Long-Term Effects of COVID-19 Disruptions on Cancer Care Still Unfolding: Dan Nardi, MS

Last month marked 5 years since the onset of the COVID-19 pandemic. In response, Dan Nardi, MS, CEO of Reimagine Care, reflects on its impact on oncology care, cancer screenings, and patient outcomes.

Reimagine Care is the nation's leading on-demand cancer care provider. It partners with health systems to deliver personalized, home-centered treatment through AI-enabled support, evidence-based pathways, and 24/7 oncology expertise.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

What were the primary barriers to cancer care access during the COVID-19 pandemic? How were these challenges addressed?

I think like a lot of health care delivery, the challenges were, overall, moving into a remote environment almost overnight. Everything shut down, it became very hard.

Hospitals and health care settings had such a hard time making this transition into what has traditionally been a clinic-based model, where patients come in and meet with their providers and their care teams. To have that go away almost overnight was really huge. For patients going through treatment, or even some of them just in the early diagnosis phases, that threw a big wrench into the ability to continue treatment plans or to begin treatment plans.

The traditional care delivery got put on hold while we figured out how to handle having patients come back in, how to handle the work staff coming back in, how to handle someone who became sick, and working through all those types of hurdles. It just became a whole new ball game.

How did the suspension of routine screenings and diagnostic procedures impact early cancer detection?

There's been a lot of studies about that. I mean, during those early days, not only were the patients more worried about what's going on at home, what's going on in the broader world at that time. A lot of our traditional health care screenings got put to the wayside.

We delayed a lot of care, and I think that was very acutely situated here in the cancer care space. We put off screenings, we put off annual physicals, we put off lab work for months and even years. That really delayed a lot of those early diagnoses and the opportunities for patients to catch things earlier.

As patients did start coming back around and having these screenings done years later, things progressed quite a bit during that time. I think we really had a big gap in what could have been early diagnosis, what could have been beginning treatment at an earlier stage. Unfortunately, that really delayed a lot of that. I think, in the next couple of years, we'll see the impact of that longitudinally.

What were the consequences of treatment delays or disruptions during the pandemic for patients with cancer? Have there been any lasting effects on outcomes?

One of the biggest things I just mentioned was disease progression. Again, you had this gap where we may have been able to catch things at a bit of an earlier stage. We didn't because we were putting off a lot of these screenings. Disease progression, I think, was one of the biggest impacts of that, which then I think led to more intensive treatments.

Patients who maybe caught something at an earlier stage, or if they had been able to catch it at an earlier stage, could have started a less-rigorous treatment protocol. Now, a year or 2 years later, it's maybe progressed into multiple stages. At this point, you have to start a fairly aggressive treatment. I think that's one, I think, also, higher ED [emergency department] utilization.

Again, if we had caught this at maybe earlier stages, it might have been a more phased-in approach for treatments. As you get into those later stages and more aggressive treatments, like I mentioned, our bodies react differently. Now, you have maybe a higher utilization of ED or urgent care programs. That's where I think there was a real big impact.

We're probably still several years out from really understanding the true impact, but there's definitely going to be an impact on the long-term survival rates. There's proven studies that the earlier you are able to have a diagnosis of cancer, treatments are much more effective. I think, in the years to come, we're going to see the true impact.