key: cord-0702623-bz27ywi7
authors: Baroni, Lorena V.; Bouffet, Eric
title: The impact of the COVID‐19 pandemic in pediatric oncology units: A lesson of resilience and hope
date: 2022-01-24
journal: Cancer
DOI: 10.1002/cncr.34089
sha: 2be4f99c569c4485ab163287db5326cb6fbc4c7c
doc_id: 702623
cord_uid: bz27ywi7

The COVID‐19 pandemic in pediatric oncology units has had a major effect on health care providers globally. Although health care providers face the situation with resilience, the multiple consequences in terms of staff availability, psychological distress, and financial burden can potentially affect the care of children.

Cancer April 1, 2022 Worryingly, nurses were the most vulnerable group, with the highest illness rates, frequent quarantines and reassignments, PPE shortages, and psychological distress. Moreover, they were more affected by the financial impact, suffering from unexpected expenses such as PPE purchases or increased transportation costs and unpaid leave for illness or quarantine.

Surprisingly, the survey did not identify any difference based on country income groups. Participants in both low-and high-income countries described similar oncologic care limitations. However, the difference in time of pandemic waves in each country may bias the results and impact on health care workers' experience. The early wave mostly affected China, Europe, and the United States, and the real impact of the COVID-19 pandemic in low-and middle-income countries may be underestimated in this survey. One may remember the devastating waves that affected countries such as India or Indonesia later in 2020 and early in 2021.

This survey is unique as it captures the global impact of the pandemic in the context of a discipline, ie, pediatric hematology/oncology. Conducting a similar study would be challenging among health care providers in the adult cancer population. The findings suggest that pediatric oncology often becomes a low priority in the face of an acute health care crisis. In this context, it would be important to measure the long-term impact of the reduction in nurses and staff or the closure of units on survival. This survey also raises numerous questions. It was conducted at a relatively early stage of the pandemic and already identified a major psychological crisis among health care providers. Would we expect an improvement 12 months later? Although the risk of burnout has been identified, little has been done to try to mitigate the psychological impact of the pandemic and the associated changes in working conditions. Looking at the daily life in pediatric oncology units, the change has been dramatic. Pediatric units used to be places where children were playing, laughing with clowns, and leaving their room as soon as they could to see their friends; parents were supporting each other, and hugs were part of the daily life. All this has disappeared, and children are now isolated in their rooms with their parents, corridors and play areas are empty, clowns are wearing masks, visitors are not allowed, and gestures and expression of compassion have to respect social distancing. For someone who has decided to embrace a career in pediatric oncology because of its many unique aspects, this period is challenging and the attractiveness of the discipline is at risk in the absence of these very special interactions with children, parents, and families. In this context, the resilience of nurses confronted by such challenges is remarkable, and this survey underlines an exceptional engagement and the power of team communication and collaboration.

At the beginning of the pandemic, implementation of these rules was fast and relatively straightforward in many places. Most of the rules have now been integrated in our daily life, and despite a high rate of vaccination in some places, there is an overall reluctance and fear to return to normalcy. Will we see pediatric units going back to what they were before the pandemic? How long will it take for a nurse or other members of the treating team to share an unmasked smile or give a hug to a child or a parent without any fear or hesitation? This perspective is probably a major driver in the resilience of the health care providers involved in the care of these children.

This survey took place at a relatively early stage of the pandemic, and a follow-up study would certainly provide a different insight. However, the results presented in this study should not be taken lightly. They reflect a serious risk that can ultimately affect the care of children and compromise the success of their treatment. In this context, one cannot emphasize enough the importance of pediatric cancer organizations in their advocacy role.

Epidemiology of COVID-19 among children in china

Early advice on managing children with cancer during the COVID-19 pandemic and a call for sharing experiences

The COVID-19 pandemic: a rapid global response for children with cancer from SIOP

Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study

The Global COVID-19 Observatory and resource center for childhood cancer: a response for the pediatric oncology community by SIOP and St

Impact of the COVID-19 pandemic on pediatric oncology provider globally: a mixed-method study

The authors made no disclosures.