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Confronting COVID-19

Planning for post-pandemic recovery

The Queen’s School of Policy Studies is laying out strategies for building a better society in the wake of COVID-19 in a series of white papers.

Photograph of Parliament building in Ottawa
The COVID-19 Working Groups have already published three white papers on ageing well, the future of work, and the future of governance after the pandemic. (Shutterstock.)

The effects of the COVID-19 pandemic have rippled across every aspect of society. To confront all this change and uncertainty, the Queen’s School of Policy Studies (SPS) brought together researchers from across the university to create several interdisciplinary COVID-19 working groups to explore the impact of the pandemic and ask how we might use it as an opportunity to reshape some parts of our world for the better. Each of the eight working groups focuses on a specific topic, including arts and culture, economics, and healthcare.

After beginning their work last spring, the working groups have begun sharing their findings through a series of white papers. Three white papers have already been published on the topics of “Ageing Well,” “The Future of Work Post-Pandemic,” and “The Impact of COVID-19 on the Future of Governance in Canada.” Significant media attention has already amplified findings from these papers, and additional publications are expected to follow from the other working groups.

“The COVID-19 Working Groups in the School of Policy Studies have given Queen’s the chance to contribute to the national dialogue on a range of pressing topics. We want to use our expertise to help Canada emerge from the pandemic with a plan for building a strong and sustainable future,” says Warren Mabee, Associate Dean and Director, SPS.

Ageing well and the future of work

Long-term care homes have been struck especially hard by the pandemic, which prompted the COVID-19 Health Policy Working Group to focus on Canada’s approach to ageing in its first white paper. “Ageing Well” broadens the perspective of the current crisis in long-term care to the forthcoming tsunami of older seniors and the critical issue of quality of life and what seniors wish.  Studies show that few want to go to long-term care, and they prefer to “age in place.” The working group suggests that Canada needs to make greater efforts to provide supports so seniors can remain in their home longer and to create a variety of other living arrangements based in the community. To accommodate the desire to live independently the white paper argues more needs to be done to prevent or at least alleviate chronic conditions such as dementia and frailty.

The pandemic has also created new urgency for planning for changes to work and the economy. Looking at issues such as labour trends, economic recovery, and income support, the COVID-19 Economic Policy Working Group explores potential long-term effects in “The Future of Work Post-Pandemic.” While some sectors of the economy may be able to return to a pre-pandemic normal, the working group shows that Canada must be prepared to address a changed economic landscape in the wake of COVID-19.

“Ageing and the economy are two of Canada’s most pressing issues. Canada will need to support the needs of 4.2 million additional seniors over the next 22 years and 82 per cent will be 75 or older.  It’s pertinent we think about the long-term implications of Canada’s next steps for seniors, and the associated costs,” says Don Drummond, Stauffer-Dunning Fellow in SPS and co-author of both white papers. “As for the economy, many worthy national initiatives under consideration would require further, massive government spending when government debts and deficits have already ballooned. These needs and desires will need to be balanced against the importance of avoiding the next crisis being fiscal.”

The future of governance

The third white paper focuses on the role of government in managing a national crisis such as this pandemic. In “The Impact of COVID-19 on the Future of Governance in Canada,” the COVID-19 Governance Working Group explores how the Canadian government can best lead the country out of the current situation. The white paper argues that government institutions function well for Canadians but will also need to be adapted for a successful recovery when the pandemic dies down. Some of the initial ideas of the working group appeared in a series of op-eds in The Ottawa Citizen and were featured in podcasts by the Institute on Governance; these ideas are refined in the final white paper

“At the heart of the paper is a recognition that governance – especially how we collectively make decisions and who is at the table – is central to the successful recovery of the country. This is an opportunity that we should not miss,” says Kathy Brock, Professor and Senior Fellow, SPS, and co-author of the white paper.

Read the white papers from the COVID-19 working groups on the SPS website. Additional publications from the working groups will be published on that website as they become available.

Modelling the new coronavirus variant

Queen’s expert Troy Day discusses the new models he developed to predict the future of the pandemic in Ontario.

