Abstract
BackgroundMany countries appear to be ill-prepared in their emergency responses towards the Corona Virus Disease 2019 (COVID-19) pandemic, particularly in managing chronic diseases such as cancer. We aimed to gain insight on the preparedness of health systems within low- and middle-income countries (LMICs) in maintaining delivery of cancer care amid the pandemic.MethodsWe performed a rapid review of publications focusing on emergency contingency plans for cancer care during the pandemic in LMICs. An online desk research was conducted to identify relevant policy documents, guidelines or scientific publications.ResultsVery few LMICs had readily accessible documents to ensure continuity in delivery of cancer care during the pandemic. A majority of publications were focused on delivery of cancer treatment whereas early detection, diagnosis and delivery of supportive and survivorship care received very little attention. Far fewer of the published guidelines appear to have been formulated at the national level by governmental agencies. A vast majority of publications constituted consensus guidelines from professional societies, followed by sharing of best practices from local institutions. Overall, three main strategies have been recommended to maintain delivery of cancer care amid the pandemic in LMICs: 1) Modification of cancer treatment regimens, 2) Changes in methods of administration of curative and supportive cancer care and 3) Implementation of generic measures to reduce the risk of COVID-19 infection in healthcare settings.ConclusionAll LMICs should consider collating best practices from the current pandemic and translating them into an explicit cancer preparedness plan, which can be escalated during future disasters.
Highlights
Many countries appear to be ill-prepared in their emergency responses towards the Corona Virus Disease 2019 (COVID-19) pandemic, in managing chronic diseases such as cancer
Conceivable that the impact of the COVID-19 syndemic will be worse in low- and middle-income countries (LMICs), where patients living with cancer are more likely to have taken a bigger hit
Such measures may include redeployment of the oncology workforce, reducing availability of hospital beds for cancer patients, rerouting of oncology patients to other centres to receive cancer care and rationing use of scarce medical resources. This notion is corroborated by reports that since have emerged from LMICs, which showed that with the surge in number of COVID-19 cases in these settings, cancer surgeries have been scaled down, clinic hours were shortened, radiology services were curtailed, systemic anticancer treatment and radiotherapy administration were prioritised based on treatment benefits and delivery of home-based palliative care were almost halted [3,4,5]
Summary
Many countries appear to be ill-prepared in their emergency responses towards the Corona Virus Disease 2019 (COVID-19) pandemic, in managing chronic diseases such as cancer. The clustering of COVID-19 and cancer within specific populations amid a backdrop of social and economic disparities is expected to exacerbate the adverse effects of each of these diseases [2] It is, conceivable that the impact of the COVID-19 syndemic will be worse in low- and middle-income countries (LMICs), where patients living with cancer are more likely to have taken a bigger hit. Conceivable that the impact of the COVID-19 syndemic will be worse in low- and middle-income countries (LMICs), where patients living with cancer are more likely to have taken a bigger hit In these settings, the healthcare systems that are already stretched due to limitation of resources may have been forced to adopt further priority-setting exercises in delivering cancer care to accommodate the delivery of urgent COVID-19 care. This notion is corroborated by reports that since have emerged from LMICs, which showed that with the surge in number of COVID-19 cases in these settings, cancer surgeries have been scaled down, clinic hours were shortened, radiology services were curtailed, systemic anticancer treatment and radiotherapy administration were prioritised based on treatment benefits and delivery of home-based palliative care were almost halted [3,4,5]
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