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9th May 2023
The global health emergency posed by Covid-19 is over, the World Health Organization (WHO) has declared, while also stressing that the disease remains a ‘global health threat’.
For over a year, the Covid-19 pandemic had been ‘on a downward trend’, due to population immunity increasing from vaccination and infection, mortality decreasing and the pressure on health systems easing, said Dr Tedros Adhanom Ghebreyesus, director-general of the WHO.
WHO and the Emergency Committee, convened under the International Health Regulations, ‘have been analysing the data carefully and considering when the time would be right to lower the level of alarm’ over the last twelve months.
Based on their recommendations, Dr Tedros declared Covid-19 over as a global health emergency on 5 Mya 2023, making the statement ‘with great hope’ he said.
‘That does not mean Covid-19 is over as a global health threat’, he stressed. Indeed, one person dies from Covid-19 every three minutes, thousands of people around the world are currently in intensive care units with the condition and there are ‘millions more’ suffering the effects of long-Covid.
‘This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths,’ Dr Tedros said, warning countries to be complacent. ‘The worst thing any country could do now’ would be ‘to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that Covid-19 is nothing to worry about’.
Instead, he advised countries to transition from ’emergency mode to managing Covid-19 alongside other infectious diseases’,’ added Dr Tedros’, evidence of which has been seen recently with WHO’s recent pulse survey revealing a move towards restoring essential health services.
Dr Tedros also celebrated the efforts of healthcare workers in helping to control the virus.
‘We have arrived at this moment thanks to the incredible skill and selfless dedication of health and care workers,’ he said. ‘The suffering we have endured, the painful lessons we have learned, the investments we have made and the capacities we have built must not go to waste’.
‘We owe it to those we have lost to leverage those investments; to build on those capacities; to learn those lessons, and to transform that suffering into meaningful and lasting change,’ he added, urging ‘a commitment to future generations that we will not go back to the old cycle of panic and neglect that left our world vulnerable’.
A version of this story was originally published by our sister publication The Pharmacist.
19th November 2021
The level of cancer diagnoses in young people fell during the first-wave of the COVID-19 pandemic but there was also an increased likelihood of admission to intensive for cancers diagnosed during the period. This was the finding from a study by researchers from Oxford University, UK who discussed their findings in a poster presentation at the National Cancer Research Institute conference.
The COVID-19 pandemic has had a major impact on cancer services in the majority of countries across the world. In the UK, a survey by Cancer Research UK in July 2020, found that 2 in 3 cancer patients reported that their cancer care had been impacted and that ratings of overall cancer care as ‘very good’ decreased from 75% ‘before lockdown started’ to 37% ‘after lockdown started’. Moreover, other research shows that in England, there were approximately 3.4 million fewer key diagnostic tests performed between March and August 2020 compared with the same period in 2019.
Given the likely impact of delays in diagnostics, the Oxford team were interested in determining how in England, the first wave of the pandemic affected childhood, teenager and young adult cancer incidence rates, diagnostic and treatment time-intervals and cancer-related intensive care (ICU) admissions. They used the QResearch database, which is derived from the anonymised health records of over 35 million patients. In addition, since QReseaerch is also linked to linked to hospital admission, mortality and cancer diagnoses data held with a disease register, it was possible for the researchers to make links between these three factors. For the present study, researchers focused on central nervous system (CNS) tumours, lymphomas, leukaemias, sarcomas and renal tumours in those aged up to 25 years of age. They compared the incidence of these cancer diagnoses between 1st February to the 15th August 2020 and compared their findings to the three preceding pre-pandemic years. As well as the number of diagnoses, the team also analysed the length of time before treatment started after diagnosis and whether or not these patients were diagnosed after being admitted to intensive care.
A total of 2607 cancer diagnoses were made from 1st January 2017-15th August 2020, with 380 during the pandemic. Overall, this represented a 17% reduction (95% CI -38% to – 6%) in the incidence-rate-ratio during the first wave of the pandemic. In particular there was a 38% (95% CI -52% to -21%)] decrease in CNS tumours and a 28% (95% CI -45% to -5%) reduction in lymphomas. Interestingly, the researchers observed that childhood cancers that were diagnosed during the pandemic were more than twice as likely to be associated with an ICU admissions (adjusted odd ratio, OR = 2.2, 95% CI 1.33 – 3.47).
The researchers also observed that the median time to diagnosis was not significantly different across the different time periods (+4.5 days, 95% CI -20.5 days to +29.5) and the median time to treatment was actually shorter during the pandemic (-0.7 days, 95% CI -1.1 to -0.30).
The authors concluded that the COVID-19 pandemic led to substantial reduction in the detection of cancer in young adults but was also associated with an increase in cancer-related ICU admissions. They suggested that this was probably due to more severe baseline disease at diagnosis and that overall, their findings demonstrate a clear disruption to cancer diagnostic pathways in this age group which need to be addressed urgently in the recovery phase of the pandemic.
Saatci D et al. The impact of the COVID-19 pandemic on cancer diagnostic pathways in children, teenagers and young adults: a cohort study in England. NCRI conference 2021
4th October 2021
The research, which was conducted across multiple hospitals in Spain, compared data from the first year of the COVID-19 pandemic with data from the previous year. Of 1385 cases of CRC diagnosed over the two-year period, almost two thirds (868 cases, 62.7%) were diagnosed in the pre-pandemic year from 24,860 colonoscopies. By contrast, only 517 cases (37.3%) were diagnosed during the pandemic, which also saw a 27% drop in the number of colonoscopies performed, to 17,337
Those who were diagnosed with CRC between 15 March 2020 and 28 February 2021 were also older than in the pre-pandemic year, had more frequent symptoms, a greater number of complications and presented at a more advanced disease stage.
Experts say the fall is a consequence of the suspension of screening programmes and the postponement of non-urgent colonoscopy investigations during the pandemic. Fewer cancers were identified by CRC screening in the pandemic period, with just 22 (4.3%) cases found in comparison to 182 (21%) in the pre-pandemic year. During the pandemic, more patients were diagnosed through symptoms (81.2% of diagnoses) compared with the pre-pandemic year (69%).
Dr María José Domper Arnal, from the Service of Digestive Diseases, University Clinic Hospital and the Aragón Health Research Institute (IIS Aragón) in Zaragoza, Spain, and lead author of the study, commented “These are very worrying findings indeed – cases of colorectal cancer undoubtedly went undiagnosed during the pandemic. Not only were there fewer diagnoses, but those diagnosed tended to be at a later stage and suffering from more serious symptoms.”
There was a significant increase in the number of patients being diagnosed with serious complications – a sign of late-stage disease – with an increase in symptoms such as bowel perforation, abscesses, bowel obstruction and bleeding requiring hospital admission. These cases made up 10.6% pre-pandemic and 14.7% during the pandemic. The number of stage IV cancers being diagnosed rose during the pandemic year, with stage IV cases making up 19.9% of cases, in comparison to 15.9% in the previous year.
“Although these figures are across a population of 1.3 million in Spain, it’s highly likely that the same drop in diagnoses would have happened elsewhere across the globe where screening was stopped and surgeries postponed, especially in countries that were heavily impacted by COVID-19”, explained Dr Arnal.
“Colorectal cancer is often curable if it’s caught at an early stage. Our concern is that we’re losing the opportunity to diagnose patients at this early stage, and this will have a knock-on effect on patient outcomes and survival. We are likely to see this fall out for years to come.”
Impact of the COVID-19 pandemic in the diagnosis and characteristics of colorectal cancer patients, presented at UEG Week Virtual 2021