Graph modeling the potential spread of COVID-19 in Ontario
A model created by Professor Troy Day of how the new coronavirus variant could spread in Ontario. (Ontario Science Advisory and Modelling Consensus Tables.)

It’s been nine months since Professor of Mathematics Troy Day joined Ontario’s COVID-19 Modelling Consensus Table, and his work is now more pressing than ever. He has turned his attention to the new variant of the virus first found in the UK, and his most recent models indicate this more infectious strand of the virus could become dominant in Ontario by February.

The Gazette interviewed Dr. Day when he first joined provincial table in April, and we’ve connected with him again to discuss his latest findings.

When did the new variant of the coronavirus become a focus of your work?

Day: I started shifting my attention to the UK variant in early December, shortly before the first cases were identified in Canada.

How did you determine that the new variant could become dominant in Ontario by February?

Day: There is a great deal of uncertainty with that projection, but we took estimates from its rate of spread in the UK and applied them to the outbreak in Ontario, under different assumptions about when the first cases arrived in Canada. If the first cases entered Canada in October (which is plausible given the extent of circulation in the UK at that time) and circulated undetected until recently, then we might expect it to become dominant in February or March. On the other hand, if it first arrived in Canada in December (as another example) this date would be pushed forward by about another two months.

According to your models, what might the ramifications be if the new variant does become dominant?

Day: The most troubling projection to me is that, if everything about the spread of the variant works the same in Canada as it has in the UK, then the doubling time of the outbreak might be reduced from around 40 days to less than two weeks.

Now that you’ve been serving in this role for nine months, can you describe the value of the table and how it affects decision making in Ontario?

Day: Good question. No doubt making decisions at the governmental level is very difficult since they need to integrate all of the information they receive about the epidemiological projections with everything else (health care capacity, economic considerations, people’s willingness to adopt different behaviours, and so on). I think our table has been important in guiding the government’s response by providing the best possible information about how the outbreak is likely to unfold under different circumstances. And, despite the pandemic, it’s been really enjoyable working with such a multidisciplinary team of people from so many different institutions and agencies.

What’s next for your modelling work and for the COVID-19 Consensus Table more generally?

Day: At the moment we are engaged both in further monitoring of the spread of the UK variant and updating the projections. We have also been modeling how best to deploy sequencing capacity for tracking the variant as well as trying to develop methodology for quickly identifying any other new variants of potential concern that might arise.

What motivates changing behaviours during COVID-19


A woman shopper wearing a surgical mask stocks up on toilet paper at a supermarket
In the early days of the pandemic, people panic bought toilet paper. (Shutterstock)

The ongoing COVID-19 pandemic has forced us to make some pretty interesting decisions like buying in bulk, wearing face masks and physically distancing from other people.

The Conversation logoHow do we make decisions and choices? Motivation is the reason why we do what we do. Motivation theory analyzes the why of human behaviour as a means of understanding people’s decision-making processes. But people’s motivations are more complicated than we might think, because decisions are usually based on several factors that may or may not be context-specific.

My research looks at how people can be motivated to innovate: I study learning environments, leadership strategies and how to develop innovation potential. Understanding motivation in innovation can help us understand how we make decisions in unusual times.

Motivation depends on what’s going on

Motivation as a field of study can be found in the writings of the Greek philosopher Plutarch and the Bhagavad Gita — among many other ancient texts — although focused psychological studies or motivation dynamics are rather recent. In the past century, motivation theory has looked at whether motivation is extrinsic or intrinsic to a task.

Those of us who study motivation have many theories to choose from, each with strengths and weaknesses. You would, however, be hard-pressed to find a framework more easily transferable than expectancy-value-cost theory (EVC), which understands motivation as uniquely contextual for each situation.

One way to think of it is as a dynamic interaction of the expectancies (confidence in the outcome) and values (what makes it valuable) going up against the perceived costs related to a given task to a given person in a given context. If your held expectancies and values outweigh your perceived costs, you are likely motivated to complete the task, and vice versa.

