The Impact of COVID-19 on Cancer Treatment

When the pandemic was first declared in mid-March, cancer screening services were temporarily suspended in order to direct resources to COVID-19 patients. As CCSN reported in our cross-national survey this summer, 23 percent of cancer patients, 33 percent of caregivers, and 34 percent of pre-diagnosis patients had a routine cancer screening cancelled or rescheduled because of COVID-19. These services are essential for ensuring that patients can have access to timely treatments and prevent their cancer from developing or worsening.

According to surveys conducted by the Canadian Association of Radiologists and the Canadian Association of Medical Radiation Technologists, there was a 50-70% decrease in the delivery of radiology services between March 11 and April 30. In Ontario, there was a 98% decrease in mammograms, 88% decrease in Pap tests, and 72% decrease in Fecal immunochemical tests, which screen for breast, cervical, and colorectal cancer respectively between mid-March and mid-May compared to the same time period last year. There has also been a drop in referrals from primary care physicians during the first few months of the pandemic, which means that many pre-diagnosis patients have not been able to see a specialist at all.

As radiology departments work to manage the growing number of patients on wait lists, they have had to prioritize those with the most urgent cases. However, this does mean that lower priority patients who continue to wait for treatment or screening may experience a progression of their cancer in the interim. In particular, “there is zero (0) capacity for new P4 scans [which are for those who are lower priority and can wait up to 60 days] because of the waitlists that existed before COVID-19.” Additionally, efforts to increase productivity back up to pre-pandemic levels have required additional resources in order to ensure that physical distancing and disinfection protocols are followed. As many provinces are entering a second wave of COVID-19, maintaining screening services while dealing with the resurgence of hospitalizations due to the pandemic will be a challenge.

After a steady decline in cases over the summer, several provinces have seen a rapid increase, with a few breaking their record for the number of cases recorded in a single day. Public health officials in Ontario are predicting that the province could experience up to 1,000 new cases daily by the time it reaches the peak of this second wave. Additionally, each confirmed case of COVID-19 has had more contacts that during the first wave, according to Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, which could be attributed to the fairly lax restrictions that were in place over the summer. Quebec has also recorded new daily records for cases this past week, passing the 1000 cases per day threshold. In Alberta, cases are also going back up as the province recorded 276 new cases on October 6th, the highest number since April.

In an effort to manage the recent increase in cases, many governments are implementing newer restrictions, particularly in hotspots. Quebec has mandated masks for high school students and banned private gatherings in red zones at least until October 28th. Ontario has implemented new restrictions for the three hot-spots – Toronto, Ottawa, and Peel region – which includes the closure of bars, restaurants, and gyms.  Alberta is taking a “lighter approach”, encouraging people to take precautions themselves in order to keep businesses operational.

Although some provinces have been harder hit by COVID-19 than others, it is still imperative that we all do our part to limit the spread. Wearing masks (especially when indoors), washing hands frequently, staying home when ill, and self-isolating for 14 days if you or someone you have interacted with has contracted COVID-19 will all help limit the spread of this illness. Since cancer patients and survivors are especially vulnerable due to weakened immune systems, it is imperative that they continue to take precautions to limit risks. Below, you can find the COVID-19 guidelines for your province.

COVID – 19 guidelines for each province

1. Alberta – https://www.alberta.ca/coronavirus-info-for-albertans.aspx
2. British Columbia – http://www.bccdc.ca/health-info/diseases-conditions/covid-19
3. Manitoba – https://www.gov.mb.ca/covid19/index.html
4. New Brunswick – https://www2.gnb.ca/content/gnb/en/corporate/promo/covid-19.html
5. Newfoundland & Labrador – https://www.gov.nl.ca/covid-19/
6. Nova Scotia – https://novascotia.ca/coronavirus/
7. Ontario – https://covid-19.ontario.ca/
8. Prince Edward Island – https://www.princeedwardisland.ca/en/topic/covid-19
9. Quebec – https://www.quebec.ca/en/health/health-issues/a-z/2019-coronavirus/
10. Saskatchewan – https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus
11. Northwest Territories – https://www.gov.nt.ca/covid-19/
12. Nunavut – https://www.gov.nu.ca/health/information/covid-19-novel-coronavirus
13. Yukon – https://yukon.ca/en/covid-19-information