Perspective: The COVID-19 Pandemic: Closing Borders, Opening Doors, and Breaking Ground on the Potential for Clinical Trial Access in Developing Countries Like Trinidad and Tobago

Abstract

China advised the WHO of the appearance of several cases of a flu-like illness in Wuhan. Within a month, the WHO had declared the situation in China a public health emergency of international concern. 1 On March 11, 2020, COVID-19 disease was declared a pandemic. As the disease spread across the globe, measures to contain its spread such as quarantines, facial masks, social distancing, and hygiene measures were recommended. In addition, countries began closing their borders and restricting travel. [2][3][4] The pandemic had a devastating impact on the economies and health care systems across the globe spanning from developed to underdeveloped countries. [5][6][7] From the earliest days of the pandemic, it was clear that the COVID-19 disease had a direct negative impact on the survival of patients with cancer, 8 and the pandemic has indirectly had an impact on care through delays in diagnosis and a break in clinical trial enrollment during the initial phase of the pandemic. 9 Difficulties with travel significantly affected the ability of patients to participate in and continue treatment on clinical trials. To mitigate the impact on patients taking part in clinical trials, sponsors, including the US National Cancer Institute (NCI), allowed for certain flexibilities, loosening rigid clinical trial requirements. For example, the NCI Cancer Therapy Evaluation Program (CTEP) allowed study medication to be sent to community oncologists closer to patients' homes if the clinical trial sites were made less accessible because of travel disruptions associated with the pandemic.