What drove people to buy up toilet paper?

For most of March and April 2020, it was pretty hard to come by toilet paper because it was literally rolling off the shelves. People were panic-buying toilet paper in bulk, and supply couldn’t keep up with demand.

Applying EVC theory suggests that people were increasingly motivated to buy toilet paper because of a perceived need to be prepared. The increase in perceived value went unchecked, and plenty of people’s motivation to buy toilet paper went through the roof as fast as their probably sound reasoning went down the drain.

Increasing, explaining or revealing the values of any task (good or bad) makes it more likely that someone will do it. When you effectively communicating why people should behave in a certain way by explaining the value of a decision or choice, they are more likely to behave in that way.

How did people adjust to working from home?

A public health mandate may have necessitated many people to work from home, but until many people actually had settled into working from home, few would have believed that they could passably perform their role from home. Folks might have been nervous or unconfident in their ability to accomplish their role early on, but over time, people grew into working from home or in whatever changed circumstance they found themselves working in.

In other words, we adapted to the reality in front of us. Lots of people would now be more likely to think it’s possible to capably manage working from home.

Our expectations of success are built by our lived experiences, especially the unplanned ones, and we are more comfortable doing what we have done in the past. These experiences change what we believe ourselves to be capable of doing.

Motivating a desired outcome

EVC theory can be applied to increase the chances of a specific outcome. As a first step, EVC theory splits the factors into two groups, those that promote the task outcome and those that hinder the task outcome. Naturally, we would want to make the promoting factors as big as possible and the hindering factors as small as possible as for instance innovating or changing thinking .

This makes for a two-pronged approach to motivate people to make the desired choice: maximizing expectancies and values and mitigating costs, such as time investment, isolation, loss of stability, sense of safety and additional effort.

In the case of people adapting to physical distancing (or pretty much anything), providing easily understood information from a trusted source will likely increase the chances of the behaviour. Explaining in clear terms what someone will get from doing something builds one or more types of value, such as fulfilling a communal or shared duty.

This can be applied anywhere, for example, fitness during the pandemic, healthy diets, physical distancing. The key is helping someone see and believe they can do something, explain what the whole point of the exercise is and what they get from doing it (fun, fulfilment, importance or reward) and then work to address their perceived barriers to actually doing it. This turns into the blueprint for driving desired behaviours.The Conversation


Eleftherios Soleas, Adjunct assistant professor, Education, Queen's University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Queen’s announces changes to support province-wide shutdown

The university is urging students to avoid returning to Kingston until after Jan. 23.

As cases of COVID-19 continue to rise rapidly across the province, the Ontario government has announced a province-wide shutdown that will go into effect as of Dec. 26 and last for 28 days. During this shutdown period, Premier Doug Ford is advising all Ontarians to stay at home to the fullest extent possible, noting that travel outside your region should be limited to only essential purposes.

In accordance with the provincial announcement, the university is strongly urging all students to avoid returning to Kingston until after the shutdown ends on Jan. 23, unless absolutely necessary. This includes students living both on and off campus and international students who were scheduled to travel to Kingston for the start of the winter academic term. 

  • This means that the start of in-person classes will be delayed, with the exception of a limited number of classes that require in-person teaching as permitted by the government, such as clinical training that supports health-related programs (e.g. Medicine, Nursing, Rehabilitation Sciences)
  • Students in other programs who were expecting to begin on-campus activity in the winter term will receive further communications from their faculty or program office.
  • Students who are scheduled to return or move into a Residence building are strongly encouraged to remain in their home communities, unless absolutely necessary. These students will receive additional information from Residence Life Services shortly.
  • International students travelling to Kingston for the start of the winter term are strongly encouraged to delay their arrival, unless absolutely necessary. These students will receive additional information from the Queen’s University International Centre shortly.
  • For already approved on-site research activity, if researchers can work remotely (from home) they should do so, only coming on campus as necessary. New requests for on-site activity are suspended. Important information on research continuity planning, including on-site access, human participant research, and field research, is available on the Vice-Principal (Research) website.
  • All athletic and recreation facilities are closed for in-person access.
  • On-campus access for employees will be limited. Only essential staff and faculty or those who must be on campus to do their work should be on campus. All other faculty, staff, senior administration, and student leadership will work remotely except for required ad hoc access (for example, to record a lecture, print documents, or retrieve files) or those with accommodation requirements.
  • All university-sponsored travel outside of Canada remains suspended indefinitely. This affects students, staff, and faculty and includes all future exchange, study abroad, letters of permission, faculty-led programs, internships, research placements, community-engaged learning, practicums, and conferences.

