The impact of COVID‐19 pandemic on access to treatment for children with cancer in India and treating center practices

Abstract

Background The coronavirus disease 2019 (COVID‐19) pandemic led the Indian government to announce a nationwide lockdown on March 23, 2020. This study aimed to explore the impact of the pandemic on the accessibility of care for children with cancer and to view strategies adopted by hospitals for service delivery. Methods Weekly average of childhood cancer (≤18 years) patient registrations during pre‐lockdown period (January 1 to March 23, 2020) were compared with post‐lockdown period (March 24 to May 31, 2020). The effect on the scheduled treatment was investigated for post‐lockdown period. A survey of health care providers was conducted to determine centers' adopted strategies. Results In 30 participating centers, 1146 patients with childhood cancer (797 pre‐lockdown period and 349 post‐lockdown period) were registered. The weekly average registration was 67.3 and 35.5 patients during pre‐lockdown and post‐lockdown respectively (decline of 47.9%). Although most centers experienced this decline, there were 4 that saw an increase in patient registrations. The distribution of patients registered post‐lockdown was found significantly different by age (lesser older age, P = .010) and distance (lesser travel distance, P = .001). 36.1% of patients, who were scheduled for any of the treatment modalities (chemotherapy, surgery, radiotherapy, and hematopoietic stem cell transplantation) during the post‐lockdown period, experienced delays. Centers adopted several strategies including modifications to treatment protocols, increased use of growth factors, and increased support from social organizations. Conclusions This multicenter study from India suggests that the COVID‐19 pandemic and the lockdown impacted 2 out of 3 children with cancer. The effect of this on survival is yet to be established.

Outcomes of COVID-19 in children with cancer – Report from the Indian Pediatric Oncology Group (InPOG) COVID-19 registry in India

“…The more significant effect of COVID-19 in India is already seen in our services across the country as the number of relapses in all curable childhood cancers is on the increase as there have been interruptions in therapy for several patients [ 12 ]. In addition, rigid lockdowns, lack of healthcare workers, loss of jobs, and financial constraints have resulted in suboptimal care.…”

Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic

“…The COVID-19 pandemic is an unprecedented global crisis that impacted pediatric cancer health care systems worldwide, with a greater effect on low and middle-income countries (LMIC). 2,3,12,[15][16][17] One year into the pandemic, the initial fears and concerns have evolved along with treatment and prevention strategies for COVID-19 and multiple effective vaccines have been developed in record time. As the pandemic continues to unfold, our 4 surveys performed over the first year of the pandemic in Latin America show the mediumterm effects on the care of pediatric cancer patients; and reveal how the medical systems and medical professionals adapted to the different health care crises that originated from the pandemic.…”

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil

“…Corroborating these findings, it is clear that the COVID-19 pandemic scenario has strongly affected the management of cancer patients worldwide [13][14][15], not only in relation to making therapeutic decisions but also regarding supportive care, as pointed out by the Mucositis Study Group of the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). In this challenging context, it is necessary to rethink new approaches to acute side effects resulting from antineoplastic treatment, such as oral mucositis [14].…”