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Pattern of Practices of Oncologists of Bangladesh in the COVID-19 Era

1 Department of Radiation Oncology, Evercare Hospital, Dhaka, Bangladesh
2 Department of Clinical Oncology, Lab Aid Cancer and Specialized Hospital, Dhaka, Bangladesh
3 Department of Oncology, Bangladesh Specialized Hospital, Dhaka, Bangladesh
4 Department of Medical Oncology, European Institute of Oncology, IRCCS, Milan, Italy

Correspondence Address:
Arman Reza Chowdhury,
Dr. Arman Reza Chowdhury, Department of Radiation Oncology, Evercare Hospital, Dhaka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/bjoc.BJOC_22_21

Purpose: The aim of this study was to investigate the impact of coronavirus disease-2019 (COVID-19) on the practice of oncology care in Bangladesh during the first pandemic surge in 2020. Materials and Methods: This was a cross-sectional survey-type study, based on a questionnaire, which was shared via email to national oncologists and enhanced by snowballing in April–May 2020. Results: A total of 48 responders joined the survey, mostly clinical and radiation oncologists practicing in specialized cancer centers of the major cities. Patients’ triage for COVID-19 was implemented in 60% of the settings surveyed, and an impact on the clinical care was unanimously reported. Delays and interruptions in cancer treatments were common, as was a reduction of patient volume treated with radiation therapy (RT). Mechanisms for priority-setting to inform clinical decisions were set by 80% of the oncologists, including changes in the treatment protocols––more commonly for palliative care interventions and regarding the RT fractionation; also, alternative therapeutic options were more commonly discussed, particularly when patients were candidate to multimodal treatments. Value-driven and choose-wisely approaches were emphasized. Telemedicine was identified as a mechanism to reduce access to hospitals, but only for selected services (e.g., follow-up) by 78%. Protecting hospitals and health workers were identified as priority interventions to shape effective COVID-19 responses. Conclusion: This survey serves as a case study of adaptations of cancer care during COVID-19 in low- and middle-income countries. Elements of priority-settings and value-driven decision-making emerged, although the long-term impact cannot be stated, at this time.

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    -  Chowdhury AR
    -  Banu PA
    -  Rahman MA
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