The Impact of COVID-19 on Radiation Oncology Clinics and Patients With Cancer in the United States
Amanda Rivera, Nitin Ohri, E.D. Thomas, Robert C. Miller, Miriam A. Knoll
Abstract
In December 2019, Wuhan, China, witnessed the outbreak of the novel coronavirus (SARS-CoV-2, Table In the United States, we are at a time where preparation for health care systems is critical. Given the rapidity with which SARS-CoV-2 is spreading, we can expect an increased burden of patients with cancer who have received a diagnosis of COVID-19 at oncology treatment clinics and a need to address this diagnosis. As of the date of this writing, the United States has witnessed an increase in confirmed cases, not far behind the large outbreaks of European countries. ince the outbreak in Wuhan, Chinese researchers have published on their experience with COVID-19 and have highlighted high-risk groups, including the elderly and patients with comorbidities, including cancer. In one of the largest series reported from Wuhan, elderly patients were at a higher risk for disease severity, with an 8.0% case fatality rate in those aged 70 to 79 years and 14.8% in those aged 80 years and older. The case fatality rate for patients with cancer in that cohort was notably higher than that among patients without cancer, at 5.6% versus 2.1% in the whole sample; however, it must be noted that this series is very small. How these numbers will evolve in the US population remains to be determined. Based on available data, the impact of patients both at risk for and positive for COVID-19 will be felt throughout oncology clinics. The burden this may place on radiation oncology clinics is of particular concern owing to the potential need for screening of patients for daily treatment, treatment interruptions, delays in restarting treatment, and a decreased workforce.