Changes implemented by US oncology practices in response to COVID-19 pandemic: Initial report from the ASCO Registry on COVID-19 and cancer
Authors: Suanna S. Bruinooge, Elizabeth Garrett-Mayer, Stephen Meersman, Patricia Hurley, Brian Bourbeau, Allyn Moushey, Sybil Green, Deborah Kamin, Stephen Grubbs, Richard L. Schilsky
Journal: Clinical Cancer Research (2020)

Background: In April 2020, ASCO initiated a registry to capture and analyze status and outcomes of patients withcancer and COVID-19, and to describe effects of the pandemic on U S  cancer practices  Initial findings of changesto care delivery are included  Methods: Practices provide data on changes to care delivery due to COVID-19 and longitudinal data on patients with cancer and confirmed COVID-19  At present, 26 cancer practices have enrolled in the Registry-5 academic,15 hospital/health-system (H/HS) owned, and 6 physician-owned (P-O) located in 19 states  Enrollment of practicesand data collection is ongoing  Results: Twenty sites, from 17 practices (3 academic, 9 H/HS owned, and 5 P-O in 15 states) responded (April 20-June 4)  All incorporated telemedicine visits;90% reported use of telemedicine was new  30% reported “decliningsome but not all” new patient requests  For patients with cancer not on active therapy, 15% of sites postponed someroutine visits, 35% conducted virtually all routine visits by telemedicine, and 50% used telemedicine for some routinevisits  Most sites (95%) reported following clinical guidelines for visit postponement;90% reported following localhealth authorities on when to resume routine visits  90% screened patients prior to in-office visits for COVID-19symptoms by phone and at clinic entrance;10% screened patients using only one method  30% modifiedintravenous (IV) drug infusions, including halting some or all (10%), shortening some or all (20%), or switching fromIV to oral drugs (15%)  While no sites conducted home-based, anticancer drug infusions, 30% are considering thisoption if COVID19 conditions change  Most sites modified laboratory specimen collection, including allowing acollection site closer to home (60%) and collection in a patient's home (1 site)  Two sites only allowed patients onoral anticancer drugs to use alternate collection sites  Only 1 site reported specimen collection in patients' homes All reported making the following changes to clinic arrangements: requiring use of masks, eliminatingaccompaniment by a support person (with exceptions), and reducing the visit numbers or increasing time betweenvisits  No sites reported shortages of anticancer or supportive care drugs  45% experienced shortages ofnasopharyngeal swabs, 45% of medical hand sanitizer, and 75% of personal protective equipment  40% of siteshave experienced staffing reductions or changes due to reduced patient visits (30%), transfer to other clinical areas(20%), availability (15%), and COVID-19 illness (15%)  Conclusions: The COVID-19 pandemic has had a substantial impact on most aspects of cancer care delivery inU S  oncology practices  All practices incorporated telemedicine, which is new to most  Adjustments were made topatient visits and scheduled IV drug infusions  Sites reported shortages of equipment related to COVID-19, notcancer or supportive care drug shortages  At the time of the AACR meeting we expect to have data from morepractices