COVID delays are making Biden’s cancer moonshot a long shot

At the start of the month, Biden announced plans to reignite his Cancer moonshoot, an initiative he initially launched as vice president in 2016. The aim is to reduce the death rate from cancer by 50 percent in the next 25 years and to improve the lives of cancer patients and their families.  

However, with the delay in diagnosis and treatment of life-threatening illnesses — including cancer — during the pandemic, this moonshot is a long shot. 

When you’re diagnosed with a life-threatening illness, timing matters. My own cancer diagnosis was delayed by a year. I was in training to be a doctor nearly 13 years ago when I noticed a tiny lump in my right armpit. I was told I had a benign cyst, and when I returned a year later because it didn’t go away, I had Stage III breast cancer that had spread to my lymph nodes.  

If my cancer had been caught earlier, it’s possible I could have avoided months of chemotherapy and radiation. If my diagnosis were delayed a few months longer, it’s possible that my disease would have been incurable.  

Throughout the pandemic, the coronavirus has crippled essential healthcare services leading to countless delays in cancer diagnoses across the country. 2020 data from cancer registries in Georgia and Louisiana showed substantial delays for cancer diagnosis and treatment services last year. Sadly, these pandemic-related delays will result in worse outcomes. Projections estimate that fewer screenings, delayed diagnosis and reduced use of chemotherapy will lead to decreased survival for breast cancer patients like me over the next 10 years.  

These delays in diagnosis and treatment are in large part due to shortages of critical healthcare resources putting unmanageable strain on our hospital systems. At the peak of omicron, we saw a record 150,000 hospitalizations at once — more than at any time previously in the pandemic. As hospital beds overflowed with COVID patients, the strain was exacerbated as staff were overwhelmed, called in sick, or even resigned.  

To conserve critical bed and staff resources, hospital systems in nearly half of U.S. states announced postponements of elective surgeries. In New York, many hospitals were forced to cut back elective surgeries due to critical bed shortages from omicron.  

I’m especially concerned about the children who are unable to get access to life-saving treatments that they need right now. Each pandemic surge has resulted in delays in cancer diagnosis and treatment for pediatric patients, both in the United States and across the globe.  Omicron, in particular, has overwhelmed our pediatric hospitals. A few weeks ago, nearly 1,000 children nationwide were admitted to the hospital with COVID-19.  These delays in care for our children may change their future forever.  

Fortunately, new cases have been declining across the country, but patients will continue to remain in the hospital for the coming weeks. And daily deaths have been at an all-time high.  

Some states where death rates are highest have the lowest vaccination rates. Tennessee, Michigan and Indiana, for example, were among the states with the highest Covid death rates towards the end of last month and they were also among the states with fewer than 60 percent of their population fully vaccinated.  

One of the most important steps the Biden administration can take in preserving critical hospital resources for cancer patients right now is to maintain and expand vaccination efforts nationally. We particularly need to increase vaccinations among our children. Currently, more than 30 percent of Americans are currently unvaccinated or under-vaccinated. Our children are also vulnerable, with 23 percent of 5- to 11-year-olds fully vaccinated, and only a little more than half of 12-to-17-year-olds fully vaccinated. Simply by choosing to get vaccinated, those who are currently unprotected can decrease the spread of this disease and conserve hospital resources.  

We also need to do a better job with testing. At the start of the omicron surge, the country was caught completely off-guard with testing. Nearly two years into this pandemic, the Biden administration should have had adequate testing capacity for such a surge.  

Clarifying guidance and messaging on mask mandates — when to implement them and how to end them — is also critical to managing the pandemic in the long run. The evidence that masks decrease the spread of COVID-19 is abundant, and, as states like New Jersey, New York and others move to end mask mandates, the Biden administration will need to prepare strategy and supplies for future mask mandates that may be necessary.  

We are on the downslope of the current omicron surge, but we are almost certain to face new variants and surges in the future. Biden’s efforts to decrease cancer deaths will need to go hand-in-hand with better control of future COVID surges and keeping our healthcare system afloat. Biden’s cancer moonshoot demands a COVID moonshoot as well.  

Susannah Hills is an assistant professor of Otolaryngology-Head and Neck Surgery at Columbia University. Hills developed an original tracheostomy care program for pediatric patients and COVID patients. She led a team of military medics, physicians and physician assistants in a specialized program to care for over 170 COVID patients at New York Presbyterian Hospital who needed airway surgery (tracheostomy) to survive.

Editor’s note: This piece was updated to reflect that nearly 1,000 children were admitted to the hospital with COVID-19.