Changes in Radiotherapy and Oncology Practices during the Coronavirus Disease-19 Pandemic: A Study of Two Radiotherapy Facilities in Lagos State, Nigeria
Authors: Sowunmi Anthonia Chima , Fashola Omotola Toyibat , Aje Eben Adepitan , Fatiregun Omolara Amina , Olatunji-Agunbiade Temitope 
Published: June 2024

Abstract

Background:
Coronavirus disease (COVID-19) outbreak in 2019 was caused by severe acute respiratory syndrome coronavirus 2 and became a pandemic in 2020, resulting in significant changes in the management of noncommunicable diseases globally including cancer. Globally, the health-care system, including the Nigerian health-care system, experienced agonizing difficulties coping with patient care, thereby transforming health-care delivery worldwide.

Aim:
This study is aimed at evaluating the changes in radiotherapy and oncology practices during the COVID-19 pandemic in two radiotherapy facilities in Lagos state.

Materials and Methods:
Using a quantitative nonexperimental design (comparative), data collection was by semistructured questionnaires filled by all medical personnel of oncology centers in Lagos University Teaching Hospital (LUTH) and Eko Hospital in Lagos over 2 months. A total of 65 questionnaires were reviewed. Data obtained were analyzed using SPSS statistics (Social Sciences Statistical Package) Version 26.0., launched in April 2019 in Chicago, USA.

Results:
The majority of the respondents were aged 31–50 (70.2%) and females (52%), with the majority of the workforce being clinical and radiation oncologists (29.2%) and 38.5% of respondents having 5–10 years of work experience. The oncology centers were operational throughout the pandemic and 67.2% of respondents confirmed that there were no changes in scheduling of new patients, but 89.2% reported a decline in patient attendance in the facility due to fear of contracting COVID-19 infection from the hospital. Implementation of personnel safety and protective measures such as staff screening before each shift, covid 19 infection testing when they exhibited symptoms, routine wearing of masks, face shields, gloves, personal protective equipment gowns, increased sterilization, and social distancing should be adhered to strictly. New operational measures were adopted for patients, which were similar to that of the staff inclusive of telehealth consultations or follow-ups (23.1%) and telehealth for on-treatment visits (16.9%). The incidence of COVID-19 infection patients who came for treatment was 34%, but they were treated at a specific time of the day and a dedicated LINAC machine was devoted to them because our cancer center has 3 LINAC machines. 75.4% of the workforce confirmed a reduction in staffing to curb overcrowding, 13.8% of staff contacted the disease, 10.8% of staff were transferred to other clinical areas, and 36.9% were unavailable due to the impact of the pandemic on the family.

Conclusion:
A standard protocol has emanated from this study which has been adopted and is being implemented by the two oncology centers as a result of the majority of the respondent’s preference for the Covid 19 induced changes during the pandemic which resulted in the improved and better standard of care for patients, safety for staff, infection control, incorporation of telemedicine, increase in hypofractionation treatment.