Zambia’s National Cancer Centre response to the COVID-19 pandemic—an opportunity for improved care

Abstract

The COVID-19 pandemic has overwhelmed health systems around the globe even in countries with strong economies. This is of particular concern for nations with weaker health systems. This article reports the response of a comprehensive cancer centre in a lower-middle income country to prevent COVID-19 transmission and how the implementation of pragmatic strategies have served as a springboard to improve cancer services beyond the COVID-19 pandemic. The strategies included establishment of a local taskforce, increased education and facilitation of good hygiene practices, staff training, patient triaging, improved patient scheduling, remote review of patients and establishing a virtual platform for meetings.

The Effects of COVID-19 on Cancer Care Provision: A Systematic Review

“…This large-scale surveillance system was informative for high-risk patients as they could make the decision to shield themselves if residing in a high-risk area. 43 The benefits of tracking were also evident in a study conducted by Ning et al who reported that active tracking reduced adverse effects that can occur from treatment delay and workforce incapacitation 46 (2) Outreach and Communication One of the most prominent strategies to ensure the maintenance of care continuity was regular communication between 77 P Brody et al 38 P P Butler et al 19 P P P P P P Casella et al 11 P P P P P P Chiang et al 14 P P P P P P Cinelli et al 53 P P Civantos et al 9 P P Civantos et al 49 P P P Collins et al 17 P P P P Curigliano et al 55 P P P Czernin et al 36 P P P P P de Marinis et al 39 P P P P Dharmarajan et al 51 P Elkaddoum et al 59 P P P Elkin et al 31 P Flannigan et al 57 P P Fosker 26 P P Frey et al 66 P Giuliani et al 58 P Gupta et al 48 P P P Grenda et al 54 P P Guven et al 12 P P P P Harky et al 61 P P P Indini et al 33 P P P P P P Jiang et al 60 P P Lee et al 15 P P P P P Lee et al 27 P P Lee et al 47 P P P Lobascio et al 56 P P Lombe et al 68 P P P Mei et al 21 P P P P P P Mendoza et al 23 P P P Millar et al 65 P Mirnezami et al 73 P P Morrison et al 69 P P Moss et al 32 P Mulvey et al 62 P...…”

“…34 Clinical space reconfiguration was also undertaken, as some centers attempted to modify their physical environment to better facilitate social distancing through freeing up physical space or marking floors and/or seating. 11,12,23,26,68 For example, a breast cancer center in Italy reorganized working spaces and schedules in radiology and outpatient clinics to minimize patient flow and increase physical distance. 21 Another study also ensured that work desks had a 2-meter separation between them to ensure adequate spacing.…”

Novel coronavirus mitigation measures implemented by radiotherapy centres in low and middle-income countries: a systematic review

“…The majority of the studies were conducted in China [13][14][15][16]. Other studies were conducted in Iran [17][18][19], Brazil [20] and Zambia [21]. Ten of the included studies employed a qualitative design [13][14][15][16][18][19][20][21][22].…”

Silver linings: a qualitative study of desirable changes to cancer care during the COVID-19 pandemic

“…While this has been most pronounced in low resource settings, fragilities in high-income countries with strong public health care systems have also been exposed [ 1 ]. Health services for the diagnosis and management of cancer were not exempt from the impact of the first wave of the pandemic, despite the application of mitigation strategies by many cancer centres [ 2 , 3 ]. The measures to combat transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broadly grouped as non-pharmaceutical interventions (NPI) including major national lockdowns (‘stay at home orders’) have had significant impacts on delays to diagnosis and treatment of cancer for many patients [ 4 ].…”