As recommended by ANZCHOG, March
Coronavirus (COVID-19) is a new strain of coronavirus affecting humans. Some coronaviruses can cause illness similar to the common cold and others can cause more serious diseases, such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). This novel coronavirus is still new and as such we are still learning more about it.
Symptoms reported in identified cases of COVID-19 include:
There is no specific treatment for COVID-19 infection. Antibiotics are not effective against viral infections. However, most of the symptoms can be treated with general medical care. There is currently no vaccine for COVID-19.
This is currently a rapidly evolving situation that is being monitored carefully. As it stands right now, we can provide some answers to commonly asked questions for those of you who have cancer and may be on treatment:
How is the virus spread?
The virus is thought to spread mainly from person to person through droplet transmission. These respiratory droplets are produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby (within 1.5-2 metres). It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly eyes, but this is not thought to be the main way that the virus spreads. This is why washing hands frequently is so important.
Am I at increased risk of more severe infection with COVID-19?
Information currently available is incomplete, particularly so for those with a compromised immune system. However we do know that these people are more likely to have a higher risk of more severe infection. At this stage, we just do not have enough information to quantify the extent of the risk, and given this uncertainty, we believe that it is very important to take extra precautions (outlined below) to protect yourself from contracting COVID-19.
Should I attend my workplace and public gatherings?
Social distancing and working from home have been discussed a lot in the media as a potential means to slow the spread of the virus and minimise the risk of the healthcare system being overwhelmed. Until this point, the infection has not been widespread in the community, however this will change, and currently the government has recommended cancelling all indoor gatherings of more than 100 people – a number which will also be lowered as this evolves. Speak to your boss, and if it’s possible for you to reduce your days in your workplace, or work from home completely, then this would be our recommendation. Please try to avoid public transport as much as possible. We would advise special caution if you are currently receiving therapy or who have had a BMT within the past 12 months. Other events you should avoid include attending shopping centres, going to the cinema or theatre, or attending gatherings with groups of more than a few people, and you should consider instituting other strict social isolation precautions, and they should remain in place for several months.
Should my children attend school?
It would be wise to refer to your local treating centre’s policy for up-to-date advice regarding this issue, especially within your local area. Most treatment centres are not recommending that the entire family self-quarantine at this point in time as it is not practical for everyone, however this may change as the situation evolves. More strict isolation may be mandated by the government if the number of cases escalates rapidly. It’s important to realise that there is a lot of information lacking about COVID-19 currently, and we are not sure if children carry it whilst remaining asymptomatic or only mildly unwell. In the absence of solid data, it would be wise to enforce hand-washing and changing clothes immediately after school before interacting with you.
What else can I do to avoid infection?
Basic hand and respiratory hygiene measures remain the most important measure for preventing infection. These include:
wash your hands with soap and water or alcohol-based hand sanitisers regularly;
cover your nose and mouth with a tissue or flexed elbow when you cough or sneeze, and be sure to dispose of the tissues immediately;
avoid contact with anyone who has flu-like symptoms;
try to stay at least 1.5-2 metres away from people who are coughing, sniffing or sneezing;
if possible, avoid close contact with family members with flu-like illnesses;
avoid touching your face.
Should I wear a mask?
There is very little evidence that face masks will reduce the risk of infection. Masks need to be worn correctly, changed frequently, removed properly, and disposed of safely in order to be effective. Sometimes, wearing a face mask can lead to a false sense of security. Therefore, we are not recommending routine use of face masks. However, masks can be useful to prevent the spread of the virus if you are infected. If you have symptoms of a respiratory tract infection and it is essential for you to attend hospital or a GP clinic, please wear a mask or request one upon arrival.
Will my supply of medications be affected by COVID-19?
Each cancer centre and hospital will be closely monitoring issues related to medication stocks, and, as of the 19th March, the government has mandated limits to the amount of medications that can be dispensed to any one person so that stocks remain adequate in the coming months. Presently, there does not appear to be any anticipation of problems with supplies of cancer-related medications.
Will my chemotherapy treatment be interrupted?
Every effort will be made to ensure that you receive your treatment as scheduled. Currently, there are no widespread plans to modify routine treatment schedules, however this will be unique to you and your treatment provider.
Should I attend my follow-up appointments at the hospital?
Many hospitals are planning to minimise the number of people required to visit. This will provide increased protection to those who are receiving treatment and the staff required to look after them. Therefore, some hospitals might conduct routine follow-up appointments by telephone or videoconference. If you are unwell with flu-like symptoms, please phone ahead for advice as to whether you should attend your appointment.
Will there be any other changes to my treatment?
It is possible that there may be shortages of blood products, such as packed red blood cells and platelets. Thresholds for transfusions of these products may be altered.
Are there any restrictions on visitors to the hospital?
Many hospitals have been placing restrictions upon the number of visitors that inpatients can have while in hospital or other members attending clinic appointments. Be aware of what your hospital’s specific guidelines are now.
I have completed my cancer treatment. Am I at increased risk?
The vast majority of people with cancer who have completed their planned treatment should have a relatively normal immune system within 2-3 months of completing therapy, and are unlikely to be at increased risk of severe infection. However this is something you should discuss with your treatment provider, especially if you have had a bone marrow transplant.
Should I and my family have the flu (influenza) vaccination?
Influenza vaccination is recommended for all family members when it becomes available in April each year, and for you when recommended by your oncologist, however it isn’t protective against COVID-19. It will however decrease your likelihood of contracting another respiratory illness over the coming Winter months.