How many Non-COVID Patients are Being Neglected?

4 April 2020. Updated 17 April 2020.

There is mounting evidence that people who’ve been patiently waiting their turn for hospital appointments have had those appointments postponed indefinitely, thereby jeopardising their health. Professor Charles Swanton, Cancer Research UK’s chief clinician, told the Sunday Times on April 5th that some cancers will become “inoperable” if diagnosis or treatment are delayed by the pandemic.

“We know that if you operate in most early stage cancers, there is a high chance of a cure,” he said. “If we wait tooling before we operate the disease may spread beyond the primary site rendering cures less likely. Delays to surgery are of huge concern for many cancer charities.”

He added: “If the coronavirus outbreak continues to press resources for months – and it could easily press resources for three to four months – that’s a worrying delay to the critical interventions required to diagnose and intervene in early stage cancers.

“That risks lowering the rate of survival and that is what we are so worried about at Cancer Research UK.”

Subsequent stories have appeared claiming the Government has estimated the number of non-COVID-19 patients who’ll die as a result of hospitals prioritising COVID-19 patients is 150,000.

This isn’t necessarily an argument for ending the lockdown since it’s possible that would result in the NHS becoming overwhelmed, with even less capacity for treating non-COVID-19 patients and more of them dying. But it’s an argument for scrutinising Imperial College’s modelling even more carefully because if its predictions of how many people are likely to require hospital care in the event of social distancing measures being relaxed are inaccurate, and the NHS would in fact have the capacity to treat more non-COVID-19 if it was no longer on a ‘war footing’, that is a reason to end the lockdown. Even during the lockdown, there may be a case for diverting fewer resources to treating COVID-19 patients since their survival rate may be lower than that of patients with, say, early stage cancer.

Further Reading

“Coronavirus lockdown will cost the lives of cancer patients”‘ by Caroline Wheeler, The Sunday Times, April 5th 2020

Coronavirus: Record weekly death toll as fearful patients avoid hospitals‘ by Kate Lay, The Times, April 15th 2020

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Simon Nicholls (sinichol)

I think we need to generate some discussion and research in this area. Given the concepts of:
– lockdown induced fear
– healthcare provisioning be repurposed

Can we find answers to some of these questions?

1) How many deadly conditions (cancer, etc) do we expect to go undiagnosed due to lockdown induced fear?
a) And what will be the impact to life expectancy for that group?

2) How many people already on a treatment pathway do we expect to die for similar reasons?

3) How many A&E treatments expected since the lockdown have not taken place?
a) And to what degree can they have been shown to mitigate death in the past? – e.g. heart attack.

Please feel free to extend and add missing ideas.

Concrete clincal evidence and scientific research rather than opinionated rhetoric is better.

If we can show evidence we have chosen the wrong “lesser of two evils” with the lockdown, then the argument becomes more powerful.

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