OPDs are closed. Operations theaters are closed. Non-COVID patients have been asked to seek medical help only in emergency cases. India’s entire healthcare set-up is working towards fighting Covid-19 patients. But patients who are suffering from serious diseases like cancer, renal disease or HIV, any day could be day when they have to get immediate medical help.

Few days ago, a story had appeared in a newspaper about an oral cancer patient, who could not get proper medical support even when she was in severe pain. Maitri, who was suffering from oral cancer, was in severe pain and the ulcers on her tongue have started bleeding. “We have to go to the AIIMS emergency almost every day because nothing else is open. They give us some painkillers and try to control the bleeding but say they cannot do anything further as the government has ordered a shutdown of all other services,” said Maitri’s husband.

Cancer, as we know is chronic disease and causes a high rate of mortality, second only to heart disease worldwide. Cancer is a relentless disease that continues to grow unless checked in a particular time frame. In such a situation, cancer patients receiving radiation therapy (time-bound) need to be attended to and continue their treatment. Since stopping treatment is not an option, all due care for the patients, attendant’s and medical professionals is required to prevent the COVID-19 infection and stop its transmission amongst this group of patients.

According to Dr. Tejinder Kataria, Chairperson Radiation Oncology, Cancer Institute, Medanta – The Medicity, “Patients on Radiotherapy treatment are not as immune- compromised as the patients who receive chemotherapy. Their blood tests are done once or twice weekly and if required, support with colony-stimulating medicines is given to support them through the treatment in a normal course. They are also supported with a high protein diet and enough fluids during their radiation treatment. They are given detailed instructions for personal hygiene during the course of their visit to the hospital. These protocols have to be adhered to, strictly during the whole course of treatment. The same protocol with a few additional precautions, as outlined below are expected to help us to continue treatment during the COVID pandemic.”

Universal precautions that include meticulous hand-hygiene, masks, gloves and hospital scrubs are provided for the medical professionals to prevent them from the infection, says Dr. Tejinder Kataria. The patients and their attendants as well as the hospital staff is screened at the entrance with a thermal sensor and also queried about their history of fever, body aches, cold, cough or respiratory symptoms besides the history of travel in last 15 days. If such a history exists the visitor is asked to remain outside the treatment premises and visit the Infections Disease (ID) specialist for further instructions.

According to the American Society of Clinical Oncology (ASCO), “To date, there is no supporting evidence to delay, withhold, or change chemotherapy, target therapy or immunotherapy in cancer patients. Therefore, routinely withholding critical anticancer or immunosuppressive therapy is not recommended.”

“Many of our patients who have recently been diagnosed with cancer or who have symptoms of cancer and are waiting a diagnosis, are stuck in limbo inside their houses because of the lock down imposed by the government to prevent community transmission”, Dr Abhishek Shankar, a front-line oncologist in Delhi, says in his blog.

Meanwhile Tata Memorial Hospital in Mumbai has urged cancer patients to stay home as they face higher risk after contracting the novel coronavirus. Cancer patients are on high risk due to lockdown and rapid spread of the deadly virus, said the hospital. Tata Memorial Hospital is strongly urging patients to not leave their home.