Researchers say "Covid-free" surgical units for cancer patients could save lives during the UK's second wave of coronavirus.
As hospital admissions for Covid-19 increase again, medical professionals are eager to secure beds for cancer patients who also need life-saving treatment.
Researchers, led by the University of Birmingham, assessed the utility of "Covid-19-free" locations in hospitals, where positive patients are strictly prohibited in order for treatment for non-Covid-related diseases to continue.
They examined the results of thousands of patients worldwide who had cancer surgery between the start of the pandemic and mid-April.
A total of 1.5 percent of patients died 30 days after their operation – higher than in the period before the pandemic. The deaths were due to lung complications, which were lower in the coronavirus-free surgical units, suggesting they were most commonly caused by Covid19.
However, the death rate was lower – 0.7 percent versus 1.7 percent – among those treated in Covid-free zones, where coronavirus-positive tests were also less common.
With the millions of people undergoing cancer removal each year, the one percent difference in mortality could be huge.
It is estimated that there are around 550,000 cancer removal surgeries in the UK each year. If all of these were done in Covid-19 free zones instead of mixed hospitals, around 6,000 unnecessary deaths from the coronavirus could be saved in the UK alone next year, the study said.
The death rate was lower in cancer patients operated on in covid-free zones – 0.7 percent versus 1.7 percent. It was believed that this was due to lower Covid-19 infection and therefore fewer lung complications
An estimated 2.3 million cancer surgeries were canceled or postponed worldwide in the first "wave" of Covid-19 to avoid the risk of getting the coronavirus in the hospital.
According to Cancer Research UK, nearly 2.5 million people in the UK at the height of the lockdown missed cancer screening, referrals or treatment, although the NHS has never been as overwhelmed as feared.
Experts fear that the number of people dying as a result of delays caused by treating coronavirus patients could be responsible for as many deaths as the pandemic itself.
MATT HANCOCK SAYS CANCER PATIENTS ARE ONLY TREATED IF COVID-19 REMAINS "UNDER CONTROL".
Cancer patients are only guaranteed treatment if Covid-19 remains "under control," Matt Hancock claimed today when he spoke about an error in an Excel spreadsheet that may have left tens of thousands of British people ignorant of the are infected, was roasted by MPs virus.
The health minister claimed it was "critically important for everyone to understand how best to keep cancer going by suppressing the disease," suggesting hundreds of thousands of patients face delays in scheduled surgery and chemotherapy could if the outbreak continues to increase.
Major surgeries were canceled and patients missed potentially life-saving therapy in the spring as fighting Covid-19 was the sole focus of healthcare instead of cancer and other gruesome diseases.
Almost 2.5 million people missed cancer screening, referral, or treatment at the height of the lockdown, despite never overwhelming the NHS – despite fears the pandemic could cripple it.
Experts now fear that the number of people dying from delays caused by treating coronavirus patients could even be responsible for as many deaths as the pandemic itself.
Surgeons have been concerned about calling for hospital beds to be "fenced in" for operations scheduled during the pandemic to avoid the spring break, which saw patients face a "tsunami of rejections" as health services focus on fighting the coronavirus concentrated.
But today in the House of Commons, Hancock warned Covid-19 that cancer treatment could be suspended again and told MPs that controlling the virus would allow the NHS to "restore the treatment we need for cancer and other deadly diseases".
He said, "It is important for everyone to understand that the best way to keep cancer services running is to suppress the disease. The better the disease is under control, the more we can recover and get cancer treatments." Continue."
The government plans to use the NHS & # 39; Covid-19 & # 39; to keep rented private medical wards free so they can continue treating cancer and other diseases while battling the rise in hospital stays from the virus.
Royal Stoke University Hospital, which transferred its cancer care to Nuffield Health in Newcastle-under-Lyme at the start of the pandemic, was cited as an example of what others should accomplish.
Mr. Hancock said, “Because (private hospitals) are very rarely under pressure from emergency care, we can ensure that they are part of the 'green' part of health care.
"(This means) that they are as free of coronavirus as possible, so they can do all kinds of cancer treatments."
He added: "These recommendations will lead to the necessary action and it is very important that the message is spread that the NHS is open and that anyone who is worried about cancer should come forward and that we can save lives." . "
One of the leaders of the study, Dr. Aneel Bhangu of the NIHR Global Health Research Unit for Global Surgery at the University of Birmingham said, "Covid-19 free areas could save many lives in future waves by safely continuing the operation despite high rates of infection in the community. & # 39;
The study used data from 9,171 patients in 55 countries on five continents, including 2,679 from the UK, 574 from the US, 1,583 from Italy, 764 from Spain, and from Australia, Spain, Denmark, China, India and South Africa.
