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Kirby A, Drummond FJ, Lawlor A, Murphy A. Counting the social, psychological, and economic costs of COVID-19 for cancer patients. Support Care Cancer 2022; 30:8705-8731. [PMID: 35690662 PMCID: PMC9188420 DOI: 10.1007/s00520-022-07178-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/25/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Cancer patients were particularly vulnerable to the adverse impacts of the COVID-19 pandemic given their reliance on the healthcare system, and their weakened immune systems. This systematic review examines the social, psychological, and economic impacts of COVID-19 on cancer patients. METHODS The systematic search, conducted in March 2021, captures the experience of COVID-19 Wave I, when the most severe restrictions were in place globally, from a patient perspective. RESULTS The search yielded 56 studies reporting on the economic, social, and psychological impacts of COVID-19. The economic burden associated with cancer for patients during the pandemic included direct and indirect costs with both objective (i.e. financial burden) and subjective elements (financial distress). The pandemic exasperated existing psychological strain and associated adverse outcomes including worry and fear (of COVID-19 and cancer prognosis); distress, anxiety, and depression; social isolation and loneliness. National and institutional public health guidelines to reduce COVID-19 transmission resulted in suspended cancer screening programmes, delayed diagnoses, postponed or deferred treatments, and altered treatment. These altered patients' decision making and health-seeking behaviours. CONCLUSION COVID-19 compounded the economic, social, and psychological impacts of cancer on patients owing to health system adjustments and reduction in economic activity. Identification of the impact of COVID-19 on cancer patients from a psychological, social, and economic perspective following the pandemic can inform the design of timely and appropriate interventions and supports, to deal with the backlog in cancer care and enhance recovery.
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Affiliation(s)
- Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
| | | | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Aras na Laoi, Western Rd, Cork, Ireland
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Busheri L, Nare S, Banale R, Bapat A, Nagarkar M, Vetale D, Joseph R, Suryawanshi S, Alhat R, Thomas G, Navgire R, Ansari D, Unde R, Shaikh S, Gangurde N, Dixit S, Varghese B, Deshmukh C, Kelkar DA, Kulkarni M, Koppiker CB. Cancer Patient Management during COVID-19 Pandemic: An Audit of a Single-Surgeon Unit in a COVID-Hotspot. South Asian J Cancer 2021; 10:39-41. [PMID: 34430517 PMCID: PMC8380147 DOI: 10.1055/s-0041-1731578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The report evaluates the effect of coronavirus disease (COVID-19) pandemic on breast cancer treatment and management at a single-surgeon cancer care unit in one of the hotspots of COVID-19 in India. In response to the pandemic, the adjustments were made in the clinical practice to accommodate social distancing. Patient consultations were done over phone call or in-clinic visit with prior appointment to reduce the risk of exposure to COVID-19. Total number of patients that were treated at the clinic and the essential surgeries performed during the pandemic phases are summarized in the report. The methodology adopted here for care and management of the cancer patients can serve as a guiding principle for cancer care units in the country.
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Affiliation(s)
- Laleh Busheri
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Smeeta Nare
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Rituja Banale
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Ashwini Bapat
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Moushumi Nagarkar
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Deepali Vetale
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Rebecca Joseph
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Swapnil Suryawanshi
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Rashmi Alhat
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - George Thomas
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Ruth Navgire
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Danish Ansari
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Rohini Unde
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Shahin Shaikh
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Nutan Gangurde
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Santosh Dixit
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India.,Center for Translational Cancer Research, A Joint Initiative between IISER Pune and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Beenu Varghese
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Chetan Deshmukh
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Devaki A Kelkar
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India.,Center for Translational Cancer Research, A Joint Initiative between IISER Pune and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Madhura Kulkarni
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India.,Center for Translational Cancer Research, A Joint Initiative between IISER Pune and Prashanti Cancer Care Mission, Pune, Maharashtra, India
| | - Chaitanyanand B Koppiker
- Orchid Breast Health Clinic and Prashanti Cancer Care Mission, Pune, Maharashtra, India.,Center for Translational Cancer Research, A Joint Initiative between IISER Pune and Prashanti Cancer Care Mission, Pune, Maharashtra, India
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Kusuma D, Pradeepa R, Khawaja KI, Hasan M, Siddiqui S, Mahmood S, Ali Shah SM, De Silva CK, de Silva L, Gamage M, Loomba M, Rajakaruna VP, Hanif AAM, Kamalesh RB, Kumarendran B, Loh M, Misra A, Tassawar A, Tyagi A, Waghdhare S, Burney S, Ahmad S, Mohan V, Sarker M, Goon IY, Kasturiratne A, Kooner JS, Katulanda P, Jha S, Anjana RM, Mridha MK, Sassi F, Chambers JC. Low uptake of COVID-19 prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: Evidence from a large-scale multi-country surveillance programme. SSM Popul Health 2021; 13:100751. [PMID: 33665333 PMCID: PMC7902538 DOI: 10.1016/j.ssmph.2021.100751] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND South Asia has become a major epicentre of the COVID-19 pandemic. Understanding South Asians' awareness, attitudes and experiences of early measures for the prevention of COVID-19 is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region. METHODS We assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative. RESULTS Participants were 61% female, mean age 45.1 years. Almost half had one or more chronic disease, including diabetes (16%), hypertension (23%) or obesity (16%). Knowledge of the primary COVID-19 symptoms and transmission routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety or depression. The prevalence of unemployment rose from 9.3% to 39.4% (P < 0.001), and household income fell by 52% (P < 0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P < 0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P < 0.001), during the lockdown. CONCLUSIONS Our results identified important knowledge, access and uptake barriers to the prevention of COVID-19 in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.
