Cancer and COVID-19: economic impact on households in Southeast Asia

The ongoing COVID-19 pandemic may worsen the existing financial vulnerabilities of cancer survivors who may be experiencing a double financial hit, both from cancer-induced financial toxicity as well as economic strains arising from loss of income and prolonged unemployment following the pandemic. The impact of the pandemic is likely to be more pronounced on cancer survivors living in resource-limited settings, such as in Southeast Asia. As health care systems in the region try to streamline resources and accommodate the influx of patients from COVID-19, many in the cancer community have experienced severe disruptions in their care. The delays and disruption of timely access to cancer care could lead to patients presenting with worsened conditions and at more advanced cancer stages in which treatment options tended to be costlier. Similar to countries around the world, the various forms of movement restrictions that were enforced have aggravated the rates of unemployment, loss of wages and the limited access to support from family or friends around Southeast Asia. The economic impact of COVID-19 hits even harder on the large proportion of the population in the region that works in the informal sector, who are often one paycheque or one episode of illness away from financial catastrophe. More worryingly, the lack of a robust social security system in many Southeast Asian countries, especially in terms of income protection, could ultimately force many cancer survivors to choose between paying for their treatments, or to forego treatments, and feed their families. Early identification of cancer patients experiencing financial toxicity following the pandemic will enable timely and appropriate interventions to be undertaken by various stakeholders, potentially averting a cascade of other economic fallouts that may last for years after cancer treatment.