Pandemic’s Hidden Toll: Millions in the UK await treatment, but not for Covid-19

When Philippa Hetherington found out in November 2020 that she had metastatic breast cancer that had spread to her lungs, doctors ordered a lung biopsy to determine what kind of treatment they might need. At the time, however, the United Kingdom was in the midst of a Covid-19 rise. She was told there was no way she could do a biopsy because lung specialists at Churchill Hospital in Oxford, where she was being treated, were again deployed to treat Covid-19 patients.

Ms Hetherington eventually received a biopsy and is currently being treated with a type of chemotherapy which she says is a good opportunity to work on her type of cancer. But as a result of the delayed biopsy, she said she missed a window to enroll in a clinical trial that could have offered her treatment with immunotherapy.

“Perhaps I should be further ahead in my treatment at this point,” Ms Hetherington said. “I felt like I was let down. If you have stage four cancer that is aggressive and incurable, you do not want to hear that.”

Oxford University Hospitals NHS Foundation Trust, which manages Churchill Hospital, declined to comment, saying it could not discuss individual cases.

Covid-19 has expanded hospitals and healthcare systems, which in turn has resulted in canceled doctor appointments and delayed procedures and tests for other diseases. According to the World Health Organization, the pandemic has led to a separate, global crisis among patients with conditions such as cancer, diabetes and heart disease who were unable to receive timely care – or who were delayed – due to health care systems overcome by Covid-19.

In most places, it is difficult to quantify how many people have delayed or forgiven health care during the pandemic. But in the UK, thanks to a centralized, government-funded health care system, officials can keep track.

At the end of October, the number of people on the UK waiting list for an elective procedure – one that is normally planned in advance and not life-threatening enough to request emergency care, such as a colonoscopy or knee surgery – hit six million.

To help combat Omicron, the Biden administration is opening more Covid test sites and delivering 500 million Covid tests to Americans. WSJ’s Daniela Hernandez breaks down why testing is still a pain point in the US, two years into the pandemic. Photo Illustration: David Fang

That’s 41% up from March 2020, just when the pandemic started here, according to data collected by the UK’s National Health Service. More than 300,000 of those currently on the list waited more than a year for their procedure, compared to just about 3,000 people in March 2020, according to the data.

The proportion of people in the current fiscal year that a cancer specialist could see within two weeks of a doctor’s referral dropped to less than 85%, compared to more than 90% pre-pandemic, according to NHS data. An analysis based on NHS data by the charity Macmillan Cancer Support found that in the first 18 months of the pandemic the number of patients starting cancer treatment in England fell by more than 33,000 compared to the 2019 average.

Covid-19 has hit hospitals and stretched health care systems. A Covid-19 ward at King’s College Hospital in London.


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Victoria Jones / Associated Press

Delays in care, which had decreased after the increase in cases of the Delta variant in the summer, could return with the spread of Omicron.

Sajid Javid, the UK health secretary, said in the coming weeks staff in the National Health Service would be deployed again from non-emergency care. “All primary care services will focus on urgent clinical needs and vaccines,” he said, adding that the national mission to curb the spread of the virus comes with some “difficult compromises.”

The secretary had earlier said he expected the waiting lists for non-emergency care to be extended as the country went into winter, and that some seven to eight million people stayed away from hospitals during the peak of the pandemic and now need to be cared for .

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Delays are common, even in the best of times, for the UK’s universal health care system, where medical care is provided at almost no cost to patients, and the system provides care based on urgency. Researchers and doctors say the pandemic has exacerbated problems in a system that was already running close to capacity.

Shirley Cochrane of Colchester, England, completed treatment for breast cancer in September 2017 when she was told she would need a follow-up every six months. Then the pandemic struck, and Colchester Hospital informed her that she had to examine her breasts at home herself and check for possible symptoms herself.

“To be cut off from the health care system, I felt a little abandoned,” she said, adding that she felt fear that she would miss something in her breasts that a professional would discover during a subsequent appointment. “I’ve had so many sleepless nights.”

Shirley Cochrane said pandemic-related delays with her cancer treatment make her feel ‘a little abandoned’.

Ms Cochrane was able to get a mammogram in May 2020, but has not had another hand since and has not had any further checks. She said she hopes to be seen by a specialist next year, although she is not sure when that may be.

The East Suffolk and North Essex NHS Foundation Trust, which manages Colchester Hospital, said it maintained telephone contact with patients during the pandemic, and that all urgent cancer treatment was ongoing.

The UK Government’s Department of Health and Social Care, which oversees health policy, said cancer diagnosis and treatment were an absolute priority, and that it supported the NHS with record investments to address the backlog, adding 8 billion ($ 10.57 billion) over the next three years to provide an additional nine million checks, scans and surgeries to patients across the country.

The Institute for Fiscal Studies, an independent UK-based research center focusing on microeconomics and public policy, estimates that in an optimistic scenario the number of people awaiting treatment next year could reach 9 million and return to pre-pandemic levels by 2025 It said 7.6 million fewer people joined a public health care waiting list in England between March 2020 and September 2021, both because of cancellations and out of fear of catching Covid-19.

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