Common Questions About the New Coronavirus Outbreak for Cancer Patients

The outbreak of the new coronavirus disease, called COVID-19, is having a serious impact on many people, including cancer patients, their families, and caregivers, especially now that the COVID-19 pandemic has spread to all 50 states and around the globe. Cancer patients are among those at high risk of serious illness from an infection because their immune systems are often weakened by cancer and its treatments. Most people who were treated for cancer in the past (especially if it was years ago) are likely to have normal immune function, but each person is different. It's important that all cancer patients and survivors, whether currently in treatment or not, talk with a doctor who understands their situation and medical history. It's also important that both patients and their caregivers take precautions to lower their risk of getting COVID-19. The US Centers for Disease Control and Prevention (CDC) has specific recommendations for people at risk for serious illness, including COVID-19 infection. Health officials are recommending people stay at home as much as possible, including working and schooling from home to slow the spread of the virus. While the news about this outbreak is changing daily, even hourly, knowing some basic facts about what can and cannot be done to help protect you and others from getting sick can be very empowering.

How can I protect myself and others from getting COVID-19?

According to the CDC, there are things all of us can do to help lower the risk of being infected (and infecting others):

Wash your hands frequently with soap and water for at least 20 seconds because it’s one of the best ways to kill germs on your hands and prevent the spread of germs to others. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.

Avoid touching your eyes, nose, and mouth because if you picked up the virus, you could infect yourself by allowing the virus to enter your body.

Avoid close contact – being within 6 feet of anyone, especially from people who are sick, coughing, or sneezing.

Cover your cough or sneeze with a tissue, then throw the tissue in the trash, or cough or sneeze into your elbow.

Avoid shaking hands.

Stay at home as much as possible and avoid gathering in groups of more than 10 people.

Stay home when you are sick.

If you must go out where you'll be around other people, wear a cloth face covering (something that covers your nose, mouth and much of your face) or a face mask (if you already have one). It’s still very important to stay at least 6 feet away from others, even while wearing a face covering or mask. Surgical and N-95 masks should be saved for healthcare workers. Using a cloth scarf or bandana or homemade face covering is recommended for the general public to help people who may have the virus (but don’t know they have it) from spreading it to others. Remember to wash your hands before putting on your face covering, to not touch your face while wearing the covering, and to wash your hands right after taking it off.

Clean and disinfect frequently touched objects and surfaces daily using a regular household cleaning spray or wipes.

Avoid non-essential travel. Check with the authorities in your area or state. If you were planning on going outside the US, the CDC recommends that travelers avoid all non-essential international travel.

If you are a cancer patient, survivor, or caregiver, talk to your cancer care team about whether there are any additional precautions needed.

Older adults are encouraged to take advantage of telehealth services and "see" their doctors without going in person for an office visit. Medicare has temporarily expanded its coverage of telehealth services. Other health insurance providers may be doing the same.

What are the symptoms of COVID-19?

The most common symptoms of COVID-19, which may appear 2-14 days after exposure, are: > Fever of at least 100.4o F (38o C) > Cough > Shortness of breath Some patients may have diarrhea or nausea before these symptoms occur. Other symptoms can include: > Body aches and pains > Feeling very tired > Nasal congestion > Runny nose > Sore throat > Headache > Loss of smell or taste Contact your doctor if you have any of these symptoms. If you or the person you’re caring for has any of the following serious signs and symptoms of COVID-19, get medical attention right away: > Trouble breathing or shortness of breath > Constant pain or heaviness in the chest > New confusion or being hard to wake > Bluish lips or face It’s important to know that some people who are infected with the virus might not have symptoms, but they could still spread the virus to others. Children in particular might be more likely to have fewer symptoms. Because of this, it’s important that everyone follow the CDC’s recommendations on how to protect yourself and others.

What else do cancer patients need to know about the coronavirus?

The COVID-19 outbreak is still new, so doctors do not have a lot of specific information on this coronavirus for cancer patients. But they do have a lot of information regarding the risk of infections in general for cancer patients. Doctors and health officials agree the best way to prevent illness is to avoid being exposed to this virus, which is especially important for cancer patients because they are at higher risk for serious illness, if they get infected, particularly patients who are in active chemotherapy and bone marrow transplant patients. That’s because their immune systems can be severely weakened by the treatment. The CDC is now recommending that health care facilities and doctors (as well as dentists) prioritize urgent and emergency visits and procedures for the coming several weeks. “We're headed for a time when there will be significant disruptions in the care of patients with cancer,” says Dr. Len Lichtenfeld, Deputy Chief Medical Officer for the American Cancer Society. “For some it may mean a delay in having elective surgery. For others it may be delaying preventive care or adjuvant chemotherapy that’s meant to keep cancer from returning.” You may need to reschedule appointments. Lichtenfeld says cancer care teams are going to do to the best they can to deliver care to those most in need. However, even in those circumstances, it won’t be life as usual. “It will require patience on everyone’s part as we go through this pandemic,” Lichtenfeld adds. “It is important to maintain contact with your cancer care team to determine the best course of action for you. This may involve non-urgent follow up visits or talking to your care team virtually [online or over the phone] and not physically going to the clinic. So, it’s important to know who to call to reach your cancer care team to find out how to proceed.” Lichtenfeld adds, “These circumstances will take months to resolve, and even then, we will continue to have changes in the way cancer patients receive their treatment.”

