The Day after Tomorrow: How Should We Address Health System Organization to Treat Cancer Patients after the Peak of the COVID-19 Epidemic?
Identifieur interne : 000478 ( Main/Exploration ); précédent : 000477; suivant : 000479The Day after Tomorrow: How Should We Address Health System Organization to Treat Cancer Patients after the Peak of the COVID-19 Epidemic?
Auteurs : Jean-Jacques Tuech [France] ; Alice Gangloff [France] ; Frederic Di Fiore [France] ; Ahmed Benyoucef [France] ; Pierre Michel [France] ; Lilian Schwarz [France]Source :
- Oncology [ 1423-0232 ] ; 2020.
Abstract
On March 11, 2020, the WHO director general declared COVID-19 a pandemic. This pandemic evolves in successive phases, i.e., phase 1 (the start phase), phase 2 ("the storm"), and phase 3 (the recession). To date, oncology and surgery groups have only given instructions for addressing phases 1 and 2. To prevent excess cancer mortality, health care systems (HCS) need to be restructured. Our aim is to detail the specificities of each epidemic phase and discuss several methods of organization to optimize cancer patient flow during the COVID-19 pandemic, particularly during phase 3. Hospitals must be reorganized in order to create a cancer hub that is free of infection, allowing for the safe treatment of patients. Hospital structures are different, but all allow for the creation of virus-free areas. Screening programs are critical and need to be applied to all people entering the virus-free zone, including health care workers. Some reorganization proposals are internal to a hospital, while others require interhospital collaboration. The heterogeneity and complexity of HCS will make interhospital management difficult. The ministry of health has an important role in managing the cancer crisis. Cancer management should be declared a priority. Oncological and surgical societies must coordinate their efforts to facilitate this prioritization. The anticipation of oncological management during phase 3 of the pandemic is necessary because it requires a complete readjustment of HCS. This adaptation should allow for the continuation of cancer care to prevent excess cancer mortality, as the virus will still be present for a currently undetermined period of time.
DOI: 10.1159/000509650
PubMed: 32683373
PubMed Central: PMC7445382
Affiliations:
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Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France, jean-jacques.tuech@chu-rouen.fr.</nlm:affiliation><country wicri:rule="url">France</country><wicri:regionArea>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France</wicri:regionArea><wicri:noRegion>France</wicri:noRegion><wicri:noRegion>France</wicri:noRegion></affiliation></author><author><name sortKey="Gangloff, Alice" sort="Gangloff, Alice" uniqKey="Gangloff A" first="Alice" last="Gangloff">Alice Gangloff</name><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Di Fiore, Frederic" sort="Di Fiore, Frederic" uniqKey="Di Fiore F" first="Frederic" last="Di Fiore">Frederic Di Fiore</name><affiliation wicri:level="3"><nlm:affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Benyoucef, Ahmed" sort="Benyoucef, Ahmed" uniqKey="Benyoucef A" first="Ahmed" last="Benyoucef">Ahmed Benyoucef</name><affiliation wicri:level="3"><nlm:affiliation>Radiotherapy Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Radiotherapy Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Michel, Pierre" sort="Michel, Pierre" uniqKey="Michel P" first="Pierre" last="Michel">Pierre Michel</name><affiliation wicri:level="3"><nlm:affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Oncology, Rouen University Hospital, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author><author><name sortKey="Schwarz, Lilian" sort="Schwarz, Lilian" uniqKey="Schwarz L" first="Lilian" last="Schwarz">Lilian Schwarz</name><affiliation wicri:level="3"><nlm:affiliation>Department of Digestive Surgery, Rouen University Hospital, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Digestive Surgery, Rouen University Hospital, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen</wicri:regionArea><placeName><region type="region">Région Normandie</region><region type="old region">Haute-Normandie</region><settlement type="city">Rouen</settlement></placeName></affiliation></author></analytic><series><title level="j">Oncology</title><idno type="eISSN">1423-0232</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">On March 11, 2020, the WHO director general declared COVID-19 a pandemic. This pandemic evolves in successive phases, i.e., phase 1 (the start phase), phase 2 ("the storm"), and phase 3 (the recession). To date, oncology and surgery groups have only given instructions for addressing phases 1 and 2. To prevent excess cancer mortality, health care systems (HCS) need to be restructured. Our aim is to detail the specificities of each epidemic phase and discuss several methods of organization to optimize cancer patient flow during the COVID-19 pandemic, particularly during phase 3. Hospitals must be reorganized in order to create a cancer hub that is free of infection, allowing for the safe treatment of patients. Hospital structures are different, but all allow for the creation of virus-free areas. Screening programs are critical and need to be applied to all people entering the virus-free zone, including health care workers. Some reorganization proposals are internal to a hospital, while others require interhospital collaboration. The heterogeneity and complexity of HCS will make interhospital management difficult. The ministry of health has an important role in managing the cancer crisis. Cancer management should be declared a priority. Oncological and surgical societies must coordinate their efforts to facilitate this prioritization. The anticipation of oncological management during phase 3 of the pandemic is necessary because it requires a complete readjustment of HCS. This adaptation should allow for the continuation of cancer care to prevent excess cancer mortality, as the virus will still be present for a currently undetermined period of time.