What Happened to the Cancer Patients who Needed Hospitalization and Surgery During the State of Emergency?
During the state of emergency established in Moldova to prevent the spread of the COVID-19 pandemic, the medical institutions that were not engaged in the fight against coronavirus worked under a special program.
On March 28, 2020, the Commission for Exceptional Situations issued provision number 8. According to this provision, medical institutions, regardless of the legal form of ownership and organization, suspended all scheduled hospitalizations during the state of emergency.
ZdG tried to find out what happened to Moldovan patients diagnosed with malignant tumors and cancer, who were scheduled for hospitalizations or surgeries during the state of emergency when these procedures were suspended by the provision number 8.
ZdG made an official request to the management of the Public Medical Sanitary Institution Institute of Oncology and found out the answer to this question.
Central Authorities Prioritized the Patients Diagnosed with the New Coronavirus
On March 7, 2020, the Chișinău authorities officially confirmed the first case of infection with the new coronavirus. Gradually, cases of COVID-19 multiplied. From March 16 until May 15, 2020, the Parliament established a state of emergency for 60 days in order to prevent the spread of the pandemic.
With the establishment of the state of emergency, the Commission for Exceptional Situations approved several decisions, imposing various restrictions, some targeting the working program of the medical institutions. By Disposition 2 of March 20, the Commission announced that public medical institutions will operate in a special regime and will provide medical care to all persons who meet the criteria of the case definition for COVID-19, regardless of their status in the system of Compulsory Health Insurance.
In this context, central authorities prioritized patients diagnosed with the new coronavirus. During the state of emergency, the Commission stopped the scheduled hospitalizations in the medical institutions.
Subsequently, by Disposition 8 of March 28, in accordance with Art. 22 of Law 212/2004 regarding the regime of the state of emergency, siege, and war, Art. 2 of the Parliament Decision No. 55/2020 on the declaration of the state of emergency, points 6, 7, 8 and 9 of the Commission’s Regulation, approved by Government Decision No. 1340/2001, the Commission announces that scheduled hospitalizations in medical institutions are stopped during the state of emergency regardless of the legal form of ownership and organization of the medical institutions.
Thus, hospitals and primary care institutions restricted scheduled medical services and suspended surgeries. This decision inevitably could affect patients with other health conditions than those diagnosed with COVID-19, or patients who were under treatment or scheduled for certain surgeries, including people diagnosed with various types of cancer.
The Institute of Oncology – the Only Institution in Moldova Specializing in the Treatment of Cancer
According to data provided by the National Bureau of Statistics, thousands of patients diagnosed with various types of cancer are registered annually. For example, on January 1, 2018, over 52,000 people with cancer were registered and over 6,000 people died of cancer the same year.
Despite high rates of cancer incidence and mortality, there is only one institution in Moldova specialized in treating cancer patients. Annually, 10,000 newly diagnosed people are treated at the Institute of Oncology, in addition to those previously diagnosed, which causes endless queues at the doors of specialists, says Larisa Catrinici, director of the Institute of Oncology.
ZdG sent an official request to the management of Moldova’s Institute of Oncology, in which it addressed several questions regarding the current situation of cancer patients who needed treatment or urgent surgeries, but who had restricted access to medical services after the authorities stopped hospitalizations and surgeries.
The Decision Approved Regarding the Patients with Cancer
In an official response, Larisa Catrinici, the director of the Institute of Oncology, pointed out the decision that hospitalizations of malignant oncological cases be considered medical emergencies between March 16 – May 15, 2020.
According to the management of the institution, the patients diagnosed with malignant tumors during the state of emergency were hospitalized in the institution for treatment, their cases being declared as medical emergencies.
According to the same answer, between March 15 and May 15, 2020, the Institute of Oncology provided inpatient medical care to 3,425 patients, including 89 children.
According to officials at the Institute of Oncology, all patients diagnosed with malignant tumors, who had indications for surgical treatment, were hospitalized and underwent surgeries.
Therefore, during the state of emergency, there were performed 751 surgeries at the Institute of Oncology in Chișinău.
Fourteen Patients on the Waiting List
During the state of emergency, 14 patients were included on the waiting list to the Diagnostic Consultative Center at the programming stage.
“At the programming stage to the Diagnostic Consultative Center, 14 patients were included on the waiting list. The colonoscopy of these patients identified intestinal polyps and they were scheduled for day surgery in order to take the biopsy for morphological examination,” states the management of the Institute of Oncology. They added that all 14 patients are scheduled for appropriate care, and their health is satisfactory.
COVID-19 Cases Registered at the Institute of Oncology
According to officials from the Ministry of Health, four employees of the Institute of Oncology have been diagnosed with COVID-19 since the beginning of May. Minister of Health Viorica Dumbrăveanu announced that three other employees of the medical institution diagnosed with COVID-19 this April have already been treated.
“In May, we registered four cases among employees. They are two employees from the Clinic and two employees from the Oncology Hospital. From January to May, 12 patients who were hospitalized within the Institute of Oncology and who met the criteria for COVID-19, were tested and the tests were negative,” said Viorica Dumbrăveanu, the Minister of Health.
Cancer in Moldova
According to the World Health Organization (WHO) data, cancer is one of the leading causes of death in developed countries, followed by cardiovascular diseases. Thus, about 10 million people die each year from cancer worldwide. Common causes of cancer might be the ecological crisis because of human activity, alcohol abuse, smoking, poor nutrition, psychosocial stress.
Oncological diseases are the second leading cause of mortality in Moldova, after cardiovascular diseases. On January 1, 2018, there were registered over 52,000 people diagnosed with various types of cancer; annually, over 9,000 new cases are identified.
According to statistical data, 6,226 patients diagnosed with cancer died in 2016 (16 percent of the total number of people who died).
The Ministry of Health, Labour and Social Protection announced that beginning with May 16, the scheduled medical services provided within the hospital and primary care medical institutions, which were limited during the state of emergency to prevent the spread of the new Coronavirus infection, will be gradually relaunched.