How Covid-19 has set back cancer care

Written by Daniel Berman, Director, Global Health

It is a year since the Longitude Prize published its study about the impact of antimicrobial resistance (AMR) on cancer treatments in the UK. In that time, the Covid-19 pandemic has spread around the world, claimed the lives of millions, brought health systems to their knees, and transformed public consciousness of infectious disease.

In this challenging period, we have seen access to treatment for other diseases decline as all efforts go into handling the thousands of daily cases of Covid-19 entering hospital systems – cancer care being a notable issue in the UK.

MacMillan estimates there are currently around 50,000 ‘missing diagnoses’, with 11% fewer referrals to hospital in England in August 2020 compared to the year before. It estimates it will take 20 months to work through the diagnosis backlog even if activity were to be increased 10% above pre-pandemic levels. Half of people currently having cancer treatment in the UK have experienced disruption to their treatment because of Covid-19.

This is not only a huge concern for the treatment of cancer, but also to the issue of AMR impacting cancer treatments. With all eyes on Covid-19 now, the immediate post-Covid period will need huge efforts to clear backlogs and treat more advanced disease, the issue of AMR is at risk of being brushed to one side.

Our findings showed that 46% of UK oncologists believe drug-resistant infections will make chemotherapy unviable. Before the pandemic, four in 10 had seen a rise in drug-resistant infections in the previous 12 months. The average oncologist sees 23% of patients develop an infection during treatment, with 5% of cancer patients who undergo surgery developing a drug-resistant infection.

That is potentially 65,000 patients at risk of acquiring a life-threatening resistant infection in the UK this decade. Antibiotics are essential for cancer care; we cannot risk a future where these lifesaving drugs no longer work, particularly at a time when there are so many other pressures on cancer treatments.

Fortunately, we are not alone in this assessment. It was notable, following the launch of our report in February 2020, that such a great focus of November’s World Antimicrobial Awareness Week was on AMR’s impact on cancer treatment, including the UICC and GARDP’s WAAW global webinar.

The roll-out of effective vaccines to immunise the population against Covid-19 is starting to ramp up in the UK, (though not nearly fast enough for people in most countries). It offers a beacon of hope that the worst of the pandemic will soon be behind us.

When we turn the corner, efforts will need to be re-focused on helping treat the patients that have found themselves caught in backlogs this last year, particularly for cancer. In turn, we will need to learn from this pandemic, redouble our efforts to ensure the slow-moving pandemic of AMR does not undo that progress, and take the appropriate steps to make sure modern medicine as we know it continues.