More information on the impact of the province-wide shutdown and its impact on Queen’s will be available in the new year. Units, department, and faculties across the university will be providing updates on their services on their websites and through other communications channels.

Queen’s wishes to thank everyone for their efforts to date and to encourage everyone to continue to do their part to keep their family, friends, and community safe from the spread of COVID-19.

Lights, camera, livestream!

Work presented by Queen’s University’s Festival of Live and Digital Art recognized as one of top 10 moments in Canadian Theatre for 2020.

During a time when theatres went dark and the performing arts community had to introduce new ways to showcase their talents, a program at Queen’s University pushed forward by moving its unique Festival of Live and Digital Art (FOLDA) online.  

As a result, the Globe and Mail has named a production at FOLDA as a top-10 moment in 2020 Canadian Theatre. Included on that list were the National Ballet of Canada and the Toronto production of Hamilton. 

In its third year, FOLDA is an annual festival held in Kingston in June that exists with the support of The Isabel Bader Centre for the Performing Arts, The Dan School of Drama and Music, and The Department of Film and Media. Due to the pandemic, it was presented this year in an entirely digital format.  

This year, Miwa Matreyek, a designer, director and performer from Los Angeles, presented three livestreamed works, including Infinitely Yours where her silhouette interacts with animations. It was included in the Globe and Mail’s top 10. 

“Iterative development has been at the core of the curatorial approach to FOLDA,” says Michael Wheeler, assistant professor, Dan School of Drama and Music. “Around a third of the pieces at FOLDA are finished works like Infinitely Yours. Many other works are works in progress as creators experiment with concepts and gain feedback from audiences. It was for this reason we were also excited to see The Chop Theatre's Pathetic Fallacy on the same Globe and Mail list. This show was developed in an iterative creation process at festivals around the world, including two years at FOLDA, before finding a completely digital presentation form working with Rumble Theatre in 2020." 

SpiderWebShow established FOLDA at The Isabel in 2018 with a goal of creating an annual festival for audiences and artists to examine how digital technologies are transforming life performance. Wheeler is also the co-creator and director of artistic research of SpiderWebShowthe first and only nationally-driven performing arts website of its kind in Canada. 

“The inclusion of Miwa Matrayek's work at FOLDA on this list of notable theatre productions emphasizes the shifting nature of the medium that SpiderWebShow has been dedicated to considering,” says Wheeler. “We are thrilled for Miwa and hope it will encourage new audiences to join us each June in an exploration of what live performance can be." 

Read more about FOLDA in the Globe and Mail. 

7 ways meaningful activities can help us get through the coronavirus pandemic

Keeping busy during the pandemic by taking on a new hobby or tackling a home renovation project can help us get through challenging times. (Shutterstock)
Keeping busy during the pandemic by taking on a new hobby or tackling a home renovation project can help us get through challenging times. (Shutterstock)

We hear over and over that it is important to remain occupied during pandemic restrictions. People are gardening, baking bread and taking on DIY projects in record numbers. But what exactly does all this “occupation” do for us in stressful times?

Meaningful activities can be a source of healing and relief in stressful times. In the fall of 2011, in response to the events of September 11, I contributed a position paper to an expert panel of the American Occupational Therapy Foundation that sought to offer guidance on meaningful activities. Although the current circumstances are dramatically different, the argument is much the same. Being occupied is good for us, and its benefits are even greater when we are beset with uncertainty, distress or upheaval.