Patients had surgery for 10 types of cancer, including breast, colon, lung and liver cancer, and no Covid-19 suspicion was raised.
Surgical units were defined as "cold" which means that the hospital did not admit Covid-19 patients or had complete separation between Covid-19 and elective surgical patients, or "hot" when surgical units were not completely separated.
NHS hospitals were able to care for Covid-19 patients in separate, dedicated areas, while patients who came to voting procedures were cared for in separate "green" areas.
Due to the risk that vulnerable people could pick up the infection and make beds free for Covid 19 patients, the operations of millions of cancer patients were canceled at the beginning of the pandemic.
Some private health centers have been hired by the NHS to act as Covid-19 free zones during the pandemic to help treat cancer and other diseases. For example, Royal Stoke University Hospital has transferred its cancer treatment to Nuffield Health in Newcastle-under-Lyme.
Only 27 percent of the patients in the study were cared for in Covid-19 cold areas.
A total of 1.5 percent of the patients died 30 days after their operation. But the death rates were also lower in the Covid-free group – 0.7 percent compared to 1.7 percent.
Of the 30-day deaths, 49.3 percent were associated with postoperative pulmonary complications and 44 percent with Covid-19 infection.
The deaths were caused by pulmonary complications, which were lower in the Covid Cold surgical units – 2.2 percent versus 4.9 percent. Not all of these deadly lung problems were caused by SARS-CoV-2 infection.
However, the researchers said it was plausible that SARS-CoV-2 infection was behind the differences in lung complication rates between cold and hot surgical units.
This cannot be said with certainty as tests were not available at the start of the pandemic.
This was because fewer patients treated in Covid-free units tested positive for SARS-CoV-2, and those who did had a higher rate of lung problems.
Around 2.1 percent caught SARS-CoV-2 in the Covid-19 free zones, and 3.6 percent in the mixed hospitals.
This was even more noticeable in hospitals in places with a high Covid-19 infection rate – 3.9 percent versus 8.2 percent. But still obviously in places with fewer cases.
Older age, male gender, and surgery in places with high numbers of Covid-19 cases in the community increased the likelihood of these lung problems after surgery, which could suggest that, given the age and gender, they were actually caused by the coronavirus are risk factors for Covid-19.
The results were published today in the Journal of Clinical Oncology.
The authors wrote in their paper: “These data support a comprehensive international redesign of surgical services to enable elective cancer surgery in cold surgical units.
“While the greatest benefits of cold units were seen in areas with high SARS-CoV-2 incidence in the community, there was a consistent effect in both high and low incidence areas.
"The establishment of these units is likely to be warranted both in the final stages of the current lockdowns in preparation for the second wave and in countries dealing with emerging outbreaks."
However, the researchers found that this could be a difficult task for hospitals.
"Governments and hospital providers must help fund this major international reshaping of surgical services and protect patients," said Dr. Bhangu.
As the pandemic enters the "second wave", a number of NHS hospitals are being designated coronavirus-free zones, the Guardian reported in September.
According to the plans contained in the newspaper, such "clean" hospitals will be kept as free of coronavirus patients as possible so that the NHS does not have to be completely around swaths of people with other diseases.
The results come after Matt Hancock said cancer patients today will only get guaranteed treatment if Covid-19 is "under control".
The Minister of Health's obscure comments that "it is vitally important for everyone to understand how the best way to keep cancer services running is to suppress the disease" suggest that more patients are experiencing delays may be faced with scheduled surgery and chemotherapy if the outbreak continues to worsen.
With all non-Covid health issues in mind, millions of Britons are still waiting for treatment after moving down the prioritization list to make room for Covid-19 patients.
A record 2.15 million people – three times the previous year – have to wait more than 18 weeks to begin hospital treatment in England.
Professor Derek Alderson, former president of the Royal College of Surgeons, said one solution to the problem is the Covid-19 free zones.
Speaking at a virtual briefing from the Royal Society of Medicine last month, he said, “The solution is that we obviously have to deal with really radical changes in the way we deliver surgical services.
"In the beginning, this was the creation of 'Covid-Light' or 'Covid-Free' views. We need to take much better account of strategic changes, so to speak, in the way we conduct complex operations and benign operations within regions. & # 39;
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