By Dawood Findakly, MD
In March 2020, the World Health Organization declared COVID-19 a global pandemic. From that moment, health care became a completely different experience. Now, on top of an overwhelmingly difficult year, and after many months, we still face many challenges as it looks like we are hitting a new critical point as the reported COVID-19 admissions are surging.
Could the next few months be the wildest, most difficult chapter of the COVID-19 pandemic? Do we need further restrictions? What about the coming holidays as we approach the end of the year? These are all questions that come to mind while thinking of the current situation and future prospects in an era of a continuing pandemic.
Are we taking the right precautions? Are we coming out of this pandemic? How can we keep cancer management on track?
As we all know, many countries, states, and regions enacted stay-at-home orders earlier in the pandemic—and we are seeing restrictions put back in place during the latest wave of cases. Now, while chatting with colleagues and coworkers, many of us continue questioning, “Will we relive this again? What is the plan moving forward? What have we learned from our past experiences?” Along with uncertainty, there is a feeling of overwhelming dread that patients will die alone in the hospital battling this invisible enemy.
Hematology-oncology is a fascinating and integral field where physicians meet people and make a difference in their lives. Health care professionals continue working hard to keep taking the best care for their patients, despite the fear and uncertainty. But this is not how we usually operate, and unlike any time before, a lot is being missed. Difficult choices are being made and more support is needed!
COVID-19 and Cancer: The Impinging of the “Two C's”
Although the world is focused on COVID-19, patients are still receiving new cancer diagnoses or are concerned about symptoms that could be cancer-related. A recently published study1 that inspected the global impact of COVID-19 on cancer therapy and research suggested significant potential consequences, and examined four aspects of our field that have been impacted:
- Cancer biology: The impact of both cancer and COVID-19 on the immune system.
- Cancer care: A projected substantially steep decline in screening by a significant percentage, reaching up to 85% to 90%.
- Cancer research: The American Cancer Society anticipated a decrease of $200 million in donations for research funding.
- Cancer outcomes: Predicted increase in future cancer-associated deaths by 4% to 17%.
This study reflects what we all know to be true: If patients are not getting appropriate screening, there will be a delay in their diagnosis, eventually leading to late treatment and worsened survival.
Raising Awareness and Paving the Way Out: We Are All in This Together
In order to paint the whole picture, while waiting for a COVID-19 vaccine to become widely available, it is essential to help people realize that prevention is better than cure. We should encourage our patients—and the people in our personal lives who need reminding—to follow the “3 W’s”: wear a mask, wash hands, and watch distance from each other.
Masks are not an accessory; they are a necessity to live and let others live. “Pandemic fatigue” is causing people to let their guards down by ignoring COVID-19 and going back to “normal” by not wearing masks or wearing them incorrectly, not being vigilant about hand-washing, not social distancing, and engaging in gatherings—things that challenge prevention efforts. A COVID-19 surge is already imminent, and if we do not take precautions, this one may not be the last.
Physicians continue to provide the utmost support to the cancer community. However, patients are stressed trying to protect themselves, given their compromised immune systems. It is difficult to explain to tired, frightened people that we cannot simply snap our fingers and make everything go back to normal. In this fragile situation, commitment and resilience are needed to inspire and prevent devastating consequences.
It is also essential to emphasize the indispensable role of not delaying screenings and to pursue treatments as cancer does not wait!
We can do this. With the lessons we learned about this pandemic during the first wave, we have the knowledge to respond more effectively now. Nationally, health institutions and health care professionals are intensifying their efforts to clarify steps in order to prepare for the expected surges. We can continue making a difference in our patients’ lives, which is exciting and rewarding in an otherwise bleak moment.
Dr. Findakly is currently an internal medicine resident at Creighton University School of Medicine (Phoenix Program). Follow him on Twitter @dawood_findakly. Disclosure.
- Bakouny Z, Hawley JE, Choueiri TK, et al. COVID-19 and Cancer: Current Challenges and Perspectives. Cancer Cell. 2020;38:629-46.