As long as human history has been recorded, we have known that it is important for human beings to be occupied in meaningful ways. Based on an exhaustive review of the international literature, there is solid evidence for seven ways that meaningful activities can support our well-being in difficult times.

1. Identity: What we do reminds us of who we are. How we occupy ourselves contributes to the formation and maintenance of the self. Difficult times threaten the integrity of the self. Occupation provides the mechanism through which the past, present and future of the self are integrated. In the face of difficult circumstances, occupation offers the potential for a fuller, more integrated self once the crisis resolves.

2. Mastery: Occupation reminds us of our capacity for exercising control over our circumstances. It validates our sense of being able to master a situation, turn it to our advantage and come out of it intact. Occupation makes people agents of their situation rather than victims of it. Occupation is both intrinsically motivated and intrinsically rewarding because of its validation of our sense of mastery and adaptation.

A woman on a red mat doing yoga in a white bedroom
Developing and maintaining habits help regain a sense of control. (Shutterstock)

3. Habit: Being occupied in usual ways in the midst of a crisis reinforces in us our normal daily habits. It reassures us that the world continues to turn and that it is possible to have a normal life again. Habits have been understood for many years to have restorative properties when chaos appears to otherwise reign. Habits have been shown to increase skill, decrease fatigue, free attention and protect individuals against the stressful effects of difficult situations.

4. Diversion: Doing something provides a diversion from the negative aspects of stressful situations. Diversional activity allows individuals to transcend the obstacles and difficulties of their daily lives, and in some circumstances, to even achieve an optimal experience beyond the fixed realities of time and space — a state we call “flow.” Occupation has the power to divert people away from the difficulties in their lives, toward satisfaction and healthy engagement.

5. Support: Being occupied often involves interacting with others — providing support to their coping efforts, and receiving support in return. The sense of belonging is widely understood to be one of the factors that helps people to achieve positive outcomes and to weather stress without undue negative consequences for their health. Shared occupations can thus have a two-fold positive effect. Besides the obvious beneficial effects for the recipient of support, occupations contributing to the welfare of another have been shown to have numerous benefits for the provider as well.

6. Survival: Many occupations actually have survival value. Evidence from anthropology and prehistory show that humans created and differentiated occupations that promoted co-operation and favoured the survival of both the individual and the group. Occupations meet safety and sustenance needs, and as such are essential tools for survival.

Hands baking bread
Baking bread is both a way to stay occupied and a useful life skill. (Shutterstock)

7. Spiritual Connection: Finally, when difficult times arise, occupations can be the means through which meaning in life is restored. Whereas in earlier times, people might have turned to religion to restore meaning, in the contemporary world of secular pluralism, occupation may be the most effective medium available through which individuals can affirm their connection with the self, with others, with the cosmos and with the divine. In stressful times, being occupied may provide the sense that one is not alone, both literally and in the most profound sense.

So keep on learning to knit, doing yoga online and sorting photographs. There are seven good reasons to do so, all of which will help to see you through this pandemic with your sense of self and community intact.The Conversation


Mary Ann McColl, Professor, School of Rehabilitation Therapy, Queen's University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Library doubles bookable study spaces

In response to student feedback and the upcoming exam period, while also considering the success of earlier phases of re-opening library spaces, Queen’s University Library is doubling the number of bookable seats available in Stauffer Library.

Students will also be able to continue to book seats at the Education Library in Duncan MacArthur Hall, and additional spaces in Mackintosh-Corry Hall. Additionally, the limit per month has been increased from 40 to 60 hours across campus per student.

Please see the Bookable Seats page for more information. With more students being welcomed back to the library, be sure to check out the Queen’s University Library’s instructional video and the Use of Bookable Seats page, in order to have a sense of what you can expect as you visit the available spaces.

Leveraging creative potential during a pandemic

Queen’s University researchers respond to a critical need with unique music program Rise, ShineSing!

The Accessible and Inclusive Music Theatre project, led by Queen’s researchers Julia Brook and Colleen Renihan, is embarking on its second year of investigating how participation in an accessible online music and movement program can improve well-being and foster creativity, particularly among older adults.  

