Lung cancer management during the COVID-19 pandemic:experience of a medical oncology unit at a tertiary hospital in Singapore

Coronavirus disease 2019(COVID-19),caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),was declared a pandemic by the World Health Organisation(WHO)on 11 March 2020.The pandemic has had profound effects on healthcare systems across the world,and also poses unique challenges for oncology services.Singapore saw its first imported case of COVID-19 on 23 January 2020,and there has since been 52,000 confirmed cases and 27 deaths as of early August 2020 locally.Oncologists have a special duty to our patients to ensure patient safety and provide optimum care without undue disruption which may compromise long-term cancer-specific outcomes.We herein examine the impact that the COVID-19 pandemic has had on our clinical services,and share our experience with regards to manpower reconfiguration,infection control measures,diagnostic evaluation of patients with suspected COVID-19,oncological management of lung cancer patients,as well as changes in the education and training of juniors,from our unique position as a Medical Oncology department in Tan Tock Seng Hospital,a tertiary hospital affiliated with the National Centre of Infectious Diseases in Singapore.