Initial Impact and Operational Response of Radiation Oncology Practices to the COVID-19 Pandemic in the United States, Europe, and Latin America

Purpose/Objective(s)

The COVID-19 pandemic has profoundly changed practice patterns in medicine around the world. The full impact on radiation oncology in the United States (US), Europe, and Latin America remains unknown. We surveyed radiation oncology practice leaders from each region to gauge initial impact and immediate operational responses to the pandemic.

Materials/Methods

From April 16 - May 30, 2020, the American Society for Radiation Oncology (ASTRO), European Society for Radiation Oncology (ESTRO), and Rayos Contra Cancer in Latin America surveyed radiation oncology practices by email to gauge initial impact and immediate operational responses to the COVID-19 pandemic.

Results

In total, 474 of 1,246 practice leaders responded across 45 nations [222/517 (43%) in the US, 139/500 (28%) from 29 nations in Europe, 115/229 (50%) from 15 nations in Latin America]. All practices in the US and Europe and 97% of practices in Latin America reported uninterrupted operation. Average treatment volumes were reduced to 68%, 75%, and 59% of baseline in the US, Europe, and Latin America, respectively. Postponement of radiation therapy for low-risk patients was widely adopted (92%, 65%, 60%). Estimated reductions in revenue greater than 20% were reported by 71%, 25%, and 53% of US, European and Latin American practices, respectively. Nearly all practices (98%, 95%, 97%) implemented formal safety procedures to protect patients and staff from infections. Staffing (70%, 57%, 52%) and PPE shortages (69%, 48%, 51%) impacted all regions; first-time adoption of telemedicine programs was widespread (89%, 76%, 64%).

Conclusion

Surveyed impact of the early COVID-19 pandemic on radiation oncology practices across the US, Europe, and Latin America was substantial. Treatment access policies reflected rapidly published international guidelines to delay treatment for low-risk diagnoses. Patients with higher risk disease continued to receive uninterrupted access to care. Despite staffing shortfalls, safety supply deficits, and financial instability, practices across these regions demonstrated resilience, quickly adopting safety recommendations and leveraging new telemedicine programs to facilitate prioritized treatment continuity. Continued surveying of international practice responses to the evolving pandemic is planned to estimate the impact on oncological outcomes. Wider outreach and surveying of practices from low and middle-income countries and regions is warranted.

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