Introduction
Coronavirus disease 2019 (COVID-19), caused by the severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a
pandemic since the 11th of March 2020 by the World
Health Organization (WHO). 1,2 All over the world,
‘lock down’ or ‘social distancing’ has been found to be the most
effective method to control this outbreak. Due to the high infectivity
and alarming increase in the number of cases affected by this contagious
disease, most hospitals have decreased or all-together stopped elective
interventions in patients suffering from head and neck cancer (HNC).
Ambulatory visits have been curtailed, wards and operating rooms are
emptied for emergency services and ventilators have been commandeered
for COVID-19 patients.
In India, over 200,000 cases of HNC occur each year where nearly 80,000
oral cancers are diagnosed every year.3 Overall,
57.5% of global HNCs occur in Asia, especially in Indian subcontinent
and they account for 30% of all cancers in India.4 In
India, 60 to 80% of patients present with advanced disease as compared
to 40% in developed countries.5 Oral cancer is the
most common HNC in men in India, mainly due to the consumption of smoked
and smokeless tobacco.6 When patients with head neck
cancer present at a stage where resection is feasible, they can expect a
reasonable outcome after the surgery and appropriate adjuvant
treatment.7 During the current pandemic, delaying
surgery for even 1-2 months may lead to more extensive surgery or
inoperability, when only supportive care can be provided. Being
semi-emergent in nature, treatment for these patients is currently on
hold or delayed in most centres across the country.
This study was conducted to assess the impact of COVID-19 pandemic and
inability of the health system to treat HNC in a timely fashion and how
surgeons are coping to this emergent situation. This article highlights
the situation in Indian, a country burdened with one of the highest
incidence of HNC.