Maintaining cancer services during the COVID-19 pandemic: the Aotearoa New Zealand experience

Abstract

COVID-19 caused significant disruption to cancer services around the world. The health system in Aotearoa New Zealand has fared better than many other regions, with the country being successful, so far, in avoiding sustained community transmission. However, there was a significant initial disruption to services across the cancer continuum, resulting in a decrease in the number of new diagnoses of cancer in March and April 2020.Te Aho o Te Kahu, Aotearoa New Zealand's national Cancer Control Agency, coordinated a nationwide response to minimise the impact of COVID-19 on people with cancer. The response, outlined in this paper, included rapid clinical governance, a strong equity focus, development of national clinical guidance, utilising new ways of delivering care, identifying and addressing systems issues and close monitoring and reporting of the impact on cancer services.Diagnostic procedures and new cancer registrations increased in the months following the national lockdown, and the cumulative number of cancer registrations in 2020 surpassed the number of registrations in 2019 by the end of September. Cancer treatment services -surgery, medical oncology, radiation oncology and haematology -continued during the national COVID-19 lockdown in March and April 2020 and continued to be delivered at pre-COVID-19 volumes in the months since. We are cautiously optimistic that, in general, the COVID-19 pandemic does not appear to have increased inequities in cancer diagnosis and treatment for M āori in Aotearoa New Zealand.

Impact of the COVID-19 Pandemic on Breast Cancer Management in Portugal: A Cross-Sectional Survey-Based Study of Medical Oncologists

“…Some countries will experience a greater impact of COVID-19, particularly those with a high prevalence of SARS-CoV-2 infection and those with poorer healthcare infrastructure/oncology management systems. Oncology services in countries with virtual elimination of the virus were able to quickly resume/catch-up following lockdown periods [ 17 ], whereas recovery in other countries will be an extremely long process. It is important that individual countries report data regarding changes to oncology management so that responses to the current pandemic can be adapted and improved, and lessons learned in the event of a future pandemic.…”

Te Aho o Te Kahu: weaving equity into national-level cancer control

“…Similar to other regions, the arrival of COVID-19 and the national lockdown in New Zealand during 2020 created disruptions and additional barriers to accessing health care in general, and in particular presented a risk to cancer diagnosis, treatment, and the continuation of care. 26,27 Te Aho o Te Kahu worked to ensure that actions (particularly emergency actions) taken within the health system did not result in the further exacerbation of existing inequities. For example, the agency engaged on a daily basis with Hei Āhuru Mōwai worked closely with clinical colleagues around the country, generated evidence-based guidance that specifically addressed pathways through which inequity could occur, 27 and then regularly monitored differences.…”

“…26,27 Te Aho o Te Kahu worked to ensure that actions (particularly emergency actions) taken within the health system did not result in the further exacerbation of existing inequities. For example, the agency engaged on a daily basis with Hei Āhuru Mōwai worked closely with clinical colleagues around the country, generated evidence-based guidance that specifically addressed pathways through which inequity could occur, 27 and then regularly monitored differences. 28 To date, as a result of these approaches, we found that with few exceptions, the disruptions caused did not increase inequity in cancer diagnosis and treatment as of the end of 2021.…”

Cancer carers’ constructions of caregiving during the COVID-19 pandemic: A study on Aotearoa- New Zealand

“…While these increased numbers may be attributed to better accessibility to diagnosis or increased awareness of cancer (Ministry of Health, 2019), such statistics are highly significant in relation to the population size. Due to the healthcare system's COVID-19 response, there were significant staff shortages in cancer wards (Millar et al, 2021). As a result, some aspects of cancer treatment shifted away from hospital-based care to home-based care with assistance provided by informal cancer carers (Masa et al, 2020).…”

“…Te Aho o Te Kahu, the government's Cancer Control Agency worked with various national organisations and agencies, such as Te Whatu Ora to implement multiple plans in response to This included the diversion of health staff toward the pandemic response, reducing staffing in oncology and other cancer service wards (Millar et al, 2021). March and April 2020 saw a 40% decrease in cancer registrations and initiation of cancer treatment, causing severe backlogs from then on (Gurney et al, 2021).…”