Professor M. John Kennedy:

Covid-19 had a massive disruption on cancer service delivery in the country and elsewhere as well. It taught us that we need to be able to provide cancer services when the next epidemic arrives – because it will arrive – without disruption to services. That requires infrastructure that enables us to do that. It requires us to be able to bring patients into the hospital, give them their treatment, get them their scans and see their doctors without running the risk of picking up Covid-19 because they are being mixed with the general population. That was a key message. It has been estimated in the United States that due to delays in diagnosis due to the Covid-19 epidemic that there will be 6,000 extra deaths from colon cancer alone in the next ten years. That is an estimate and it gives us sort of a feel for the impact it will have. Of course, with many cancers, delays in surgery are critically important in long-term cure rates and I think Covid-19 will probably demonstrate that. I imagine huge amounts of work will be done over the next few years by epidemiologists analysing that. It showed us we need better infrastructure so we can cope with the next epidemic, which we do not have at the moment and need to develop. One of the recommendations in the cancer strategy is that we have a rolling plan for improvement in cancer service delivery in terms of physical infrastructure, which is day treatment, radiation therapy, inpatient units and so on.

I will give a Covid-19 example. In many institutions we have inpatient facilities where multiple immuno-suppressed patients are in a single room, using an individual bathroom. That is not consistent with an epidemic. We cannot do that. We need individual rooms because we need to be able to protect patients. It demonstrated to us the critical importance of infrastructure, particularly in continuing services, despite the next pandemic.