Contingency planning should treatment need to change during the COVID-19 outbreak
Hope for the best, plan for the worst. It’s a phrase you may well have heard used by oncologists when thinking about organising treatments for children with cancer. We tend to set up plan A, but consider what Plan B and maybe even what Plan C could be should things go awry.
In the face of the current pandemic, the health service is expected to be under enormous strain, mainly due to adult cases. The resources that we usually have may be stretched, and in some cases and some places absent. In order to create a plan B, and C should those resources become very thin, Children’s Cancer and Leukaemia Group (CCLG) has been working with our members, national and international experts in childhood cancers, to provide guidance on how to safely change what we do without moving from our quest for cure.
You might have noticed some changes in place already – with more telephone or video consultations rather than face to face reviews – perhaps a change in the way that blood tests are taken. CCLG has also developed national guidance for safely reducing tests such as kidney or heart tests to minimise journeys to hospitals, in turn aiming to reduce risk for spreading the virus when attending hospital. Some of the scans you are used to having, particularly off treatment and were told would happen at a certain time may be rescheduled based on the best evidence we have to make sure this is safe.
We do not know of anywhere which is needing to change the actual anti-cancer treatment given at this moment in time. We have been asked to formally plan for what we would do if the Children’s and Young Persons Cancer services came under extreme pressure. We do not want to compromise the quality and effectiveness of current anti-cancer therapy. However, where therapy intensity can safely be reduced without compromising chance of cure these might be considered if necessary. These are not things that we have wanted to think about, and we hope that all our efforts have been a waste of time. However, we want you to know that there has been thinking and planning, there has been intense debate and consultation, and that while we have written these plans down, most of these we hope not to need to use.
Dr Bob Phillips, Consultant Paediatric Oncologist, with Angela Polanco, Parent Advisor, Ashley Gamble, CCLG Chief Executive, Prof Kathy Pritchard-Jones, President, International Society for Paediatric Oncology and Prof Richard Grundy, CCLG Chairman on behalf of the CCLG Executive.