Since the global outbreak of the coronavirus pandemic several months ago, UICC has sought to respond to the need for organisations to come together and share knowledge and best practices. On 23 April, UICC again convened 100 participants for a second webinar on how the coronavirus pandemic is affecting the cancer community. Panellists from Spain, Colombia, Brazil and the Pan American Health Organization exchanged on how to provide emotional and financial support to civil society, manage the need for treatment, anticipate the aftermath of the pandemic, and fundraise in a virtual environment marked by economic and social distress.
Spain is one of the hardest hit countries in terms of coronavirus-related cases and deaths. During the webinar, Ana Fernández-Marcos, Advocacy and Institutional Relations Director at the Spanish Association Against Cancer (Asociación Española Contra el Cáncer, AECC), touched upon three major consequences of coronavirus: a tremendous health impact in terms of how to limit the infection of cancer patients in hospitals; the social and economic consequences; and the emotional impact of confinement and fear of infection.
To address the heightened uncertainty and anxiety caused by the pandemic, AECC implemented a virtual accompanying system that has supported and guided 18,000 people so far, built on its preexisting “infocancer” channel that offers a round-the-clock (24/7) hotline response, and doubled the funding it usually provides to cancer patients and families in need.
“The impact of the pandemic on the healthcare system will subside but the social and economic fallout has barely started,” said Ms Fernández-Marcos. “We need to identify future challenges regarding projects that have been postponed, such as in research, and develop new strategies.”
While the recorded number of cases and deaths relative to population remain lower in Latin America than in Europe or the United States, health systems are already at risk of being overwhelmed. Brazil is currently the most affected country, with more than 4,500 recorded deaths and over 50,000 registered cases as of 28 April – but according to the Euronews report relaying these figures, public health experts think that the number of cases could be up to 15 times higher. Chile, Peru, Ecuador, and the Dominican Republic are also heavily affected, illustrating the heavy toll exacted by the coronavirus in countries where it can prove more difficult to implement widespread testing and detect cases, trace and isolate them while not overwhelming health services so that they can operate within their capacity.
Silvana Luciani, Chief of the Unit of Noncommunicable Diseases, Violence and Injuries Prevention at the Pan American Health Organization (PAHO), said that the speed of this pandemic is faster than the ability to process scientific information about the virus and develop medical technologies. The organization is working closely with ministries of health to support health services in the response efforts, including the protection of doctors and nurses and other frontline workers, improve the capacity of public laboratories for testing, which is important to reducing the community transmission of the infection, and monitor and evaluate the COVID-19 situation and impact of the pandemic in the region.
Colombia has some 5,600 recorded cases as of 28 April, and the cancer community mobilised rapidly after WHO officially declared a pandemic, said Dr Lina Maria Trujillo, Medical Director at the National Cancer Institute in Bogotá. Beyond the issues of postponed treatments and patient exposure to contagion, Dr Trujillo notes a delay in transplants, including bone marrow transplants, and a decrease in blood donations. “We are also concerned with the health of doctors and nurses, as in Colombia staff tend to work in and move between different medical facilities,” she said. In Colombia as in Brazil and elsewhere, there is a push to designate or scale up the number of coronavirus-free hospitals or wards to help protect people who require non-covid-related medical care. Dr Trujillo also said that a lot could be done to develop home delivery and telemedicine options, as some flexibility is being shown by authorities in light of the pandemic.
Maira Caleffi, a breast cancer surgeon and Volunteer President at the Brazilian Federation of Philanthropic Breast Health Support Institutions (Federação Brasileira de Instituições Filantrópicas de Apoio à Saúde da Mama or FEMAMA), said that the question facing her team at the hospital and FEMAMA every day is: “How do we continue our work in a situation of such distress.” Due to COVID-19, cancer treatments have been postponed indefinitely and patients themselves cancel their appointments out of fear of infection and due to misinformation.
“Basic medical services in cancer centres are up and running and professionals are there on hand to receive patients, but people have been asked to stay at home so they don’t come. The message from authorities has not been clear enough and so we are fighting now to get the right information out,” said Dr Caleffi. As elsewhere, there is real concern about an epidemic of advanced cancer cases and expensive treatments after the COVID-19 threat subsides. “It is not always an emergency, but it is an urgency to diagnose and treat as soon as possible.” Growing political instability in Brazil may further complicate the situation.
The coronavirus pandemic has had rapid and serious implications for NGO funding. Dr Caleffi explained that like many donor-supported organisations in the cancer community, FEMAMA relies heavily on activities like concerts and rallies, which require a large and close gathering of people and that can therefore no longer take place.
Organisations have adapted their working models to offer webinars, WhatsApp groups and other virtual platforms for their members to continue the work and unite patients and caregivers. Nevertheless, it remains difficult to maintain momentum and support patients emotionally and economically.
Ms Luciani at PAHO said she saw three opportunities for NGOs and civil society working in cancer control to adapt and innovate: “Develop advocacy and mobilise the community, promote the adaptation of healthcare services, and contribute to knowledge generation.”
“Finding a balance between services offered and their sustainability, as well as establishing clear priorities, are key,” said Ms Fernández-Marcos at AECC. “Once funding comes in, we need to look at the next steps, be creative and develop a plan to keep up our work and provide even more and better services.”
A number of resources from the panellists and other organisations from the UICC network are available here, together with the recordings of the webinars. For any questions do not hesitate to contact firstname.lastname@example.org