SP-0371 Radiotherapy service continuity during the COVID-19 pandemic

Abstract

The COVID-19 (SARS-CoV-2) pandemic has a great impact on our lives in nearly every aspect ever since early 2020. Restrictions and the impact of the pandemic also affects the health care systems and changed with the numbers of infections in each respective area, region or state… with the continuity of health care services being one of the mayor concerns. Not only units directly linked to the care for SARS-CoV-2 patients were impacted but the whole health care service. In regard to radiotherapy service several aspects had to be weighted to ensure safe continuity of cancer therapy for patients and staff. These included adequate PPE which especially in the early phases proofed to be in short supply across many countries. Furthermore, safety measurements were issued and special concepts were created to lower the risk of infections in the hospital. On the one hand, these were enacted to secure our cancer patients and colleagues but on the other hand also to ensure availability of sufficient numbers of staff to secure adequate continuity of service respectively. Among these concepts several different strategies evolved including the use of home office where possible, creating split teams and changed formats for team meetings but also the wider use of hypofractionation and attempts to reduce the number of patients in the waiting areas to ensure safe distance and several others… Additionally, separated waiting areas or treatment time slots for infected patients as well as patients with suspected infection were established in several institutes to allow treatment of these patients when a delay of the treatment was no option. Furthermore, several governments enacted mandatory regular testing for health care workers, prohibited traveling and among other health care workers prioritized those working with cancer patients in their vaccination programs. However, with the ongoing impact of the pandemic and the respective restrictions further issues arise. In some cases, patients did not seek health care or had to suffer prolonged waiting times for diagnostic scans or therapy and now enter radiotherapy departments with somewhat more advanced stages of cancer. Furthermore, the lack of social contacts and restrictions regarding activities have a huge effect on stress levels. Unattended, this could pose a challenge because compensation/recreation strategies of health care workers are impeded in a time in which these are confronted with additional pressure. Continuous education is also affected, with CPD options being delayed or reorganized into online formats but often lacked networking possibilities. Additionally, media reports and changing guidelines and restrictions produce a constant stress level. Last but not least vaccination programs are often not proceeding as fast as might be desired and the effectiveness of the vaccinations could be impaired by mutations of the virus. In summary service continuity was provided with somehow manageable impact on the radiotherapy service, but the ongoing impact of the pandemic puts further pressure on the health care systems and radiotherapy service and especially on each and every staff member rises. We have to address these issues to ensure continuous and safe radiotherapy for our patients but also to keep ourselves and our colleagues safe and healthy.