Page 35 - IJSA, Vol. 4, No 2, 2021

International Journal of Science Annals, Vol. 4, No. 2, 2021
рrint ISSN: 2617-2682; online ISSN: 2707-3637; DOI:10.26697/ijsa

Figure 1 Discussion
The Difference of Oncology Surgeries Between Two The first two confirmed cases of COVID-19 in Indonesia
Periods was announced by the President of Indonesia on March
2nd 2020 (Lotfi et al., 2020). The cases then continued to
Number of Surgeries 125 and in response to the growing number, the Indonesian
150
rise as the government conduct the testing and tracing,
National Board for Disaster Management declared an
100
emergency period for 91 days, effective until May 29th,
75
2020. On March 31st, 2020, President Joko Widodo
50
25
police to enforce a large-scale social restriction policy as
0 declared a public health emergency and invoked the
stipulated by Law No.6/2018 on health quarantines
March April May June July (Wiratraman, 2020). Because of this measure, people are
Months encouraged to stay at home and avoid all unnecessary
2019 2020 activities including visits to the healthcare (GP practice,

The same trends show on the outpatient visits to primary healthcare, and hospital) for non-emergency
Oncology Unit (Table 2). cases. In Moewardi Hospital, which is 1 of 3 COVID
Table 2 regional hospitals. The bed capacity for COVID-19
The Number of Outpatient Visits patients has increase from 7 beds in March to 57 beds in
Outpatient July 2020.
Month Year P value
visits Lack of effective mitigation strategies against COVID
March 2019 589 <0.001 and implementation lockdowns to control the spread of
2020 170 infection aggravated the healthcare crisis. COVID has a
April 2019 466 <0.001 major adverse impact on cancer care delivery globally.
2020 181 Therefore, a hospital policy is not to accept new patients
May 2019 574 <0.001 except for emergency patients or those with life-
2020 238 threatening conditions. The hospital also has a policy on
June 2019 592 <0.001 cancer patient care, in this case, the surgery schedule
2020 293 (Usman et al., 2021). Our findings show that during the
July 2019 557 <0.001 early pandemic period, especially the first two months
2020 290 after the first two cases were announced and the large-
There was a significant decrease in the early pandemic scale social restriction was implemented, there was a
period (March 2020) which was only 170 visits to the significant drop in the number of patient visits to
outpatient oncology unit, compared to the year before oncology care in Moewardi Hospital (p<0.001). The
which was 589 visits. The number of the visits gradually number of oncology surgery was the lowest in April
rose and peaked in June 2020, and slightly decreased in 2020, after the hospital was appointed by the government
July 2020, as seen in Figure 2. as COVID-19 referral hospital (by the end of March
Figure 2 2020). These findings are in line with the study by
The Difference of Oncology Outpatient Visits Between Reichardt, et al (2020) which reported there was a highly
Two Periods significant reduction in overall cancer admission in 75
Helios hospitals in Germany for the early lockdown
600 period from March 13th to April 28th, 2020 compared to
of Outpatient Visits 400 hospital admission. A similar result was also found by
the same period in 2019 (Reichardt et al., 2020). A study
Number 500 by Mulholland et al. (2020) also had similar findings;
there were sharp drops in both emergency and planned

Stohr et al. (2020) who reported that there was a
300
reduction in hospital admission following the
200
government-imposed social restriction, even for
100 emergency cases. Tzeng et al. (2020), reported that the
high number of COVID-19 cases without symptoms was
0 an obstacle for reduction in hospital admission for cancer
March April May June July sufferers.
Months The significant decline in oncology surgeries patient’s
2019 2020 visits might be due to the following reasons:
1) On the early pandemic year, people were encouraged
There was a significant decline in the surgery numbers to restrict their visits to healthcare facilities. Despite the
on 5 months pandemic period compared to the same unchanged oncology services in surgery and outpatient
timeframe in 2019 (p<0.001), as seen in Table 1. departments, people delayed their surgery and outpatient
Similar findings were shown in outpatient visits, which visit unless it's emergency cases;
was showing a significant decline each month when
compared between two periods.

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