Oncology provider experiences during the COVID-19 pandemic

Abstract

Purpose The COVID-19 pandemic upended nearly all aspects of daily life and of medical care, placing a double burden of professional and personal concerns on those who provide medical care. We set out to assess the burden of the pandemic on provider outlook and understand how cancer survivorship providers experienced rapid changes to practice. Methods We distributed a survey through the American College of Surgeons Commission on Cancer (CoC) to its accredited organizations in mid-October 2020. We included questions on provider characteristics, changes in patient care practices resulting from the pandemic, worry about COVID-19, and concern about impact on cancer survivors. Results Of the n = 607 participants, three-quarters were female and three-quarters were White. Only 2.1% of participants reported having had COVID-19, but 43% reported anxiety about getting COVID-19 and over a quarter experienced sadness or depression, anxiety about the future, changes to sleep, difficulty concentrating, or social isolation. Approximately half of providers also expressed significant concern about progression of cancer in patients who experienced care delays or were afraid of accessing in-person care. In terms of changes to survivorship care, respondents reported changes to visitor policies, delays or cancellations, and efforts to reduce in-person visits. Conclusions COVID-19 has taken a significant toll on front-line healthcare professionals, including oncologists and cancer care allied health professionals. Findings support proactive mental health support of healthcare professionals as well as emergency preparedness to manage delays to care for cancer patients in the event of future unexpected pandemics.

The lived experiences of hematology healthcare providers during and beyond the COVID‐19 crisis: A qualitative study

“…These concerns contribute to the growing compilation of findings on the mental health toll of the pandemic on oncology HCPs. 7,9,21 Even prior to the pandemic, emotional stress, depression, and burnout were significant issues among HCPs. 11 Hematology HCPs in this study were critical of their organizations' supportive initiatives which were seen as "band-aid" measures that did not address their needs.…”

“…Some providers noted they had observed increasing turnover and intentions to leave among their co‐workers, compounding the issue of intensified workloads. These concerns contribute to the growing compilation of findings on the mental health toll of the pandemic on oncology HCPs 7,9,21 . Even prior to the pandemic, emotional stress, depression, and burnout were significant issues among HCPs 11 …”

“…In contrast, there is little research focusing on the pandemic's impact on hematology HCPs, and targeted support initiatives have not yet been developed. Research focused on HCPs in oncology settings more generally has shown that HCPs in this setting experienced significant stress as their responsibilities changed and increased dramatically during the pandemic 7–9 . These responsibilities include balancing the potential benefits and risks of administering immunosuppressive cancer treatment, ethical dilemmas of rationing treatment, and meeting the needs of COVID‐19 infected patients.…”

Subcutaneous Administration of Cytarabine for Pediatric Patients with Langerhans Cell Histiocytosis Decreases Burden of Patient Travel and Infusion Center Utilization

“…the vinblastine shortage, directly impact patient treatment selection 6 , the SARS-CoV2 pandemic influenced therapeutic decisions with a unique aspect of minimizing in-person interactions when safe and feasible. In fact, a survey of oncology providers during the SARS-CoV2 pandemic found that 47% changed treatment selection to specifically reduce in-person visits 7 . Given that LCH-III treatment involves up to 26 infusion center visits for intravenous vinblastine 2 , and the current phase 3 randomized control trial comparing vinblastine to cytarabine involves 70 infusion center visits for intravenous cytarabine 4 , we similarly sought strategies to reduce in-person visits for LCH care with a transition to subcutaneous cytarabine.…”