An ‘epidemic curve’ shows progression of an illness in an outbreak over time. The curve shape can be altered by a number of community responses, including quarantine, isolation of people with the virus (and their close contacts) and social distancing measures.

The following graph, based on modelling* by the Australian Government in April 2020, depicts three theoretical modelling scenarios in relation to the COVID-19 pandemic:

Figure 1 – Curves representing possible COVID-19 scenarios comparing weeks since the 
beginning of the outbreak to number of patients with COVID-19.

• The red curve shows an uncontrolled outbreak where the virus moves rapidly through the community, with no health system or community action to slow the spread.
• The blue curve shows the effect on patient numbers of quarantine and isolation measures.
• The green curve shows the additional impact of social distancing measures.
   

The following conceptual graph depicts two "COVID-19 curve’ scenarios, in relation to health system capacity:

Figure 2 – Acute and recovery phases of triage and management during the 
COVID-19 pandemic against health system capacity

• Health system capacity represents the capacity of hospitals to treat patients (based on factors including availability of hospital supplies, healthcare worker resources, personal protective equipment, intensive care unit (ICU) bed and ventilator capacity, and access to pathology and imaging services).
• Curve A represents a scenario in which demand on the health system rapidly increases during the COVID-19 pandemic, surpasses hospital capacity and overwhelms the health system (similar to scenarios that have occurred in Italy and New York) before entering recovery phases.
• Curve B is a flattened curve where the health system capacity is not challenged (such as Australia).

Triage and management guidance for cancer care has been categorised into three acute phases (acute phases I, II and III) and two recovery phases (early phase and late phase recovery) (American College of Surgeons 2020).

• During the acute phases of the pandemic (acute phases I-III), hospitals are either preparing for a surge of COVID-19 patients or managing high volumes of COVID-19 patients.
• During the recovery phases of the pandemic (early phase recovery; late phase recovery), there is either a stable number of new cases, or a decline in new cases.

Best practice approaches to cancer care will vary depending on: 

• the phase of the COVID-19 pandemic curve at any particular time; and
• the relationship between the point in the curve and the health system capacity.

Depending on the number of patients with COVID-19 and the health system capacity, cancer care planning may need to be amended or modified in order to minimise exposure to, and risk of harm from, COVID-19 and improve outcomes for people with cancer.

Australia’s cancer survival outcomes are amongst the best in the world. While cancer is a leading cause of death in Australia, mortality rates are decreasing for most cancer types.

Management of cancer is supported by the Optimal Care Pathways for people with cancer, which are designed to guide the delivery of consistent, safe, high-quality and evidence-based care for people with cancer.

The principles underpinning these optimal care pathways have been augmented to support optimal cancer care during the COVID-19 pandemic. 

Below is a summary framework for cancer management mapped to pandemic phases across the continuum of care.

Read the detailed framework for cancer management mapped to pandemic phases across the continuum of care.