Coronavirus has turned the NHS upside down and inside out and by re-organising to treat people with the virus, other potentially fatal diseases like cancer have taken a backseat. At University Hospital Southampton NHS Foundation Trust, which Inside Health visited weekly as the pandemic unfolded, cancer diagnoses fell by half in March and April and of the 50% who were asked to come in for follow up, only 25% actually did. The virus was more frightening than a potential cancer diagnosis. Divisional Director for Medicine at Southampton, Dr Trevor Smith, tells James Gallagher, the BBC's health and science correspondent. that patients are coming back, but it will take a long time to tackle the backlog. For those with cancer caught up in the pandemic, they have experienced disruption, cancellations, altered treatments and they have had to cope with consultations and even surgery by themselves, without loved ones to support them. Charly from Wiltshire was diagnosed with breast cancer in February and her treatment was changed as lockdown happened. Instead of chemotherapy then surgery, she had surgery first. And a mastectomy instead of a lumpectomy. But despite the disruption to her care, she still considers herself one of the lucky ones because she did get treatment.

Others weren't so lucky and across the country, lives have been lost. The focus now is on Covid-proofing cancer care and tackling the backlog in screening, diagnosis and treatment. And it's an enormous backlog.

Professor Charlie Swanton, chief clinician of Cancer Research UK tells James Gallagher, the BBC's health and science correspondent, that 2.7 million people have missed out on cervical, breast and colorectal screening and 300,000 fewer people than normal have been referred under the urgent 2 week cancer pathway. The creation of Covid-free cancer hubs, he says, safe zones for cancer treatment, are vital, but it will still take a long time to recover and of course there's the spectre of a second wave of coronavirus which would disrupt services all over again.

Confidence building includes rapid Covid-19 testing for staff and Dr Trevor Smith from Southampton tells James about the saliva test pilot for key workers in the city. The new test just involves putting saliva in a sample pot, much easier than the normal "have you got it" swab test which involves wiping the back of the throat and deep inside the nose. Dr Navjoyt Ladher, GP and Head of Education at the British Medical Journal gives a simple guide to the "have you got it" tests: PCR, antigen and perhaps if the trial is a success, the new saliva test as well as the "have you had it tests"; the antibody tests.

And finally in the week that in England at least, guidance for those who are "clinically vulnerable" and shielding on the advice of the government changes, Inside Health's Dr Margaret McCartney reviews the new advice for those in all four nations of the UK.

Producer: Fiona Hill

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