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\begin{document}

\title{The impact of COVID-19 pandemic on access to treatment for children with
cancer in India and treating centre practices: Results of the
InPOG-ACC-20-04 study}



\author[1]{Jyotsna Sharma}%
\author[2]{amita mahajan}%
\author[3]{Sameer Bakhshi}%
\author[4]{Veerendra Patil}%
\author[5]{Nishant Verma}%
\author[6]{Venkatraman Radhakrishnan}%
\author[7]{Amitabh Singh}%
\author[8]{Smita Kayal}%
\author[9]{Rachna Seth}%
\author[3]{Deepam  Pushpam}%
\author[10]{Ramandeep Arora}%
\affil[1]{Cankids}%
\affil[2]{Indraprastha Apollo Hospital}%
\affil[3]{IRCH, AIIMS}%
\affil[4]{Basavatarakam Indo American Cancer Hospital \& Research Institute}%
\affil[5]{King George's Medical University}%
\affil[6]{Cancer Institute-WIA}%
\affil[7]{Vardhman Mahavir Medical College and Safdarjung Hospital}%
\affil[8]{Jawaharlal Institute of Postgraduate Medical Education and Research}%
\affil[9]{All India Institute of Medical Sciences}%
\affil[10]{Max Super-Speciality Hospital}%


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  \date{May 15, 2024}


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\begin{abstract}
Background The COVID-19 pandemic had led the Indian government to
announce a nationwide lockdown on the 23rd of March 2020. This study
(InPOG-ACC-20-04) aimed to explore the impact of this on the
accessibility of care of children with cancer in India and to see
strategies adopted by hospitals for service delivery during the
lockdown. Procedure Weekly average childhood cancer (\textless{}18
years) patient registrations during pre-lockdown period (Jan 1st, 2020
to March 23rd 2020) were compared with the post-lockdown period (Mar
24th, 2020 to May 31st, 2020). The effect on the scheduled treatment was
investigated for the post-lockdown period. A survey of health care
providers was conducted to determine centres' strategies to deal with
the effect of COVID-19. Results In 30 centres participating in this
study, 1146 childhood cancer patients were registered from Jan 1st, 2020
to May 31st 2020. The weekly average patient registration was 67.3
pre-lockdown and 35.5 post-lockdown which was a decline of 47.3\% with
travel distance being a factor. While most centres experience this
decline, there were a few who saw an increase in patient registrations.
Of those patients scheduled for treatment during the post-lockdown
period, 36.1\% experience delays in one or more modalities. Centres
adopted several strategies to including modifications to treatment
protocols, increased use of growth factors, and increased support from
social organisations. Conclusion Our multicentre study from India
suggests that the COVID19 pandemic and the lockdown impacted two out of
three children with cancer. The effect of this on survival remains to be
established.%
\end{abstract}%



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