Today, OzSAGE, a multi-disciplinary network of Australian experts, releases its advice paper for Protecting adults and children with solid tumour and blood cancers and people with significant immunosuppression.
Extra measures are required to protect people with cancer and on treatments that cause immunosuppression in order to prevent hospitalisations and death and an increased risk of the emergence of SARS-CoV-2 variants.
In 2020 almost 150,000 Australians were diagnosed with cancer and there were just under 50,000 deaths from cancer. Most children and many adults with cancer are cured of their cancer so the additional risks associated with COVID-19 are important to mitigate. Patients with cancer and people with diseases or on treatments that cause significant suppression of the immune system have poor outcomes with COVID-19. They may experience more persistent COVID-19 infection and viral shedding, predisposing to accelerated viral evolution or increased risk of developing new SARS-CoV-2 variants. After two doses of COVID-19 vaccination, patients on chemotherapy and with other causes for immune suppression remain at higher risk of hospitalisation and death from COVID-19. Despite making up less than 3% of patients, they constitute 44% of breakthrough infections admitted to ICU even after double dose vaccination.
During the pandemic, there have been delays in diagnosis and decreased rates of cancer screening in Australia. Diversion of resources due to high workloads from COVID-19 has impacted on the delivery of clinical services to non-COVID patients, including immunocompromised patients with serious illnesses. Data on delayed presentations from Victoria and international modelling studies, is predicted to translate into excess cancer deaths and increased demand on health service resources over the next few years. The pre-pandemic multidisciplinary clinical workforce is stretched. There is a risk of burnout and attrition. Pre-pandemic cancer services had varying degrees of access to state-of-the-art infrastructure. This exaggerates the impact of COVID-19 on these essential services.
OzSAGE makes a series of recommendations to protect this large group of Australians.
These are detailed in the full advice document but include:
- Rapid rollout of a 3rd dose of vaccination which is essential to prevent infection, illness and hospitalisation.
- Implementing a VaccinesPLUS strategy because vaccination alone will be insufficient to control COVID-19 in a manageable way.
- Maintaining essential non-COVID19 service provision to ensure diagnoses are not delayed and cancer treatments can be maintained.
- Rapidly developing education campaigns to advise and encourage Vaccine and vaccine-PLUS strategies to protect patients with immunocompromise following the lifting of restrictions.
- A call for extra resources required to protect this substantial and at-risk population of Australians.
“One in two Australians will develop cancer in their lifetime. People with cancer and other conditions that affect the immune system are valuable members of our society. A civil society protects all of its citizens including the most vulnerable”Professor Eva Segelov
“Blood cancer patients are amongst the most vulnerable in this pandemic. As we start to feel a sense of normalcy and freedom, we need to remember that they can’t because they are not as protected by vaccination. We need to commit to no one left behind.”A/Prof Nada Hamad
“As we open up further, the COVID-19 pandemic will impact on health services. We need to ensure patients with cancer including those in regional areas can access treatment safely and health services are given the necessary resources to do so. The majority of people with cancer are cured so it’s incredibly important that they are protected at this critical time.Assoc/Prof Craig Underhill, Medical Oncologist, Albury Wodonga