publication date: Sep. 18, 2020

Guest Editorial

HOLA COVID-19 study focuses on disruption of cancer care in Latin America


Carolina Bernabe, MD

Principal investigator, HOLA COVID-19 study,

Essen Medical Health



Ana Velazquez Manana, MD

Medical oncology fellow,

Helen Diller Family Comprehensive Cancer Center,

University of California San Francisco



Coral Olazagasti, MD

Hematology/oncology fellow,

Zucker School of Medicine at Hofstra/Northwell


Narjust Duma

Narjust Duma, MD

Assistant professor of medicine,

Division of Hematology, Medical Oncology and Palliative Care,

Department of Medicine,

Carbone Cancer Center,

University of Wisconsin-Madison


This story is part of The Cancer Letter’s ongoing coverage of COVID-19’s impact on oncology. A full list of our coverage is available here.

As of September, more than 270,000 deaths have been confirmed in Latin American countries due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Brazil and Mexico are among the top four countries with the highest death toll due to COVID-19, along with the United States and India. It is believed that Latin American countries are especially vulnerable due to high levels of inequality and poverty, crowded living conditions in urban areas, lack of sanitation, slow and uneven governmental response, and strained healthcare systems.

The rapid outbreak of SARS-CoV-2 has changed how health care is delivered in first-world countries—cancer care is no exception, and is a subject of high concern, given the importance of timeliness of interventions in outcomes. The HOLA (Hematology Oncology in Latin America) COVID-19 study was born out of concern for how the ongoing pandemic has affected cancer care in our home countries.

Among Latinos, the cancer screening rate is already low, and COVID-19 may have significantly worsened this situation. Our study seeks to highlight the barriers and struggles that hematologists and oncologists have faced during this health crisis.

As Latinas in medicine, we want to give our colleagues in Latin America a voice and share the challenges they face during COVID-19, particularly with regard to cancer care.


Evolution of care during COVID-19

Our study is a cross-sectional survey  of how hematology-oncology practices in Latin America have adapted during the COVID-19 pandemic. We are also interested in describing the changes in the routine management of patients with cancer, from diagnosis to completion of therapy.

Additionally, we would like to evaluate the implementation of telemedicine in developing countries.

The survey was distributed widely across Latin American countries, and it includes perspectives from all oncology subspecialties, from medical oncology to surgical oncology.

The survey was launched on Aug. 4, 2020, and it was available for four weeks. Currently, data accrual has been completed and the data are being analyzed.

Our study team is composed of a group of practicing oncologists and cancer care specialists representing nearly all Latin American countries. Team members publicized our study and recruited participants via social media platforms, email, and other local physician communication methods.

Participants were provided a link to complete the anonymous online questionnaire in their language of preference. The questionnaire was available in English, Spanish and Portuguese.

We aim to have these results by fall 2020.


Challenges amid a pandemic

With the arrival of a second wave of infections, it is imperative that we learn where the provision of care was most disrupted.

Identifying the challenges that our colleagues faced during these unprecedented times will help create policies to improve cancer care and address the long term effects of the pandemic in cancer care. 

The obstacles that COVID-19 has brought to developing countries have been different from the ones that first-world countries have faced while caring for patients with cancer.

It is imperative for Latin American oncologists to shed light on these barriers to improve the delivery of care during this pandemic, and future global health crises.

The long-term importance of the HOLA COVID-19 study is twofold. Primarily, current trends in population and environmental changes suggest that the influence of climate change, and its societal impact, will predict the onset of more frequent and severe global pandemics.

Therefore, understanding how these events affect at-risk healthcare systems will allow for better preparedness and contingency plans—to sustain care for vulnerable populations.

Secondly, analyzing the current changes to clinical practices and cancer care delivery will allow us to prepare and understand how the COVID-19 pandemic will directly affect the long-term outcomes of patients with cancer. It is time to give Latin America a voice!

Copyright (c) 2020 The Cancer Letter Inc.