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.