COVID has led to delays and postponed chemotherapy sessions. Due to the ongoing pandemic, private and public hospitals had decided to postpone elective surgeries including cancer treatment procedures which have led to a major fall in hospital revenues and may impact cancer patient’s treatment process. Is prioritizing COVID care over cancer care a solution?
Recently, a report published by NCRP (National Centre for Disease Informatics and Research), Bangalore mentioned that the total new cancer cases per year are projected to go up from ~980K cases in 2010 to ~1.2M cases in 2020. Cancer is the second most common cause of death in India after cardiovascular diseases, causing ~785K deaths in 2018. Oral cancer for men and cervical cancer for women were the most prevalent cancer patterns in India. Apart from these, breast, lung, stomach, and colorectal cancer are the other common types of cancer popular in India.
India’s incidence rate, when compared to other nations, is much better; at 106.6 per one lakh population as opposed to Australia (468.0), New Zealand (438.1), and USA (352.2). Although India’s incidence rate may be lower, in absolute terms, as the country has one of the highest numbers of cancer cases in the world. The reason for India having a lower incidence rate than most developed countries is that one of the main risk factors for cancer is aging. Since developed countries have a higher life expectancy, their citizens have a higher possibility of developing cancer. Although every type of cancer has a specific cause, there are a few causes that are more prominent than the others. Obesity, consumption of tobacco or pan masala, excessive alcohol consumption, delayed child-birth, reduced breast-feeding, chemicals consumed through water or food, pollution, stress and lack of exercise are some of the most common causes attributed to different types of cancer.
Generally, hospitals make profits only when occupancy rates are 80-85%. Due to COVID, occupancy rates have dropped drastically in hospitals. Equipment and resources procurement costs have increased due to local sourcing since global supply chains (imports mainly from China) are disrupted. Hospitals that were over-reliant on any single distributor are facing the heat due to logistical issues. Along with hospitals' procurement of drugs being affected, the attendance and workforce participation of hospital personnel are also impacted.
People who were supposed to undergo treatment are now on oral medicines to get some relief. Hospitals have stopped chemotherapy sessions since cancer patients are more susceptible to COVID due to their lower immunity levels. During active treatment, cancer patients require frequent hospital visits, pre-operative and post-operative stays, chemotherapy sessions, laboratory tests and radiological imaging, daily appointments for radiotherapy sessions (often over weeks). Even though chemotherapy or radiotherapy starts, hospitals will have to follow new sanitation protocols while it’s the cost would be borne by patients. Some of the protocols involve mobilizing additional resources like masks, gloves, and personal protection equipment. Hospitals need to procure enough ventilators and oxygen masks in preparation for future requirements.
In the current circumstances, Hospitals should come up with a rescue strategy for cancer patients to restart the chemotherapy sessions, either through home-based chemotherapy provided by home healthcare startups or create separate sanitized wards for them. Prioritizing one critical illness over others may not be the best way to go.
Aryaman Tandon, Leader, Healthcare Practice
Anjan Bose, Practice Leader & Advisor, Healthcare Practice