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Affiliation(s)
- Dian Kusuma
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
| | | | | | - Mehedi Hasan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Sara Mahmood
- Services Institute of Medical Sciences, Lahore, Pakistan
| | | | | | | | - Manoja Gamage
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Abu AM Hanif
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | | | - Marie Loh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
| | | | | | | | | | - Saira Burney
- Services Institute of Medical Sciences, Lahore, Pakistan
| | - Sajjad Ahmad
- Punjab Institute of Cardiology, Lahore, Pakistan
| | | | - Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Ian Y. Goon
- School of Public Health, Imperial College London, London, UK
| | | | - Jaspal S. Kooner
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | | | - Malay K. Mridha
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Franco Sassi
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
| | - John C. Chambers
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
| | - NIHR Global Health Research Unit for Diabetes and Cardiovascular Disease in South Asia
- Centre for Health Economics & Policy Innovation, Imperial College Business School, UK
- Madras Diabetes Research Foundation, Chennai, India
- Services Institute of Medical Sciences, Lahore, Pakistan
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Max Healthcare, New Delhi, India
- Punjab Institute of Cardiology, Lahore, Pakistan
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- School of Public Health, Imperial College London, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Akhtar N, Rajan S, Chakrabarti D, Kumar V, Gupta S, Misra S, Chaturvedi A, Azhar T, Parveen S, Qayoom S, Niranjan P, Tiwari S. Continuing cancer surgery through the first six months of the COVID-19 pandemic at an academic university hospital in India: A lower-middle-income country experience. J Surg Oncol 2021; 123:1177-1187. [PMID: 33567139 PMCID: PMC8014154 DOI: 10.1002/jso.26419] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/12/2021] [Accepted: 01/28/2021] [Indexed: 12/12/2022]
Abstract
Background The novel coronavirus pandemic (COVID‐19) hinders the treatment of non‐COVID illnesses like cancer, which may be pronounced in lower‐middle‐income countries. Methods This retrospective cohort study audited the performance of a tertiary care surgical oncology department at an academic hospital in India during the first six months of the pandemic. Difficulties faced by patients, COVID‐19‐related incidents (preventable cases of hospital transmission), and modifications in practice were recorded. Results From April to September 2020, outpatient consultations, inpatient admissions, and chemotherapy unit functioning reduced by 62%, 58%, and 56%, respectively, compared to the same period the previous year. Major surgeries dropped by 31% with a decrease across all sites, but an increase in head and neck cancers (p = .012, absolute difference 8%, 95% confidence interval [CI]: 1.75% — 14.12%). Postoperative complications were similar (p = .593, 95% CI: −2.61% — 4.87%). Inability to keep a surgical appointment was primarily due to apprehension of infection (52%) or arranging finances (49%). Two COVID‐19‐related incidents resulted in infecting 27 persons. Fifteen instances of possible COVID‐19‐related mishaps were averted. Conclusions We observed a decrease in the operations of the department without any adverse impact in postoperative outcomes. While challenging, treating cancer adequately during COVID‐19 can be accomplished by adequate screening and testing, and religiously following the prevention guidelines.
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Affiliation(s)
- Naseem Akhtar
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shiv Rajan
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Deep Chakrabarti
- Department of Radiation Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sanjeev Misra
- Director, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arun Chaturvedi
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Tashbihul Azhar
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shirin Parveen
- Department of Anaesthesiology, Era's Lucknow Medical College, Lucknow, Uttar Pradesh, India
| | - Sumaira Qayoom
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Palavalasa Niranjan
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shashwat Tiwari
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
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