How COVID-19 is Impacting Cancer Care Centers in the U.S.

April 2020

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How to Support Patients in a Critical Time


By Elizabeth Koelker

The novel coronavirus (COVID-19) pandemic has overwhelmed our healthcare system—squeezing it at both ends. In hotspots, healthcare workers continue to fight on the frontlines with access to resources like personal protective equipment (PPE) and ventilators limited. Local governments, meanwhile, have extended stay-at-home orders to help flatten the curve.

Elsewhere in the U.S.—in areas seeing little to no confirmed COVID-19 activity—healthcare workers are being furloughed, as elective surgeries, a key revenue driver, are cancelled, and local care centers are forced to close their doors. 

For cancer care centers and their patients, however, the COVID-19 pandemic is providing a different set of challenges.
 

Three Ways COVID-19 is Impacting Cancer Care

Considered to be one of our most vulnerable populations, cancer patients are immunocompromised and thus more susceptible to infection. Additionally, infections due to COVID-19 can be more severe for cancer patients than in those who are not immunocompromised.

Recognizing this, the Centers for Disease Control and Prevention (CDC) has released guidelines for the immunocompromised, which underscore the importance of social distancing.

Adding to that, the pandemic has impacted cancer care in three critical ways:

1. Supply Shortage
As a result of social distancing, blood drives have been canceled. These efforts, though designed to limit loss of life due to the virus, have caused a blood supply shortage. In fact, the American Red Cross, as well as cancer centers and hospitals across the country, have issued an emergency call for blood donors due to this shortage, as blood and platelet donations are critical for cancer care.

2. Access to Care
According to the American Cancer Society, nearly 2 million new cancer cases are expected to be diagnosed in 2020. While it’s difficult to predict the true impact of COVID-19 on cancer discovery and treatment, it’s possible we’ll see an increase in late-stage cancer diagnoses given reduced access to care. For example, many imaging facilities have closed or ceased screening exams during this time. As a result, it’s likely many patients will sit with symptoms to avoid a trip to the hospital.
Patients currently undergoing treatment experience increased risk and exposure to COVID 19 as it’s difficult to follow social distancing guidelines and still maintain treatment. What’s more, office closings have also impacted cancer patients and survivors’ abilities to attend in-person well-checks, which play a key role in the mental health of this population.

3. Mental Health
Among the most significant challenges for cancer patients is the impact on mental health. Cancer patients already feel a lack of control over their bodies and lives during treatment, and as restrictions are put in place to protect the general public, many may become even more isolated due to their diagnosis.

An important aspect of cancer treatment is maintaining social connection as well as physical activity. Unfortunately, COVID-19 has ceased many medically based exercise programs, as well as art, music and pet therapy initiatives.

While cancer patients are feeling increased stress due to COVID-19, so too are the physicians, staff and health systems treating them. Though many are still solely dedicated to cancer care, they are being required to attend all meetings related to COVID-19, as their hospitals face patient surge and limited bed capacity, and cancer care facilities may be transformed to treat COVID-19 patients. The pandemic has forced many providers to behave, act and feel more like machines—increasing the possibility of burnout in a time when that is already heightened.
 

How Healthcare Organizations Can Support Their Cancer Care Centers, Providers and Patients

Provide support for staff
COVID-19 is not just a healthcare crisis. It’s impacted schools and daycare facilities which provide support for working parents, including healthcare professionals. Healthcare leaders must consider how they can support their staff during this time—be it providing daily meals, tapping the local community to assist with childcare or providing on-campus respite areas.

Consider virtual visits
Generally, cancer programs have made progress towards introducing telemedicine, but in this current environment it could be a critical component of cancer care and diagnoses. For example, telemedicine services could help patients voice concerns over symptoms to assess whether an in-person visit is necessary. Additionally, digital support provides regular touchpoints with patients and can otherwise make them feel more comfortable asking questions around their condition. Some patients have even created virtual support groups through FaceTime, Skype, Zoom and other services, as in-person support is unavailable.

Preserve care for your most critical patients
The American Society of Clinical Oncology published a chart to help provide guidance on treatment during COVID-19. This chart helps providers assess treatment based on cancer type and grade to inform conversations with patients. Though it’s possible some treatment can be delayed, it’s important to treat all patients with the same level of urgency, while helping them understand their diagnoses and the most appropriate next steps.