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Cancer and COVID-19: Interview with BC Cancer’s chief medical officer, Dr. Kim Nguyen Chi

Reflecting on the challenges, innovation and adaptations from the pandemic.
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​Throughout the ongoing COVID-19 pandemic, cancer organizations around the world have continued to innovate and provide patients with the best care possible. BC Cancer remains responsive to the ongoing COVID-19 pandemic, maintaining patient care and safety within the regional centres and has been at the forefront of innovations and adaptations to better serve patients, their families, and the public. Dr. Kim Nguyen Chi is BC Cancer’s chief medical officer and is part of the dyad leadership team with chief operating officer, Heather Findlay. 

We spoke to Dr. Chi for his comments on how BC Cancer has managed throughout the pandemic. 

Addressing challenges
What has BC Cancer been doing to ensure patients and staff remain safe from COVID-19 exposure when inside a regional cancer centre? 

Throughout the pandemic, maintaining patient care has continued to be our number one priority. Our staff across BC Cancer have worked incredibly hard to ensure patients continued to receive care. As new recommendations came from the Provincial Health Officer, we rapidly initiated a number of safety measurements including: implementing an essential visitor policy, dramatically increasing the number of digital health appointments and mailing prescriptions to patients as a way to reduce exposure and promote physical distancing within our centres. We also implemented a screening policy to screen each person entering our centres, developed staff guidance for personal protective equipment (PPE), a universal mask policy, and had staff working from home where possible. 

More recently, our data indicates that COVID-19 infection rates amongst BC Cancer patients has been approximately half that of the general population in B.C. In contrast, other jurisdictions have reported that cancer patients have  a higher infection rate compared to the general population. We attribute the low incidence rates to the safety measures we have put in place within the centres, but as well to patients who have been physically isolating themselves and following the guidelines set out by our Provincial Health Officer. We recognize the hardship for patients especially to be more isolated from their supports when they need it the most; as they undergo a cancer diagnosis and treatment.  I’d like to thank them and all British Columbians for their efforts to reduce the spread of COVID-19. 

What effect has COVID-19 had on cancer screenings and surgeries? 

There has been some impact and concern that some cancers in British Columbians may be under diagnosed as a result of the pandemic. This could be due to a combination of issues, including decreased access to diagnostic services and apprehension by the public about accessing the health care system either for concerning symptoms, or for routine screening for non-symptomatic people during the pandemic. In particular, BC Cancer’s breast screening program was temporarily suspended in March but resumed in June with increased safety measures. The volume of screenings BC Cancer provides daily is lower than pre-pandemic due to the cleaning protocols in between patients; however screening mammography sites remain fully booked. 

The initial screening test kit for colon cancer, called a Fecal Immunochemical Test (FIT), remained available in B.C. with a requisition from a primary health care provider. FIT tests are conducted in a person’s own home and sent back to the lab for assessment. An abnormal FIT test would result in a referral for a colonoscopy. In the month of December 2020, labs processed more FIT tests than they did in December 2019. 

Pap tests for cervix screening are conducted by primary care providers at their office or clinic. The Cervical Cancer Screening Laboratory continues to process any Pap sample it receives and sends primary care providers the results.

Overall, we initially saw an approximate 20 per cent decrease in new cancer diagnoses in the first part of the pandemic, however this has been increasing back to pre-COVID levels. We have not exceeded pre-COVID levels – meaning we may not be catching up with those missed diagnoses. We are concerned that when these cancers are diagnosed, they will be at a more advanced stage than if they had been caught earlier. I would encourage people to attend their cancer screening appointments and if anyone is concerned about their health, I urge them to speak to their doctor immediately. Our website’s COVID-19 & Cancer Screenings page has a lot of good information, including FAQs, for anyone looking for more information

Cancer surgeries continued to be identified as a priority in British Columbia during the first wave of the pandemic. Provincially, surgeries occurred within appropriate timelines with mitigation strategies developed on a case-by-case basis. In many instances in B.C., we saw patients receiving care earlier than what would have happened pre-pandemic, because surgical capacity increased when elective procedures were paused. 

Recognizing adaptations
How has BC Cancer adapted to the pandemic? 

As part of the early response last year, we were able to quickly expand digital health services across our cancer centres, approximately 70 per cent of appointments were done over the phone or using secure video services. Today approximately half our appointments continue to be offered digitally, with the exception of tests and treatments like chemotherapy or radiation therapy, which of course have to be conducted in-person. 

Celebrating innovation
What other innovations have been inspired by the COVID-19 pandemic? 

BC Cancer has partnered with the Provincial Health Services Authority’s Office of Virtual Health on a remote patient monitoring program. The program is the first of its kind in BC for patients who are receiving care for head and neck or lung cancer. The program provides patients the tools needed to report on their symptoms daily from the comfort and safety of their home and have that information tracked by their care team remotely. The at-home assessments are closely monitored by doctors who can intervene if there are any concerns; possibly before a patient knows to seek care. 

We also have researchers at BC Cancer’s Genome Sciences Centre (GSC) using genome science to understand how different people respond to COVID-19 infection. GSC scientists were the first ones to sequence the SARS coronavirus genome in 2003, which helped accelerate vaccine development. 

As vaccines for COVID-19 begin to roll out across Canada, BC Cancer remains responsive to the ongoing pandemic to ensure the safety of our patients, their families, and our staff. Visit our COVID-19 and Cancer page or the BC Centre for Disease Control COVID-19 website for up-to-date information. 

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