ABSTRACT
Background: The ESMO Resilience Task Force has investigated wellbeing since COVID-19 in relation to work, lifestyle and support factors in oncology professionals globally. We reported on the significant impact of the initial surge of the pandemic on wellbeing and job performance (Banerjee et al. 2021). As the pandemic continues, it is imperative to understand experiences and concerns to better inform support measures for the oncology workforce. Methods: Three anonymous online surveys were conducted during the COVID-19 pandemic (S1, Apr/May 2020;S2, Jul/Aug 2020;S3, Feb/Mar 2021). Longitudinal analysis of responses at these timepoints were conducted. Here, we present responses to questions on job demands and resources, and perceived job performance since COVID-19 (JP-CV). Results: We analysed 3894 individual responses (S1, n=1520;S2, n=942;S3, n=1432): 53% (n=1961/3731) female, 45% (n=1679/3731) =/<40 years, 31% (n=1132/3692) non-white ethnicity, >100 countries. There has been significant increases from S1 to S3 (p<0.001) in feeling overwhelmed with workload (29% vs 45%);COVID-19-related clinical (14% vs 58%) and research (16% vs 64%) work;out-of-hours work (16% vs 41%), shift work (12% vs 26%) and overall working hours (17% vs 47%);and inadequate time for personal/family life (35% vs 45%). 59% (n=1156/1946) were unable to take allocated annual leave. While JP-CV has improved (34% vs 49%, p<0.001), there remained concerns about the negative impact of the pandemic on career development/training (43%), job security (37%) and international fellowship opportunities (76%). Overall, less than half had felt supported by their work management, professional societies or government, and/or had access to wellbeing support services. 25% (n=266/1086) were considering changing their future career with 38% (n=100/266) contemplating leaving the profession. Conclusions: Since COVID-19, oncology professionals have reported increased job demands, concerns over career development/training and job security, and inadequate time for personal life. There is a real threat of potential attrition in the current workforce. National and international stakeholders must act together to ensure robust recovery plans as we emerge from the COVID-19 crisis. Legal entity responsible for the study: The authors. Funding: ESMO. Disclosure: K.H.J. Lim: Financial Interests, Personal, Invited Speaker, Speaker honorarium: Janssen;Non-Financial Interests, Officer, Trainees committee representative for the North West deanery: Royal College of Physicians (UK);Non-Financial Interests, Officer, Trainees representative at the RCP Patient Safety Committee: Royal College of Physicians (UK);Non-Financial Interests, Officer, ACP representative at the RCP Student and Foundation Doctor Network (SFDN): Royal College of Physicians (UK);Non-Financial Interests, Officer, Trainees committee member: Association of Cancer Physicians (ACP) UK;Non-Financial Interests, Officer, Young Oncologists Committee (YOC): ESMO;Non-Financial Interests, Officer, Resilience Task Force (RTF): ESMO;Other, Currently funded by Wellcome-Imperial 4i Clinical Research Fellowship: Wellcome Trust. K. Punie: Other, Institutional, Other, institution received speaker fees or honoraria for consultancy/advisory roles: AstraZeneca, Eli Lilly, Gilead Sciences, Medscape, MSD, Novartis, Pfizer, Pierre Fabre, Hoffmann La Roche, Mundi Pharma, PharmaMar, Teva, Vifor Pharma;Other, Institutional, Research Grant: Sanofi;Other, Personal, Other, Travel support: AstraZeneca, Novartis, Pfizer, PharmaMar and Roche. C. Oing: Other, Personal, Other, research funding and honoraria: Roche;Other, Personal, Other, travel grant and honoraria: Medac Pharma and Ipsen Pharma;Other, Personal, Other, travel grant: PharmaMar. E. Elez: Other, Personal, Other, personal fees: Hoffman La - Roche, Bristol Myers Squibb, Servier, Amgen, Merck Serono, ArrayBiopharma, Sanof. T.M.S. Amaral: Other, Personal, Other, personal fees: Pierre Fabre and CeCaVa;Other, Personal, Other, personal