Background
The impact of the COVID‐19 pandemic on European gynaecological cancer patients under active treatment or follow‐up has not been documented. We sought to capture the patient perceptions of the COVID‐19 implications and the worldwide imposed treatment modifications.
Methods
A patient survey was conducted in 16 European countries, using a new COVID‐19‐related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations.
Findings
We collected 1388 forms; 592 online and 796 hard‐copy (May, 2020). We excluded 137 due to missing data. Median patients’ age was 55 years (range: 18–89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID‐19, only 17.5% were more afraid of COVID‐19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow‐up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (
n
= 892) said that they received no information around overall COVID‐19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS
A
nxiety and
D
epression Scores were 8.8 (range: 5.3–12) and 8.1 (range: 3.8–13.4), respectively. Multivariate analysis identified high HADS‐depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients’ anxiety.
Interpretation
Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID‐19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients’ communication and education.
This study provides an important insight into the response of food safety systems during the first months of the pandemic, elevating the perspective of preventing Covid-19 within conventional food safety management systems. A multi-country survey was conducted in 16 countries involving 825 food companies. Based on the results of the survey, it is obvious that the level of maturity of a food safety system in place is the main trigger in classifying companies and their responses to the pandemic challenge.
Staff awareness and hygiene are the two most important attributes in combating Covid-19, opposed to temperature checking of workers in food establishment and health protocols from the World Health Organization, recognized as attributes with limited salience and importance. Companies confirmed implementation of more restrictive hygiene procedures during the pandemic and the need for purchasing more additional personal protective equipment. Retailers were identified as the food supply chain link mostly affected by the pandemic opposed to food storage facilities ranked as least affected. During this challenging period, all companies declared that food safety has not been compromised at any moment. It is important to note that less than a half of the food companies had documented any emergency plans associated with pandemics and health issues in place.
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