Cancer & COVID-19
What is COVID-19?
COVID-19, or coronavirus disease 2019, is an illness caused by a novel (or new) coronavirus that was first identified in an outbreak in Wuhan, China, in December 2019.
The virus can spread from person to person, through small droplets from the nose or mouth that are produced when a person coughs or sneezes. Another person may catch COVID-19 by breathing in these droplets or by touching a surface that the droplets have landed on and then touching their eyes, nose, or mouth. Increasingly, it appears the virus may also be able to remain airborne and be spread that way.
Symptoms from COVID-19 can be mild to severe and may appear between 2 and 14 days after exposure to the virus. The symptoms may include fever, cough, shortness of breath, chills, headaches, sore throat, and new loss of taste or smell. Other symptoms may include aches and pains, fatigue, nasal congestion or runny nose, or diarrhea. In some people, the illness may cause severe pneumonia and heart problems, and it may lead to death. Other people who are infected may not develop any symptoms. COVID-19 can occur in both children and adults. Symptoms in children seem to be milder than symptoms in adults. There have been recent reports of a multisystem inflammatory syndrome in children associated with COVID-19, with symptoms such as rash, fever, abdominal pain, vomiting, and diarrhea.
An analysis of 928 people with cancer and COVID-19 presented during the ASCO2020 meeting revealed that having active, progressing cancer was associated with a 5 times higher risk of dying within 30 days compared with patients who were in remission from cancer.
What can I do to avoid getting COVID-19?
The most important way to protect yourself is to avoid being exposed to COVID-19. Stay at home as much as possible and avoid areas where people gather. Avoid unnecessary travel, and follow guidance on travel restrictions issued by the U.S. Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO).
Another critical way to protect yourself is to wash your hands often with soap and water for at least 20 seconds, about the amount of time it would take to hum the Happy Birthday song from beginning to end twice. If soap and water is not available, use hand sanitizer that contains at least 60% alcohol.
In addition to washing your hands frequently, it’s important to
- Avoid touching your eyes, nose, and mouth.
- If you must cough or sneeze, use a tissue. Then throw the tissue away. Or, cough or sneeze into your elbow rather than your hand.
- Avoid close contact with people who are sick.
- Clean frequently touched objects and surfaces with household cleaning spray or wipes. These surfaces and objects include doorknobs, counters, toilets, keyboards, tablets, phones, light switches, and more.
When in public, it is important to wear a mask or cloth face covering that covers the nose and mouth. This can help prevent the spread of COVID-19 because some people with COVID-19 have no symptoms and don’t know they have the virus, or they may not have yet developed symptoms. You should not wear masks with exhalation valves or vents because the vents allow your own respiratory droplets to leave the mask and can put others at risk. Surgical face masks and N95 masks should be reserved for health care workers because these masks are in limited supply. Remember that wearing a cloth face mask or face covering should not replace social or physical distancing. In fact, if you are out in public, you should do both practice physical distancing of at least 6 feet from other people and wear a mask.
Are there special precautions that people with cancer should take?
People with cancer, people who are in active cancer treatment, older patients, and people with other serious chronic medical conditions, such as lung disease, diabetes, or heart disease, are at higher risk for the more severe form of COVID-19 that could lead to death. Recent data have shown that people with active or progressing cancer may be at higher risk than those whose cancer is in remission. The same rules apply for people with cancer as for those without cancer. Be sure to wash your hands well and wash them frequently. Avoid touching your face and avoid close contact with people who are sick.
People who are at higher risk of getting very sick from COVID-19 should avoid any non-essential travel during this time of COVID-19 outbreak. Avoid leaving your home unless it is necessary. Avoid any social gatherings. If you must leave your home, keep a distance of at least 6 feet between yourself and other people. Only leave your home for essential reasons, such as buying groceries, going to the doctor, or picking up medication from the pharmacy. Wear a cloth face covering or mask and make your trip out as brief as possible. Another option is to have your food and medications delivered.
Walking or exercising outdoors is fine as long as the area is not crowded and you are able to keep a distance of at least 6 feet from other people.
Be sure to keep enough essential medications, both prescription and over-the-counter, to last for at least 1 month. Create or update an emergency contact list that includes family, friends, neighbors, and community or neighborhood resources who may be able to provide information or assistance to you if you need it. Connect with your family and friends virtually, through video chats or phone calls.
If you are scheduled for cancer treatments, have a discussion with your oncologist about the benefits and risks of continuing or delaying treatment. If you are not scheduled for cancer treatment but are scheduled for an appointment with your oncologist, it may be possible for the doctor to conduct the visit using videoconferencing or telemedicine. Be sure to check with your cancer care team to see if this is recommended for you.
Finally, it is always important to have your health care wishes in writing, in case you are too sick to make decisions for yourself. This way, your family and your medical team will know what is important to you and what your wishes are. If you have not yet done this, now is a good time. Cancer.Net has valuable information on this topic. Because hospitals and clinics are limiting visitors, having your health care wishes in writing is more important than ever. Here are some examples of important questions to ask yourself, to discuss with your loved ones and write down.
- What level of quality of life would be unacceptable to me?
- What are my most important goals if my health situation worsens?
- If I am unable to speak for myself, who is the person in my life who I would want to speak for me?
- Who should not be involved in making decisions for me?
- If my heart stops, do I want to have CPR (cardiopulmonary resuscitation) done?
What should I do if I think I may have COVID-19?
Call ahead before visiting the office or infusion center if you have a fever and other symptoms of a respiratory illness, such as cough and shortness of breath. Let them know if you think you may have COVID-19. They will ask you questions about your symptoms, travel history, exposure, and medical risk factors to find out if you should be tested for COVID-19. They will then give you instructions on how to get tested in your community.
If it is possible that you have COVID-19, you should stay at home and isolate yourself while you are tested and waiting for your test results. Staying home when you are sick is the best way to prevent transmitting COVID-19 and other respiratory viruses, such as the flu, to other people. If you live with someone, you should quarantine yourself in one part of the home to lower the risk of spreading the virus to the rest of the people who live with you. And again, be sure to wash your hands often.
If you are concerned that you’ve been exposed to someone with COVID-19, closely watch for developing symptoms. Check your temperature regularly for fevers. If you have active cancer or are currently in cancer treatment, let your medical team know about your possible exposure.
If I have had COVID-19, will I be able to continue cancer treatment?
If you have tested positive for COVID-19, you should have a discussion with your oncologist about the impact of this on your cancer treatment. A negative COVID-19 test is recommended before chemotherapy or other cancer treatment starts again.
When your cancer treatment resumes or continues, it is important to wear a mask when coming to the clinic and infusion center. Continue to practice good hand hygiene by using hand sanitizer or handwashing before and after visits.
Where can I get the latest information about COVID-19?
Staying up to date on the latest information on the COVID-19 outbreak is important. The CDC (www.cdc.gov) and your local and state health departments (www.venturacountyrecovers.org) will have ongoing information about COVID-19 in our community.
Adapted from Cancer.net for VCHOS