fees and travel grants: BMS;Other, Perso al, Other, grants, personal fees and travel grants: Novartis;Other, Personal, Other, grants: Neracare, Sanofi and SkylineDx. P. Garrido Lopez: Other, Personal, Other, personal fees: Roche, MSD, BMS, Boerhinger-Ingelheim, Pfizer, AbbVie, Novartis, Lilly, AstraZeneca, Janssen, Blueprint Medicines, Takeda, Gilead, and ROVI. M. Lambertini: Other, Personal, Other, Consultant: Roche, AstraZeneca, Lilly and Novartis;Other, Personal, Other, Honoraria: Theramex, Roche, Novartis, Takeda, Pfizer, Sandoz, and Lilly. C.B. Westphalen: Other, Personal, Other, honoraria, travel support and advisory board: Bayer, BMS, Celgene, Roche, Servier, Shire/Baxalta, RedHil, and Taiho;Other, Personal, Other, speaker honoraria: Ipsen;Other, Personal, Advisory Board: GSK, Sirtex, and Rafael. J.B.A.G. Haanen: Other, Personal, Advisory Role, personal fees for advisory role: Neogene Tx;Other, Institutional, Other, grants and fees paid to institution: BMS, MSD, Novartis, BioNTech, Amgen;Other, Institutional, Other, fees paid to institution: Achilles Tx, GSK, Immunocore, Ipsen, Merck Serono, Molecular Partners, Pfizer, Roche/Genentech, Sanofi, Seattle Genetics, Third Rock Ventures, Vaximm. C. Hardy: Other, Personal, Other, Director of a private company Hardy People Ltd.: Hardy People Ltd. S. Banerjee: Other, Institutional, Research Grant: AstraZeneca, Tesaro and GSK;Other, Personal, Other, Honoraria: Amgen, AstraZeneca, MSD, GSK, Clovis, Genmab, Merck Serono, Mersana, Pfizer, Seattle Genetics, and Tesaro. All other authors have declared no conflicts of interest.
ABSTRACT
Background: The impact of the COVID-19 (CV-19) pandemic on wellbeing has the potential for serious negative consequences on work, home life and patient care. The ESMO Resilience Task Force collaboration set out to investigate wellbeing in oncology over time since CV-19. Methods: 2 online surveys were conducted (survey I April/May;survey II July/August 2020). Statistical analyses were used to examine group differences, associations and to explore predictors of key outcomes: 1) wellbeing/distress (Wellbeing Index (WBI-9)), 2) burnout (1 item);and 3) CV-19 job performance (2 item CJP;standard of care and job delivery compared to pre-CV 19). Results: Survey I had 1520 participants from 101 countries. Responses indicate that CV-19 is impacting the oncology workforce resulting in a number of changes to work and personal lives. 25% were at risk of distress (poor wellbeing, WBI ≥4);38% reported feeling burnout and 66% were not able to perform their job compared to pre-CV-19. Higher CJP was significantly associated with better wellbeing and not feeling burnout (p<0.01). Differences were seen in wellbeing and CJP between countries (p<0.001) and related to CV-19 country mortality rate (p<0.05). The main predictors of wellbeing, burnout and CJP were resilience and changes to work hours. Others frequently identified were coping strategies, ethnicity, concern about training/career, worried about current wellbeing, and working conditions. In Survey II, results from 942 participants are undergoing analysis. Overall, comparisons between surveys show overall wellbeing and burnout rates have worsened overtime but CJP has improved. Among 272 participants who completed both surveys, WBI scores ≥4 (indicating higher risk of distress) and burnout rates were higher in survey II compared to survey I (22% vs 31% p=0.01;35% vs 49% p=0.001 respectively) suggesting wellbeing and burnout may be worsening overtime. CJP improved (38% vs 54% p<0.001). Conclusions: In the largest global survey series, COVID-19 is impacting on the wellbeing and job performance of oncology professionals. Risk of distress and burnout has increased over time. Urgent measures to address wellbeing and improve resilience are essential. Legal entity responsible for the study: ESMO. Funding: ESMO. Disclosure: S. Banerjee: Research grant/Funding (institution): AstraZeneca;Research grant/Funding (self): GSK;Honoraria (self): Amgen;Honoraria (self): AstraZeneca;Honoraria (self): MSD;Honoraria (self): GSK;Honoraria (self): Clovis;Honoraria (self): Genmab;Honoraria (self): Merck Serono;Honoraria (self): Mersana;Honoraria (self): Pfizer;Honoraria (self): Seattle Genetics;Honoraria (self): Tesaro. C. Oing: Research grant/Funding (institution): PharmaMar;Travel/Accommodation/Expenses: Ipsen;Travel/Accommodation/Expenses: PharmaMar;Travel/Accommodation/Expenses: Medac. K. Punie: Honoraria (self): AstraZeneca;Honoraria (self): Eli Lilly;Honoraria (self): Novartis;Honoraria (self): Pfizer;Honoraria (self): Pierre Fabre;Honoraria (self): Hoffmann La Roche;Honoraria (self): Vifor Pharma;Speaker Bureau/Expert testimony: Eli Lilly;Speaker Bureau/Expert testimony: Mundi Pharma;Speaker Bureau/Expert testimony: Novartis;Speaker Bureau/Expert testimony: Pfizer;Speaker Bureau/Expert testimony: Hoffmann La Roche;Honoraria (self): Teva;Research grant/Funding (institution): Sanofi;Travel/Accommodation/Expenses: AstraZeneca;Travel/Accommodation/Expenses: Novartis;Travel/Accommodation/Expenses: Pfizer;Travel/Accommodation/Expenses: PharmaMar;Travel/Accommodation/Expenses: Hoffmann La Roche. M. Lambertini: Advisory/Consultancy: Roche;Advisory/Consultancy: Novartis;Honoraria (institution): Theramex;Honoraria (institution): Takeda;Honoraria (institution): Roche;Honoraria (institution): Lilly;Honoraria (institution): Pfizer;Honoraria (institution): Novartis. C. Benedikt Westphalen: Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bayer;Honoraria (self), Honoraria (institution), Travel/Accommodation/Expenses: Celge e;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Ipsen;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: MedScape;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Rafael Pharmaceuticals;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: RedHIll;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Servier;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Shire;Honoraria (self), Honoraria (institution), Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Taiho;Research grant/Funding (institution): Roche. P. Garrido Lopez: Advisory/Consultancy: AbbVie;Speaker Bureau/Expert testimony: AstraZeneca;Advisory/Consultancy: BluePrint Medicine;Advisory/Consultancy, Speaker Bureau/Expert testimony: Boerhinger Ingelheim;Advisory/Consultancy, Speaker Bureau/Expert testimony: BMS;Advisory/Consultancy: Gilead;Advisory/Consultancy: Guardant Health;Advisory/Consultancy: Janssen;Advisory/Consultancy: Lilly;Advisory/Consultancy, Speaker Bureau/Expert testimony: MSD;Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis;Advisory/Consultancy, Speaker Bureau/Expert testimony: Pfizer;Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche;Advisory/Consultancy, Speaker Bureau/Expert testimony: Takeda;Speaker Bureau/Expert testimony: Rovi;Speaker Bureau/Expert testimony: Sysmex. T.M.S. Amaral: Honoraria (self), Travel/Accommodation/Expenses: BMS;Honoraria (self), Travel/Accommodation/Expenses: Novartis;Honoraria (self): PIerre Fabre;Honoraria (institution): Neracare;Honoraria (institution): Sanofi. J.B.A.G. Haanen: Advisory/Consultancy: AIMM THerapeutics;Advisory/Consultancy: Amgen;Advisory/Consultancy: AZ;Advisory/Consultancy: Bayer;Advisory/Consultancy: BioNtech;Advisory/Consultancy: BMS;Advisory/Consultancy: GSK;Advisory/Consultancy: Gateta;Advisory/Consultancy: Immunocore;Advisory/Consultancy: Ipsen;Advisory/Consultancy: Merck Serono;Advisory/Consultancy: MSD;Advisory/Consultancy: Molecular Partners;Advisory/Consultancy: Roche;Advisory/Consultancy: Sanofi;Advisory/Consultancy: Seattle Genetics;Advisory/Consultancy: Third Rock Venture;Advisory/Consultancy: Vaximm;Research grant/Funding (institution): Neogene;Research grant/Funding (institution): Amgen;Research grant/Funding (institution): BMS;Research grant/Funding (institution): BIoNthech;Research grant/Funding (institution): MSD;Research grant/Funding (institution): Novartis;Advisory/Consultancy: Genentech. All other authors have declared no conflicts of interest.