Reasons for the surge and ways to prevent it
Post-Hurricane Katrina, reduced access to cancer care was significantly
associated with difficulty obtaining treatment.6 We
believe that lack of timely access to care could lead to a similar
post-COVID-19 surge of advanced stage HNC across the country. During
these unprecedented times, there are many reasons for which a patient
may be evaluated later than usual. Patients themselves may fear visiting
their doctor at the risk of potentially contracting COVID-19, while
physicians have limited their schedules and a patient could be given a
later appointment time. Clinics have limited their schedules in order to
optimize the safety of their staff and their patients. Reasons for these
restricted schedules include but are not limited to, lack of personal
protective equipment (PPE), lack of rapid COVID-19 testing, lack of
transportation, social distancing and shelter-in-place orders, limiting
office visits for patients deemed high risk of contracting COVID-19,
lack of access to telemedicine services, and staffing concerns. Fear of
contracting COVID-19 has been shown to play a significant role in
patients not seeking medical care. In Italy, hospital statistics from
the period of March 1-27, 2020, showed substantial decreases (ranging
from 73-88%) in pediatric emergency department visits compared with the
same time periods in 2018 and 2019. All parents who were surveyed
reported avoiding hospitals for fear of infection with
COVID-19.8 In light of this, patients and their
primary care physicians should be reminded that Otolaryngology – Head
and Neck Surgery clinics are still open and consider patient safety the
highest priority. This can be done through a variety of platforms such
as social media, phone calls, emails, virtual town halls, and online
patient portals just to name a few. Patients who are concerned about
coming to clinic should be made aware that adequate precautions are in
place to decrease the risk of contracting COVID-19 and when appropriate,
can be offered telemedicine services.