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32683373</PMID><DateRevised><Year>2020</Year><Month>08</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1423-0232</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jul</Month><Day>17</Day></PubDate></JournalIssue><Title>Oncology</Title><ISOAbbreviation>Oncology</ISOAbbreviation></Journal><ArticleTitle>The Day after Tomorrow: How Should We Address Health System Organization to Treat Cancer Patients after the Peak of the COVID-19 Epidemic?</ArticleTitle><Pagination><MedlinePgn>1-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1159/000509650</ELocationID><Abstract><AbstractText>On March 11, 2020, the WHO director general declared COVID-19 a pandemic. This pandemic evolves in successive phases, i.e., phase 1 (the start phase), phase 2 ("the storm"), and phase 3 (the recession). To date, oncology and surgery groups have only given instructions for addressing phases 1 and 2. To prevent excess cancer mortality, health care systems (HCS) need to be restructured. Our aim is to detail the specificities of each epidemic phase and discuss several methods of organization to optimize cancer patient flow during the COVID-19 pandemic, particularly during phase 3. Hospitals must be reorganized in order to create a cancer hub that is free of infection, allowing for the safe treatment of patients. Hospital structures are different, but all allow for the creation of virus-free areas. Screening programs are critical and need to be applied to all people entering the virus-free zone, including health care workers. Some reorganization proposals are internal to a hospital, while others require interhospital collaboration. The heterogeneity and complexity of HCS will make interhospital management difficult. The ministry of health has an important role in managing the cancer crisis. Cancer management should be declared a priority. Oncological and surgical societies must coordinate their efforts to facilitate this prioritization. The anticipation of oncological management during phase 3 of the pandemic is necessary because it requires a complete readjustment of HCS. This adaptation should allow for the continuation of cancer care to prevent excess cancer mortality, as the virus will still be present for a currently undetermined period of time.</AbstractText><CopyrightInformation>© 2020 S. Karger AG, Basel.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tuech</LastName><ForeName>Jean-Jacques</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Department of Digestive Surgery, Rouen University Hospital, Rouen, France, jean-jacques.tuech@chu-rouen.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France, jean-jacques.tuech@chu-rouen.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gangloff</LastName><ForeName>Alice</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Di Fiore</LastName><ForeName>Frederic</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Benyoucef</LastName><ForeName>Ahmed</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Radiotherapy Department, Centre de Lutte Contre le Cancer Henri-Bequerel, Rouen, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Michel</LastName><ForeName>Pierre</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Digestive Oncology, Rouen University Hospital, Rouen, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwarz</LastName><ForeName>Lilian</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Digestive Surgery, Rouen University Hospital, Rouen, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UNIROUEN, UMR 1245 INSERM, Rouen University Hospital, Department of Genomic and Personalized Medicine in Cancer and Neurological Disorders, Normandie University, Rouen, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>07</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Oncology</MedlineTA><NlmUniqueID>0135054</NlmUniqueID><ISSNLinking>0030-2414</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19 outbreak</Keyword><Keyword MajorTopicYN="N">Cancer</Keyword><Keyword MajorTopicYN="N">Health care systems</Keyword><Keyword MajorTopicYN="N">Oncology</Keyword><Keyword MajorTopicYN="N">Pandemic</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>06</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>7</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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17;70(5):364-369</Citation><ArticleIdList><ArticleId IdType="pubmed">32372077</ArticleId></ArticleIdList></Reference><Reference><Citation>Euro Surveill. 2020 Mar;25(10):</Citation><ArticleIdList><ArticleId IdType="pubmed">32183930</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><region><li>Haute-Normandie</li><li>Région Normandie</li></region><settlement><li>Rouen</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Tuech, Jean Jacques" sort="Tuech, Jean Jacques" uniqKey="Tuech J" first="Jean-Jacques" last="Tuech">Jean-Jacques Tuech</name></noRegion><name sortKey="Benyoucef, Ahmed" sort="Benyoucef, Ahmed" uniqKey="Benyoucef A" first="Ahmed" last="Benyoucef">Ahmed Benyoucef</name><name sortKey="Di Fiore, Frederic" sort="Di Fiore, Frederic" uniqKey="Di Fiore F" first="Frederic" last="Di Fiore">Frederic Di Fiore</name><name sortKey="Di Fiore, Frederic" sort="Di Fiore, Frederic" uniqKey="Di Fiore F" first="Frederic" last="Di Fiore">Frederic Di Fiore</name><name sortKey="Gangloff, Alice" sort="Gangloff, Alice" uniqKey="Gangloff A" first="Alice" last="Gangloff">Alice Gangloff</name><name sortKey="Michel, Pierre" sort="Michel, Pierre" uniqKey="Michel P" first="Pierre" last="Michel">Pierre Michel</name><name sortKey="Michel, Pierre" sort="Michel, Pierre" uniqKey="Michel P" first="Pierre" last="Michel">Pierre Michel</name><name sortKey="Schwarz, Lilian" sort="Schwarz, Lilian" uniqKey="Schwarz L" first="Lilian" last="Schwarz">Lilian Schwarz</name><name sortKey="Schwarz, Lilian" sort="Schwarz, Lilian" uniqKey="Schwarz L" first="Lilian" last="Schwarz">Lilian Schwarz</name><name sortKey="Tuech, Jean Jacques" sort="Tuech, Jean Jacques" uniqKey="Tuech J" first="Jean-Jacques" last="Tuech">Jean-Jacques Tuech</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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