Considerations for head and neck oncology practices during the coronavirus disease 2019 (COVID‐19) pandemic: Wuhan and Toronto experience

Abstract

The practices of head and neck surgical oncologists must evolve to meet the unprecedented needs placed on our health care system by the Coronavirus disease 2019 (COVID-19) pandemic. Guidelines are emerging to help guide the provision of head and neck cancer care, though in practice, it can be challenging to operationalize such recommendations. Head and neck surgeons at Wuhan University faced significant challenges in providing care for their patients. Similar challenges were faced by the University of Toronto during the severe acute respiratory syndrome (SARS) pandemic in 2003. Herein, we outline our combined experience and key practical considerations for maintaining an oncology service in the midst of a pandemic. K E Y

Surge after the surge: Anticipating the increased volume and needs of patients with head and neck cancer after the peak in COVID‐19

“…1,2 COVID-19 has already had extraordinary effects on how multidisciplinary head and neck cancer (HNC) teams provide HNC patients in initial hotspots such as Wuhan, China and in Italy as well as the United States and throughout the world. [3][4][5] Following previous regional disasters such as Hurricane Katrina in 2008, there was an increase in incidence of patients presenting with advanced head and neck cancers. 6 We should be prepared for a similar surge in this patient population with the current pandemic after we pass the COVID-19 incidence peak.…”

Head and neck cancer surgery in COVID-19 pandemic in Northern Italy

“…Otolaryngologists are at very high risk of SARS-Cov-2 infection as they cope with the upper respiratory tract, that is the main reservoir of SARS-CoV-2 [3]. Aerosolization of the SARS-CoV-2 may be extremely high during sinonasal and upper airway procedures, particularly when powered instruments are employed [4,5].…”

Head and neck oncological ablation and reconstruction in the COVID-19 era – our experience to date

“…In an Table 1 The NHS England strategy designed to categorise surgical cancer treatment. 4,6 Priority During a major case consenting process, a discussion about the potential COVID-19 related complications was undertaken given the increased mortality rate if infected during the perioperative period, or the patient had a false negative test on their preadmission screening. 9,10 This discussion was documented on the patient consent form, notes and any written communication arising from the preoperative consultation.…”

“…Similar strategies have been developed elsewhere in the world in response to the unique challenges arising from continuing head and neck cancer surgery during the COVID-19 crisis. [4][5][6][7] Both national and regional cancer alliance guidelines along with local problem solving have helped to develop the pathway put in place. As the UK moves into the recovery and restoration phase of the COVID-19 pandemic, it is hoped that our experience presented will aid clinicians in other Trusts to set-up COVID-19-protected cancer hubs or "green" zones within general hospitals.…”