Radiation oncology during COVID‐19: Strategies to avoid compromised care

The COVID‐19 pandemic will present a range of challenges to radiation oncology departments. Early data suggest that cancer patients carry a higher than average, but still low absolute risk of hospitalization from COVID‐19. The risk of severe events for those who are hospitalized however, is high. Resources for usual cancer care will likely be limited. Decisions to alter, delay or omit treatment during this period should consider both the risk of the cancer and of COVID‐19 to the patient, as well as resource constraints. There is a need for departments to adapt with goals of maintaining an uninterrupted, high quality service and of minimizing compromise to oncologic care. Patients with cancer are at above‐average risk from COVID‐19. We propose a decision making framework from a radiation oncology perspective to consider competing risks to patients from COVID‐19 and from alterations to usual oncologic care as well as strategies to minimize these risks.