedicine could open a new era for medical oncology specialists.


Subject(s)
Breast Neoplasms/drug therapy , Cancer Survivors , Coronavirus Infections/prevention & control , Medical Oncology/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/organization & administration , Administration, Oral , Adult , Aftercare/methods , Aftercare/organization & administration , Aftercare/standards , Aftercare/trends , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Betacoronavirus/pathogenicity , Breast Neoplasms/diagnosis , Breast Neoplasms/mortality , Breast Neoplasms, Male , COVID-19 , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Cancer Care Facilities/trends , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross-Sectional Studies , Female , Genital Neoplasms, Female/diagnosis , Genital Neoplasms, Female/drug therapy , Humans , Infection Control/organization & administration , Infection Control/standards , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Male , Medical Oncology/methods , Medical Oncology/standards , Medical Oncology/trends , Medication Therapy Management/organization & administration , Medication Therapy Management/standards , Medication Therapy Management/trends , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/drug therapy , SARS-CoV-2 , Telemedicine/standards , Telemedicine/trends
12.
Technol Cancer Res Treat ; 19: 1533033820945774, 2020.
Article in English | MEDLINE | ID: covidwho-714428

ABSTRACT

INTRODUCTION: The novel Coronavirus disease 2019 pandemic is sweeping through China, posing the greatest ever threat to its public health and economy. As a tertiary cancer center in Southwest China, we formulated and implemented an anti-infection protocol to prevent the spread of Coronavirus disease 2019 in our department. METHODS: The anti-infection protocol divided patients into 3 categories, namely outpatients, inpatients, and patients receiving radiation therapy at our cancer center, and each category had a distinct anti-infection protocol to minimize the risk of Coronavirus disease 2019 transmission. In each category, the patients were classified into high-, intermediate-, and low-risk groups. Each risk group was managed differently. A survey of patient volume changes prior to and during the Coronavirus disease 2019 outbreak was performed. RESULTS: We carried out the anti-infection protocol at our cancer center during the Coronavirus disease 2019 outbreak. We found that the total volume of both outpatient visits and inpatient treatment declined significantly depending on the conditions of each group. Radiation therapy and palliative service had the lowest and highest volume reductions at 58.3% and 100%, respectively. The decline in outpatient volumes was higher than the decline in inpatient treatment services (78.8% vs 71.8%). There was no Coronavirus disease 2019 cross-infection at our center, or Coronavirus disease 2019-related injury or death. The anti-infection protocol measures continue to be taken at the hospital even today but they have been modified depending on the prevalent local conditions. CONCLUSIONS: Challenges from the Coronavirus disease 2019 pandemic remain in our community. The anti-infection protocol implemented at our cancer center has been effective in preventing cross-infection. Whether our anti-infection protocol experience can be applied to curb the spread of the infection in other parts of the world remains to be tested.


Subject(s)
Betacoronavirus/pathogenicity , Cancer Care Facilities/standards , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Hospitals/standards , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/virology , Humans , Neoplasms/virology , Pneumonia, Viral/complications , Pneumonia, Viral/virology , SARS-CoV-2 , Telemedicine
13.
Cancer Control ; 27(3): 1073274820941973, 2020.
Article in English | MEDLINE | ID: covidwho-696408

ABSTRACT

The world is facing the pandemic linked to COVID-19 virus infection that has rapidly spread worldwide, and severe complications have been reported to occur in around a third of patients. To date, there is no approved vaccine or specific therapy against COVID-19, but many trials are ongoing with some of them showing promising results. It has been shown recently that patients with cancer are at high risk of infection and they are more susceptible to develop severe events such as the necessity of invasive ventilation and death. Therefore, this crisis presents a real challenge for health systems especially in low- and middle-income countries where the health systems are already fragile such as African countries. In this article, we describe the epidemiological situation of the infection in Morocco and the different challenges in cancer centers in the era of COVID-19, in addition to various strategies that have been implemented to prevent and control the infection spread in oncological units in order to ensure the continuation of adequate cancer care.


Subject(s)
Cancer Care Facilities/standards , Cancer Care Facilities/trends , Coronavirus Infections/prevention & control , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Delivery of Health Care , Humans , Morocco/epidemiology , Neoplasms/diagnosis , Neoplasms/epidemiology , Oncology Service, Hospital , Pneumonia, Viral/epidemiology , SARS-CoV-2
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