One piece of the jigsaw for the cancerrecovery strategy: Prevalence of COVID-19 in patients with cancer

Background: COVID-19 has forced governments to make drastic changes to the health care system While thesemay have reduced COVID-19 morbidity/mortality, there have been unintended consequences on society and non-COVID-19 health issues Although initial data start to inform us how to care for cancer patients during COVID-19, there is as yet no long-term follow-up To start making informed decisions about cancer care, it is crucial tounderstand the scale of COVID-19 infection in cancer patients Therefore, we introduced swab testing for patientsvisiting Guy's Cancer Centre Methods: Our Centre in South-East London treats approximately 8,800 patients annually (including 4,500 newdiagnoses) and is one of the largest Comprehensive Cancer Centres in the UK at the epicenter of the UK COVID-19epidemic The first COVID-19-positive cancer patient was reported on 29 February, 2020 Until 30 April, 2020, aCOVID-19 swab was ordered for cancer patients with symptoms necessitating hospitalization or if they werescheduled to undergo a cancer-related treatment From 1 May, 2020, COVID-19 testing was introduced as standardof care, with about 25% of patients being swabbed daily depending upon staff and testing kit availability Weanalyzed data from 7-15 May, 2020 for COVID-19 test results in all cancer patients at our Centre Results: 2,647 patients attended for outpatient, chemotherapy, or radiotherapy appointments from across SouthEast London (and England) Of these, 654 were swabbed for COVID-19 (25%) Over 57% of patients filled out asymptom assessment, and 97% were asymptomatic Of the patients tested, nine were positive for COVID-19(1 38%) of whom seven were asymptomatic Based on data from the Office for National Statistics, between 28 April-10 May, 2020, 0 27% of the community population had COVID-19 (95%CI: 0 17-0 41) However, for those working inpatient-facing health care or resident-facing social care roles, this was estimated at 1 33% (95CI%: 0 39-3 28) Nevertheless, London has been the region hardest hit by COVID-19, so the rate of 1 38% among asymptomaticcancer patients, the majority of whom will have been shielding, is likely to be more representative of the localsituation However, this “snapshot” of prevalence is not enough for an evolving situation Conclusion: Cancer service providers will need to understand their local cancer population prevalence and keepthis under regular review The absolute priority is that cancer patients have the confidence to attend hospitals andbe reassured that they will be treated in a COVID-19-managed environment