COVID-19 and Cancer: Handling uncertainty – Working Together (Guest blog)

A year ago, we couldn’t have imagined what life would be like in April 2020. Today, my world ends at the door of the home office. Our relationships with friends and business partners are mediated through technical tools such as web cameras or telephones. Who would have ever thought we’d spend more time in virtual reality than in the real world?
However, for people like me this is probably a minor, temporary problem whereas there are other people for whom the pandemic has become a big threat. As Bettina Ryll says in her recent blog: Cancer patients belong to the risk group. Already living in difficult conditions, often between hope for survival and fear of dying, they are even more exposed to risk in these times.
Everyone, oncologists, nurses and all other healthcare professionals, are doing their best for cancer patients. Because they believe that every patient counts. But as described in the blog above, some cancer patients may face difficulties to get access to their treatment because some hospitals must avoid unnecessary exposure to additional risks. In some healthcare settings treatment initiations may have to be postponed, some treatment cycles may be suspended.[1]  
Time to question how we do things...
This new reality requires us, industry, regulators and payers, to work on solutions that address the problems mentioned above. Here are a few little steps: are there alternative/flexible dosing schemes where cancer patients can visit the hospital less frequently? Can some tasks such as infusions be applied at home, by nurses instead of doctors? In other disease areas such as diabetes patients can do self-injections. In mental health, e-health applications allow for caring about depressive patients.[2] Although personal interaction cannot be replaced[3], could some counselling happen through video and other online tools?
At larger scale, the European Commission is working with the originator and the generics industry to ensure continued medicines supply.[4] Private-public partnerships like IMI provide a network of sites for clinical trials of potential COVID-19 therapies.[5]
New reality, new challenges
We live in a new world with new challenges which require new approaches. Resources have become scarce. And health systems might be even more stretched when the crisis is over. We must adapt to this new reality.
The EFPIA Oncology platform has made a start in bringing different stakeholders together to share experiences and best practices. Recently, it launched a series of webinars on cancer in times of a pandemic as we believe we must discuss the impact on Europe’s Beating Cancer Plan, on cancer funding and on health systems in the longer run.
These are small steps, but it's a start. The world remains complex and new innovations are needed more than ever and will continue to require good collaboration and interaction. In times where we need each other’s skills, where there is a big unmet need, not only against COVID-19, we should also change our ways of working together towards our shared objective – to improve cancer patients lives.

[1] See e.g. American Cancer Society (15 April 2020), Survey: COVID-19 Affecting Patients’ Access to Cancer Care. Delays and financial strain dominate cancer patients’ experience in pandemic; (accessed: 20 April 2020); Schrag D, Hershman DL, Basch E (2020), Oncology Pracice During the COVID-19 Pandemic; JAMA; ESMO (2020), COVID-19: Supporting Oncology Professionals; (accessed: 20 April 2020); Lambertini M et al. (2020), Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists’ perspective; ESMO Open
[2] Klasnja P, Pratt W (2014), Healthcare in the pocket: Mapping the space of mobile-phone health interventions. Methodological Review; J Biomedical Informatics 45; 184-198;
[3] Tarricone R et al. (2019), Mobile Health Divide Between Clinicians and Patients in Cancer Care: Results From a Cross-Sectional International Survey; JMIR Mhealth Uhealth 7(9):e13584
[4] APM (14 April 2020), Drug firms in Europe get new competition flexibility to work together to combat Covid-19
[5] IMI (30 March 2020), IMI networks are helping set up and run COVID-19 drug trials; (accessed: 16/04/2020)

Deepak Khanna

Deepak Khanna is Senior Vice President and Regional President, EMEAC Oncology for MSD. Deepak took on this new...
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