Lessons learned from COVID-19 lockdown for cancer care: a nationwide survey of oncologists in Luxembourg.
- Public Health Expertise
- Public Health Research
COVID-19 is placing unprecedented pressures on healthcare systems. The current pandemic has required healthcare professionals to reorganise profoundly their everyday practice while trying to maintain standards of non-COVID-19 healthcare. Despite measures taken by governments and healthcare providers, cancer patients may face treatment disruption. This study aims to improve the understanding of the impact of COVID-19 on clinical oncology activity from the perspective of healthcare providers in Luxembourg.
A 47-item online survey was created, including four sections covering general information, implemented COVID-19 containment measures, COVID-19 cases in oncology departments and their impact on clinical activities, and the routine use of preventive measures in oncology. In Luxembourg, the lockdown was introduced simultaneously for the entire country on 16 March 2020 until 4 May 2020. Following the lifting of this lockdown, we sent our online survey via email to all oncologists active at national level to assess their clinical experiences during this period. We also analysed data on the nationwide daily number of radiotherapy sessions provided between January 2020 and November 2020, compared to 2017-2019.
The survey had a response rate of 45%, with representation of all national hospitals. Results showed that all respondents moved to teleconsultations during the lockdown, with 92% using phone and 23% video consultations. 77% reported treatment plan changes, with 54% of planned palliative chemotherapy modified and 31% cancelled. Treatment shifts from systemic to oral, lower dose administrations or larger intervals were introduced to reduce hospital visits. Patients received influenza (84%) or pneumococcal (64%) vaccination recommendations regardless of their cancer treatment.
The lockdown reduced the national number of radiotherapy sessions by almost one third. Even following the lockdown, the number of radiotherapy sessions provided remained lower between July and October 2020 compared to the numbers from pre-lockdown and from 2017-2019.
This snapshot of the clinical practice in cancer care during a national lockdown may support decision-making for future outbreaks and improvement in clinical practice for other non-communicable diseases.