COVID-19, in just two years, has already left deep scars on our world – from public health priorities and social norms to broader global economics and our personal, mundane lives. Perhaps the biggest impact has been felt on our healthcare systems.
Hospitals have been overwhelmed, understaffed, and overcrowded as critically ill patients seek treatment. We know, too, that COVID-19 is particularly dangerous to immunocompromised individuals.
That certainly includes kids with cancer.
If we want to best serve pediatric cancer patients, we must understand and tackle the new obstacles that the COVID-19 pandemic has put in their path.
These are valuable sources & studies we consulted for this list:
Although hospitals specifically designed to target and treat cancer, such as St. Jude Children’s Research Hospital, have not seen the same overcrowding as less specialized facilities, the pandemic has caused many children to have delayed access to a cancer diagnosis and treatment.
The pandemic has not only crowded hospitals, but it has made many Americans reluctant to seek medical treatment – particularly for issues that seem “non-urgent” for fear of becoming infected in a medical setting that involves the chance of exposure to COVID-positive patients.
Between this reluctance and an overburdened healthcare system, patients lose precious time to diagnose their cancer and receive treatment.
Clinical studies and trials are key in developing new, more effective ways of treating pediatric cancer. Not only has the pandemic delayed the opening of new clinical trials, but it has decreased participation in them.
As ASCO reports:
"A total of 48.5% of phase I trials, 61% of phase II trials, and 64% of molecular platform trials closed to recruitment in at least one site. Worryingly, 16% of sites stopped all clinical trial recruitment for pediatric patients with cancer.”
Additionally, the ability to follow-up and monitor trial participants in person was hindered.
Although COVID infections are rarely serious in children (even in more vulnerable pediatric patients), a COVID diagnosis commonly results in delayed or abandoned cancer care. This also results in suboptimal care – and although we do not yet know the long-term impact of these interruptions, we do know that they are detrimental to the patient’s overall wellbeing and progress.
Supply chains have been disrupted the world over. While we often consider this in terms of holiday shopping, gas prices, and construction materials, pediatric cancer care has been impacted, too. Shortages of blood supplies, chemotherapy treatments, and other necessary medical equipment have created difficulty and delays in receiving appropriate treatment.
Perhaps the only good thing to come from the COVID-19 pandemic is a renewed priority in general hygiene and the prevention of viral spread. Pediatric cancer patients are vulnerable to any and all illnesses due to their compromised immune systems. While today’s efforts to wash hands, disinfect, and wear masks are largely about preventing COVID infection, they also help reduce the spread of other illnesses that can be serious in children with cancer.
Overall, the U.S. healthcare system has had to rework its procedures and policies in the wake of the COVID-19 pandemic. There have been changes in protocol for hygiene, communication, and services. Low and middle-income countries have been most impacted by these disruptions in care – and already experience higher mortality rates among pediatric cancer patients.
In high-income countries, the delays and disruptions have been less noticeable, but they are still significant.
Of course, changes in the quality and availability of cancer care impacts the well-being of childhood cancer patients. Inconsistency or unavailability of treatments can result in longer treatment and recovery periods. Decreasing early diagnoses can result in cancer spreading unchecked.
Combined with the necessary isolation imposed by the COVID-19 pandemic – both for those infected and high-risk individuals – this creates emotional and social issues.
Here’s the takeaway: COVID has changed the way pediatric cancer patients are treated. Some of these changes will not last forever, while others are here to stay. Regardless, if your child is experiencing odd medical symptoms, brave the crowd to get your child timely care and a diagnosis. As much as you are able, do not delay or put off treatment.
Support your child emotionally, mentally, and physically.
The pandemic has posed challenges for us all – but it has most impacted the vulnerable among us, like kids with cancer. Continue to champion the cause. COVID-19 can’t stop us from kicking cancer together!