The first year of the program Rise, ShineSing! included three weeks of in-person sessions at the Isabel Bader Centre for the Performing Arts which saw sessions of 50 people in the rehearsal hall, singing and moving together, followed by 12 weeks of online sessions over Zoom. 

We came together as a team to consider what a collaborative approach to these wicked problems of ageism in music theatre, loneliness, and a lack of understanding about the creative potential of people throughout the lifespan could yield,” says Dr. Renihan, whose research investigates issues of voice, cultural memory, and empathy in opera and music theatre. 

After moving online due to the pandemic, Drs. Brook and Renihan decided to continue the program, based on its early success. 

We determined this program filled a significant need in the community,” says Dr. BrookWe are both community-minded musicians and scholars, wanting to work and make beautiful change in our local community here in Kingston. We believe in the flexibility that music theatre offers with its combination of music, story, and movement. We believe that one can thrive and be creative across the lifespan. 

Dr. Renihan adds for the second year of the program they are aiming to share their findings through publication, public presentations, and through the formation of a national network of researchers and creators with similar goalsThey are also interested in the effects of participation in this kind of creative work on well-being. Finally, with the pandemic, they are investigating the surprising gains of engaging in performance and creation over Zoom. 

The second year of the program includes participants from outside of Kingston, including some people from long-term care homes, recognizing the need in this community for interaction, connection, and artistic stimulation, especially during the COVID-19 pandemic. 

During each weekly session, participants engage in a series of vocal and movement warm-ups, and sing and dance to a repertoire of folk, musical theatre, and popular hits. 

“Our project aims to find ways to help people of all ages and abilities to leverage their creative and artistic potentials in a digital space,” says Dr. Brook, whose research area focused on music education. 

This research project is currently recruiting participants of all ages and abilities: No previous singing or dancing experience is required, and no digital savvy beyond clicking the Zoom link is needed. 

To find out more, sign up for a weekly newsletter and get the Zoom link to participate by visiting the project’s website at www.riseshinesing.ca. 

The Accessible and Inclusive Music Theatre Project is supported by the Social Sciences and Humanities Research Council of Canada, the Canadian Foundation for Innovation, and the Dan School of Drama and Music at Queen’s University. 

Checking in with students

  • Kate Johnson speaks with engineering students
    University Chaplain Kate Johnson speaks with Queen's students about their experience so far this year with remote learning. (University Communications)
  • Larissa Mankis speaks with a pair of students at the door to their house
    Larissa Mankis, project lead for Support Services & Community Engagement, speaks with Queen's students during the Treat Yourself initiative on Tuesday, Nov. 11. (University Communications)
  • A Treat Yourself team interacts with students on the sidewalk and at the entrance of a house.
    Treat Yourself teams handed out treat bags and information about student services and resources, upcoming on-campus flu vaccine clinics, how to socialize safely, tips on staying connected and active, and much more. (University Communications)
  • Sexual Violence Prevention and Response Coordinator Barb Lotan speaks with a student at her door
    Barb Lotan, Sexual Violence Prevention and Response Coordinator, and her dog Trixy deliver a treat bag and information on health and wellness resources at Queen's University. (University Communications)

Queen’s students living in the near-campus neighbourhood received a special check-in visit from  Student Affairs staff and campus partners on Nov. 11 and 12.

Going door to door, while observing social distancing and other safety measures, the “Treat Youself” initiative created an in-person opportunity for staff to ask students how they are doing, hear about their experiences with remote learning, and what would be helpful for the university to consider with respect to their needs. 

The teams were equipped with treat bags and information about student services and resources, upcoming on-campus flu vaccine clinics, how to socialize safely, tips on staying connected and active, and much more. They also promoted university services that are open for in-person bookings, including study spaces, library services, and workout availability at the Athletics and Recreation Centre.

“The students we spoke with were happy to see us and appreciated the opportunity to chat about their challenges and successes of the past few months,” says Larissa Mankis, project lead for Support Services & Community Engagement (SS&CE). “It was great to hear how resilient many of our students are in these uncertain times.”

