Practical Considerations for Treating Patients With Cancer in the COVID-19 Pandemic

Segelov, Eva; Underhill, Craig; Prenen, Hans; Karapetis, Christos S.; Jackson, Christopher; Nott, Louise; Clay, Tim; Pavlakis, Nick; Sabesan, Sabe; Heywood, Ellen; Steer, Christopher; Lethborg, Carrie; Gan, Hui; Yip, Desmond; Karanth, Narayan; Karikios, Deme; MacIntyre, C. Raina

doi:10.1200/op.20.00229

Cited by 64 publications

(91 citation statements)

References 39 publications

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“…Notable exceptions included oncologic imaging which consisted of 97.5% outpatient reports at baseline with overall decrease in volume by 41.8%. This was likely due to cancer patients requiring ongoing outpatient imaging, such as restaging and post-treatment scans (13). It is possible that lesser reductions in volume observed in US, nuclear medicine, and IR was due to ongoing imaging needs in a subset of the population.…”

Section: Discussionmentioning

confidence: 99%

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

et al. 2021

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Rationale and Objectives: Quantify changes in total and by-subspecialty radiology workload due to deferring nonurgent services during the initial COVID-19 pandemic, and describe operational strategies implemented due to shifts in priority. Materials and Methods: This retrospective, Institutional Review Board-exempt, study was performed between February 3, 2020 and April 19, 2020 at a large academic medical center. During March 9À15 (intervention period), nonurgent outpatient service deferments began. Five-week periods pre-(baseline) and postintervention (COVID) were defined. Primary outcomes were radiology volume (reports per day) overall and in 11 subspecialty divisions. Linear regression assessed relationship between baseline vs. COVID volumes stratified by division. Secondary outcomes included changes in relative value units (RVUs), inpatient and outpatient volumes. Results: There were 62,791 baseline reports vs. 23,369 during COVID; a 60% overall precipitous volume decrease (p < 0.001). Mean volume decrease pre-and during-COVID was significant (p < 0.001) amongst all individual divisions. Mean volume decrease differed amongst divisions: Interventional Radiology experienced least disruption (29% volume decrease), 7 divisions experienced 40%À60% decreases, and Musculoskeletal, Breast, and Cardiovascular imaging experienced >75% volume decrease. Total RVUs decreased 60% (71,186 baseline; 28,476 COVID). Both outpatient and inpatient report volumes decreased; 72% (41,115 baseline; 11,326 COVID) and 43% (12,626 baseline vs. 6,845 COVID), respectively. In labor pool tracking data, 21.8% (162/744) total radiology employees were reassigned to other hospital duties during the intervention period. Conclusion: Precipitous radiology workload reductions impacted subspecialty divisions with marked variation. Data-driven operational decisions during COVID-19 assisted workflow and staffing assignment changes. Ongoing adjustments will be needed as healthcare systems transition operations to a "new normal."

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Section: Discussionmentioning

confidence: 99%

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

et al. 2021

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“…Due to the current outbreak, health care practitioners may have experienced a variety of multilevel stressors, such as (1) interruptions in routine job duties and responsibilities, (2) limited knowledge and data, and (3) worries about job security due to decreased patient volumes. COVID-19 has caused significant upheavals in the cancer health care infrastructure, including disturbed clinical visits, canceled or delayed medical surgery or procedures, and bridled therapeutic strategies [ 44 , 49 ]. For health care practitioners, these changes force them to tackle constant unexpected disruptions to routine job duties and responsibilities, such as the need to quickly learn and adopt telemedicine tools until COVID-19 ceases to be a threat to society.…”

Section: Cancer Screening Challenges Opportunities and Solutionsmentioning

confidence: 99%

The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities

Cancino¹,

Su²,

Mesa³

et al. 2020

JMIR Cancer

125

124

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Cancer is a leading cause of death in the United States and across the globe. Cancer screening is an effective preventive measure that can reduce cancer incidence and mortality. While cancer screening is integral to cancer control and prevention, due to the COVID-19 outbreak many screenings have either been canceled or postponed, leaving a vast number of patients without access to recommended health care services. This disruption to cancer screening services may have a significant impact on patients, health care practitioners, and health systems. In this paper, we aim to offer a comprehensive view of the impact of COVID-19 on cancer screening. We present the challenges COVID-19 has exerted on patients, health care practitioners, and health systems as well as potential opportunities that could help address these challenges.

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“…Research also indicates that, compared to COVID-19 patients without cancer, COVID-19 patients with cancer are more likely to have higher risks in all severe outcomes (e.g., higher mortality rates) [ 5 , 6 ]. Additional factors may further increase cancer patients’ vulnerability to COVID-19, such as limited access to medical resources and cancer care, during this pandemic [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

McDonnell

Liang

et al. 2020

Preprint

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Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning the distinctive challenges cancer caregivers face amid COVID-19. Additionally, this paper will present practical insights into the diverse intervention approaches that can assist in the delivery of digital health solutions for cancer caregivers amid and beyond COVID-19.Methods A systematic review of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus in September, 2020. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy was developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process.Results NA—This is a protocol study.Conclusions COVID-19 has uprooted cancer care as we know it. Due to barriers introduced by the COVID-19 pandemic, such as medical resources rationing, cancer caregivers often have to step up to address patients' healthcare needs and wants. This, in turn, will exert substantial stress on informal caregivers, above and beyond COVID-19-related burdens the general public shoulders on a daily basis. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond.Study Protocol Registration: PROSPERO CRD42020196301

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Practical Considerations for Treating Patients With Cancer in the COVID-19 Pandemic

Cited by 64 publications

References 39 publications

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

Radiology Workload Changes During the COVID-19 Pandemic: Implications for Staff Redeployment

The Impact of COVID-19 on Cancer Screening: Challenges and Opportunities

Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

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