As of April 1, 2020, more than 800 000 cases of coronavirus disease 2019 (COVID-19) had been confirmed worldwide. The death toll in Italy is approaching 12 000 people, with Spain not far behind. The USA has reported more than 164 000 cases of the disease, including more than 38 000 cases in New York City alone. There are concerns that the COVID-19 could overwhelm health-care systems worldwide. Many nations have reported a shortage of ventilators.

The UK is one of several countries to have suspended elective surgery. On March 26, Gethin Williams, a colorectal surgeon at the Royal Gwent Hospital in Newport, Wales, warned that his institution was under severe strain, with operating theatres turned into intensive care units to accommodate the influx of patients with COVID-19. “The rate at which COVID-19 is going through the Royal Gwent, there'll be no colorectal surgery for the foreseeable future”, he said. “Without treatment, some cancers could obstruct, others could metastasise.”

Oncology societies and national authorities have been quick to issue guidelines on cancer care during the pandemic. Giuseppe Curigliano (European Institute of Oncology, Milan, Italy) is a council member of the European Society for Medical Oncology (ESMO). “ESMO is taking this very seriously”, he said. “They are offering guidance to medical oncologists and giving training on how to manage patients with cancer while this pandemic goes on.” According to an analysis of Italian patients published in March, 20% of those who died from COVID-19 in the country had active cancer.