In addition to the team in SS&CE, Mankis also thanks the offices on campus that contributed their time and resources to support this initiative including: Off-Campus Housing; Student Experience Office; Faith and Spiritual Life; Student Wellness Services; Sexual Violence Prevention & Response Office; Student Life & Learning; and Office of the Vice-Provost and Dean of Student Affairs, as well as the volunteers who completed the deliveries.

Treat Yourself was the second near-campus neighbourhood tour of the term, following an off-campus student Welcome Kit distribution in September as part of ongoing efforts to engage with students living in nearby housing and help them navigate the COVID-19 context.

“For those who volunteered, this was another opportunity to show students we are thinking about them, that we are here, and that we appreciate all they are doing to keep themselves and their community safe,” says Lindsay Winger, Assistant Dean, Support Services and Community Engagement, Student Affairs. “We appreciate how different a year this is, and we want to thank them for the steps they are taking, and make sure they are aware of all of the ways they can stay well, get involved and access support.”

Any student is encouraged to email supportservices@queensu.ca to receive the information that was distributed, and chat with a staff member. 

The impact of delayed cancer treatments

New research shows minimizing treatment delays could improve cancer survival rates.

Tim Hanna
Timothy Hanna (Oncology) of the Cancer Research Institute at Queen's University teamed up with Will King (Public Health Services) and King's College London's Ajay Aggarwal, for a study on impact on a person’s mortality if their cancer treatment is delayed by at least one month. (Supplied Photo) 

A new international study led by researchers from Queen’s University and King’s College London has found there is a significant impact on a person’s mortality if their cancer treatment is delayed by even one month. The study published Nov. 6 in the British Medical Journal (BMJ) found in many cases, patients have a six to 13 per cent higher risk of dying from cancer if their treatment is delayed by four weeks. The risk keeps rising the longer their treatment does not begin. The study was led by Timothy Hanna, Associate Professor (Oncology) at the Cancer Research Institute at Queen’s University, as well as Will King (Public Health Sciences) and Ajay Aggarwal (King’s College London).

Researchers embarked on the study because most countries have experienced deferrals of elective cancer surgery and radiotherapy as well as reductions in the use of systemic therapies because of COVI-19. Health systems have also redirected resources to preparing for the pandemic.

The researchers carried out a review and analysis of relevant studies into the subject published between January 2000 and April 2020. 

These studies had data on surgical interventions, systemic therapy (such as chemotherapy), or radiotherapy for seven forms of cancer – bladder, breast, colon, rectum, lung, cervix, and head and neck – that together, represent 44 per cent of all incident cancers globally.

They found 34 suitable studies for 17 types of conditions that needed to be treated (indications). These studies collectively involved more than 1.2 million patients. The association between delay and increased mortality was significant for 13 of these 17 indications.

In addition, the researchers calculated that delays of up to eight weeks and 12 weeks further increased the risk of death and used the example of an eight-week delay in breast cancer surgery which would increase the risk of death by 17 per cent, and a 12-week delay that would increase the risk by 26 per cent. 

“As we move towards the second COVID-19 wave in many countries, the results emphasize the need to prioritize cancer services including surgery, drug treatments and radiotherapy as even a four-week delay can significantly increase the risk of cancer death” says Dr. Aggarwal. 

The authors acknowledged that their study had limitations such as the fact that it was based on data from observational research which cannot establish cause, and it was possible that patients with longer treatment delays were destined to have inferior outcomes for reasons of having multiple illnesses or treatment morbidity.

The analysis was based on a large amount of data and researchers ensured that they only included high quality studies that accurately measured what they were investigating.

“A four-week delay in treatment is associated with an increase in mortality across all common forms of cancer treatment, with longer delays being increasingly detrimental” says Dr. Hanna. “In light of these results, policies focused on minimizing system level delays in cancer treatment initiation could improve population level survival outcomes.”

The research is now available online in The BMJ.


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