Cancer Care Continues Amidst COVID-19 Financial Impact

Hamilton, Bermuda, June 30, 2020

Bermuda Cancer and Health Centre (the Centre) acknowledge that oncologic care worldwide has been adversely impacted by the ongoing public health emergency. However, on Island the Centre's radiation therapy unit has been treating patients throughout the COVID-19 pandemic, including during the shelter in place.  

The Centre is situated at a challenging intersection between the desire to safeguard vulnerable cancer patients from COVID-19 while continuing to provide timely diagnostic services and treatment to avoid compromising oncologic outcomes. 

The Centre's first goal has been ensuring the safety of patients and staff, and the second goal has been the continuity of patient care.

Suspending cancer screening services during the 'shelter in place' period enabled the Centre to rapidly implement adaptations to workflow to ensure that patients requiring radiation were not disadvantaged. However, suspending these services has resulted in an immediate reduction in revenue.

"We needed to make sure all mitigating steps were in place," says Lynne Woolridge, chief executive officer, Bermuda Cancer and Health Centre. "Suspending screening services enabled radiation treatment to continue while the Centre's teams planned the way forward."

The Centre pivoted to minimise exposure and COVID-19 disease spread.  For people undergoing radiation cancer treatment, steps were immediately put in place to pre-empt the possibility of treatment breaks and to provide continuing care and a supportive environment.

The Centre has now reinstated all services, but due to the necessary health guidelines and restrictions such as physical distancing, the Centre is working at a reduced capacity to maintain patient comfort and safety, reducing projected income even further for the remainder of 2020. 

"It was important for the Centre to resume screening services," says Dr Chris Fosker, radiation oncologist, Bermuda Cancer and Health Centre.  "Being able to identify cancer in the earliest stages gives us the best chance of treating it successfully."

In accordance with international and local guidelines, patients and employees are currently required to enter through separate entrances and undergo a screening process with survey questions reviewing classic COVID-19 symptomology (fever, cough, and dyspnea) as well as a history of known exposure, temperature checks and the wearing of provided surgical facemasks. 

All individuals (patients, staff and vendors) are required to don appropriate personal protective equipment (PPE), which may include the following depending on the clinical service: isolation gown, gloves (following proper hand hygiene), a surgical mask or NIOSH-approved N95 filtering respirator with either a face shield or goggles. 

"PPE has proven to be an unexpected expense in both time and money" states Fosker.  "The cost and need for PPE are challenging to project as there are so many variables."

Fosker continues "Daily patient volume, type of clinical appointment and staffing levels all affect the amount and type of PPE required on any given day.  And in the event the Centre is impacted by a COVID-19 positive patient the PPE requirements are higher."

The Centre's infectious control team spends hours each week estimating inventory vs need, and sourcing and ordering items such as gowns, masks, gloves, sanitizer, thermometers, eyewear, face shields, overalls, chair covers and airflow solutions.  The need for PPE is an unbudgeted expense of $21,000 to date; however, it is expected to exceed $50,000 by year-end.

As soon as the Centre found itself immersed in COVID-19 policies, procedures and PPE procurement, the management team shifted its focus to the long term financial impact COVID-19 will have on the not-for-profit.

Steps are being taken to safeguard the charity; however, it may not be enough as they work to maintain current staffing levels as the majority of staff working directly with patients, support the two clinical departments.  The initial step was to re-examine the 2020 budget and identify items that have now been deferred or cancelled.

Coupled with the negative impact COVID-19 is having on fundraising efforts such as our Relay For Life event, 2020 will be a challenging year for the cancer charity. Relay traditionally raises $700,000 annually; however, current trends estimate this will drop by 65% this year. 

These funds are critical in the charity's effort to provide residents with equal access to cancer care. In 2019, the Centre subsidised over $2 million in clinical services providing members of our community, those without health insurance and those with limited health insurance, access to early cancer detection and radiation treatment they otherwise may not have been afforded.

Click here or more information on COVID-19 cancer related resources.

To receive information on the Centre's community impact or to discuss giving opportunities email Deborah Titterton Narraway, to make a donation today click here.

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