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Nation’s cancer chief warns delays in cancer care are likely to result in thousands of extra deaths in coming years – The Washington Post

The government’s top cancer doctor warned Thursday that delays in screenings, diagnoses and treatment because of the coronavirus pandemic are likely to result in thousands of “excess” deaths from the disease in coming years.

Norman “Ned” Sharpless, director of the National Cancer Institute, said new estimates by the institute show there will be 10,000 more breast and colorectal cancer deaths over the next decade than would have been expected without the coronavirus. Those deaths represent about a 1 percent increase in the almost 1 million deaths expected from those malignancies in the next 10 years. Breast and colorectal cancer account for about one-sixth of all cancer deaths.

Sharpless said his estimates were based on a “conservative” analysis of the two cancers — perhaps too conservative, he said. The researchers estimated, for example, that there has been a 75 percent decrease in mammograms and colonoscopies in recent months, but now think the number might be 90 percent or more. In either case, he said, the estimates show that even a relatively short disruption of screening and care can lead to more deaths.

The cancer institute head spelled out his views in an editorial published Thursday by Science; he elaborated on them in an interview. He wrote that while there has been a steep drop in cancer diagnoses in the United States since the start of the pandemic, “there is no reason to believe the actual incidence of cancer has dropped.” The result, he said, is that “cancers being missed now will still come to light eventually, but at a later stage (“upstaging”) and with worse prognoses.”

While delaying screenings and care was, to some extent, prudent during the height of the pandemic, “ignoring life-threatening non–COVID-19 conditions such as cancer for too long may turn one public health crisis into many others,” he added in the editorial.

He said doctors can take steps to try to keep the effects from getting worse. They need, for example to make patients feel comfortable about returning to hospitals, clinics and doctors’ offices for screening and treatment. “If we let them be afraid for six months or a year,” he said, “the numbers get worse and worse.”

His concerns are echoed by many oncologists and cancer centers.

“We are all worried there is a downstream ripple effect where screening studies were omitted completely,” said Margaret E. Van Meter, an oncologist who treats breast cancer at Intermountain Healthcare in Murray, Utah. Routine mammograms — for women without symptoms — were canceled for months at most facilities across the United States, while mammograms for women with symptoms typically continued.

Medical centers also postponed many cancer surgeries they deemed less urgent, such as early-stage breast cancers that could be treated first with medication.

Van Meter said some of her patients who were longtime cancer survivors were happy to switch to telemedicine visits and probably suffered no ill effects. Many newly diagnosed patients with aggressive malignancies have not hesitated to come in for treatment, she said. “When faced with two very serious threats, they are choosing to get cancer treatment,” she said. “They are taking precautions but have not been crippled by coronavirus fear.”

In addition to cancer treatment, Sharpless in the editorial expressed concern that an unprecedented disruption in cancer research may slow the development of needed therapies. “Given the long timeline between basic cancer research and changes to cancer care, the effects of pausing research today may lead to slowdowns in cancer progress for many years to come,” he said.

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nation Tyson

Tyson says nation’s pork production is down 50%, despite Trump’s order to keep meat plants open – The Washington Post

President Trump’s executive order last week requiring meat processing plants to stay open to ward off shortages may not be a cure-all for the food industry segment that has been hardest hit by coronavirus outbreaks.

On Monday morning, Tyson Foods said during an investor call that U.S. hog processing capacity had dropped by 50 percent.

The company has been severely affected. Three of Tyson’s six main U.S. processing facilities remain closed, and three others are operating at reduced capacity, the company said.

Steve Meyer, an economist for Kerns and Associates, an agricultural risk management firm, said Tyson’s production numbers may be even more dire.

“By my calculations, last Friday, pork production was down 42.9 percent for all U.S. companies,” he said by phone Monday. “Tyson, by my calculations, was down by 57,780 hogs processed per day from a capacity of 78,500 processed per day. That’s 74 percent short.”

Tyson declined to give further details.

Tyson closed its Columbus Junction, Iowa, plant on April 6 after recording 200 coronavirus infections and at least two employee deaths. (The facility is open now and running at three-quarters capacity, Meyer said.) Next, the company suspended operations at its Perry, Iowa, pork plant on April 20 for deep cleaning. The company slowed and then closed its largest pork plant, in Waterloo, Iowa, on April 22 after 182 cases of covid-19, the disease the novel coronavirus causes, were linked to the facility. And a fourth pork plant, in Logansport, Ind., halted operations April 25 after nearly 900 employees, or 40 percent of the workforce, tested positive for the coronavirus.

Although pork processing was most affected, the Tyson beef supply is also threatened, with sick workers forcing shutdowns. The Tyson Fresh Meats beef plant in Pasco, Wash., closed, and Tyson said last week it would temporarily suspend operations at its Dakota City, Neb., beef processing plant after a surge of hundreds of coronavirus cases linked to the facility.

According to a Centers for Disease Control and Prevention report, 115 meat and poultry processing facilities in 19 states had reported covid-19 cases as of Friday. Among approximately 130,000 workers at these facilities, 4,913 cases and 20 deaths have been recorded.

Dermot Hayes, an economist at Iowa State University, said Tyson has been hit particularly hard for two reasons. It was hit first, so the spread has had longer to play out. And more recently, Tyson has been checking everyone at its plants and finding many workers testing positive for the virus.

“At one in Missouri, they tested 2,000 workers and 350 workers were positive,” Hayes said. “None of them had symptoms.”

Tyson announced last week that it plans to resume limited production this week at the Logansport facility, after a plant tour with local health and government officials, a union representative and medical professionals.

“We’ve taken additional precautions to reassure team members that they are returning to a safe work environment and have made additional changes to continue supporting them during this global health crisis,” said Todd Neff, senior vice president. “While the facility was idled, we added more workstation barriers, installed more hand sanitizer dispensers and did additional deep cleaning and sanitation. We’re also now screening employees for additional symptoms.”

But according to Meyer, if consumers’ neighborhood grocery stores have exclusive purchasing contracts with any of the multinational corporations that have been hit particularly hard, there could be shortages.

“You’re going to see empty shelves,” he said. “Not all the time, and it won’t last forever.”

Hayes said part of what will increase prices is that consumers will probably see a scarcity of pork, beef and chicken all at the same time because of the plant closures. Consumers can’t just substitute a cheaper animal protein, because all are likely to cost more.

“Usually pork loin is $2 per pound at Costco,” he said. “That could go to $3.”

Costco announced on Monday some restrictions as supply tightens, saying fresh meat purchases are temporarily limited to three items per warehouse member among the beef, pork and poultry products.

If prices increase significantly, Hayes said, it will tank exports.

“We export huge quantities of meat all over the world, about 30 percent of what we produce,” he explained. “Those export customers are much more price sensitive, so price increases will result in less exports.”

He said it remains to be seen whether that would boost quantities available for domestic retail.

The president invoked the Defense Production Act last week to classify meat processing plants as “critical infrastructure,” a move that was widely seen as giving processors protection from liability for workers who fall ill on the job.

“If it works,” said Hayes, “consumers will see a modest increase in prices. If it doesn’t work, they’ll see a big increase.”

The executive order came on the heels of Tyson Foods taking out full-page advertisements in The Washington Post, the New York Times and the Arkansas Democrat-Gazette, with company Chairman John Tyson warning that the U.S. “food supply chain is breaking.”

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