INTRODUCTION:
During the COVID-19 pandemic, the prime care is directed towards the
management of huge burden of infected cases therefore, a large number of
patients with non-communicable diseases are subject to lack of attention
and interrupted routine care. Pediatric Hematology Oncology patients
demand holistic care therefore these patients might get affected
tremendously during this pandemic.
On 31 December 2019, the first case of pneumonia of unknown cause was
reported in Wuhan, China. The outbreak was declared as a Public Health
Emergency of International Concern on 30 January 2020. The World Health
Organization (WHO) announced a name for the new coronavirus disease:
COVID-19 on 11 February 20201. This novel corona virus
disease spread rapidly worldwide, with epidemics in around 215 countries
and meeting the definitions of a pandemic2. Estimated
case fatality rates are around 2% which may rise to 15% in aged
patients3. As there is no vaccine or specific
antiviral therapy yet available therefore, only prevention or delay
community spread of the virus can be done by containment and laborious
case finding. In many countries where COVID-19 became widespread,
quarantine and social distancing measures have been adopted to slow its
further spread4.
In Pakistan, first confirmed case of COVID-19 was reported on
26th February 20205. Country wide
lock down was announced in the last week of March in order to control
the increasing number of cases6. Patients with
non-communicable diseases especially cancers are particular at risk and
may be affected during this COVID-19 pandemic largely in two ways:
elevated risk of severe COVID-19 disease, and disrupted delivery of
cancer therapies due to quarantines, social distancing measures, and
interrupted healthcare delivery.
The subspecialty of Pediatric Hematology/Oncology (PHO) has recently
developed over few decades in Pakistan with around 15 specialized
centers all over the country. Being a low-middle income country, major
challenges in the management of these patients has been poor access and
delayed presentation to the specialized centers, insufficient healthcare
facilities, and lack of public awareness, illiteracy, poverty and
malnutrition. On the canvas of these innate challenges and suboptimal
care delivery to the pediatric hematology-oncology patients in a
developing country, the emergence of COVID-19 pandemic has added up to
the existing challenges. The objectives of this study were to determine
the effects of COVID-19 pandemic over the patients of non-communicable
diseases like pediatric hematology/oncology and the analyze the
challenges faced by the Pediatric Hematologists/ Oncologist in a
developing country during the pandemic.