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.