Does health insurance cover coronavirus testing and care?

You may or may not have out-of-pocket costs if you get tested for coronavirus or if you need medicines or other care for COVID-19. You’ll need to check with your health insurance company about coverage. Here are some tips and resources to get you started: > Call the toll-free number on the back of your insurance card > Read about Medicare coverage of coronavirus-related needs > See Medicaid’s frequently asked questions about COVID-19 > Learn about coronavirus and your Marketplace health plan coverage

Should people still get screened for cancer during this pandemic?

Health officials are urging everyone to stay home as much as possible to further reduce the risk of being exposed to COVID-19. What should you do if you’re due for a cancer screening? According to Dr. Richard Wender, Chief Cancer Control Officer for the American Cancer Society, “the American Cancer Society recommends that no one should go to a health care facility for routine cancer screening at this time." This means if you're due for your screening to detect breast, colon, cervix, or lung cancer, postpone your appointment for the near future. “Remember, these screening tests save lives. When restrictions lift, it's important to reschedule any screening test that you're due to receive,” says Wender. "Getting back on track with cancer screening should be a high priority," he adds. Screening tests are different from tests your doctor might order if you have symptoms that could be from cancer. If you’re having symptoms you’re concerned about, contact your health care provider about the best course of action for you at this time.

What is a coronavirus?

Coronaviruses are a family of viruses that can cause common colds, as well as more serious respiratory diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The first coronavirus was discovered in the 1960s.

What is COVID-19?

COVID-19 is the name of the illness caused by a new coronavirus that has led to a large outbreak, which was first reported in China in December 2019. The name of this coronavirus is “SARS-CoV-2.” Principal Deputy Director of the CDC, Dr. Anne Schuchat, says this new COVID-19 illness, referred to by some people only as COVID, is “spread in a similar way to the common cold or to influenza."

How serious is the COVID-19 illness?

“The vast majority of individuals who contract the novel coronavirus, they will experience mild to moderate symptoms and their treatment will be to remain at home, treating their symptoms the way they would a severe cold or the flu,” said Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health in a statement. “For some individuals, a smaller percentage, especially those who may be medically fragile, they will require medical attention including possibly hospitalization.” According to the CDC, people who may be at greater risk for serious complications if they are infected with this new virus include:

Older adults (aged 65 or older) or people living in nursing homes or long-term care facilities

People with weakened immune systems**

People with chronic lung disease (including moderate or severe asthma)

People with serious heart conditions

People who are severely obese

People with medical conditions such as diabetes, kidney failure, or liver disease

**Many conditions can weaken the immune system, such as cancer and its treatment (including a bone marrow transplant), smoking, having had an organ transplant, being born with an immune deficiency, having poorly controlled HIV or AIDS, and taking medicines that weaken the immune system, such as long courses of steroids.

How does the virus spread?

According to the CDC, the virus spreads mainly from person-to-person:

When somebody who is infected and coughs or sneezes, the virus can be spread in respiratory droplets.

These droplets might reach the mouths or noses of people who are in close contact (within about 6 feet), which could lead to an infection.

The droplets can also land on surfaces, which people might then touch. This could potentially lead to an infection if a person then touches their mouth or nose. Some people who do not have symptoms may still be able to spread the virus. Because of this, it’s important that everyone follow the CDC’s recommendations on how to protect yourself and others.

Can I get COVID-19 from a blood transfusion?

According to the American Red Cross, there is no evidence that this new coronavirus can be transmitted through a blood transfusion.

Is there a vaccine against the new coronavirus?

There are no vaccines available yet against the virus that causes COVID-19. Several pharmaceutical companies are working on vaccines. The first clinical trial for a COVID-19 vaccine just started in mid-March. However, it will likely be at least a year or a year and half before a vaccine might be available, according to the NIH’s Fauci.

Are there medicines to treat COVID-19?

At this time, there are no FDA-approved drugs to treat COVID-19, although some medicines might be helpful in treating symptoms from the disease. The drugs chloroquine and hydroxychloroquine, which are already used to treat malaria and some other conditions, are being studied as possible treatments for COVID-19. Because they are already available to treat other diseases, some doctors are trying them in certain patients with COVID-19. These medicines can sometimes have serious side effects, so they should only be taken under the supervision of a doctor. But for doctors to truly know that these drugs are safe and effective for use against COVID-19, they still need to be studied in clinical trials. Several new drugs that might help treat COVID-19 are also being studied in clinical trials. Despite claims now appearing online and in social media, it’s important to know that there are no tests that can be done at home that have been proven to diagnose COVID-19. Likewise, there are no supplements or other treatments available online or in stores that have been proven to prevent, treat, or cure COVID-19. The WHO has a list of myth busters to debunk some claims you may have heard about how the new coronavirus may be transmitted or treated. Bottom line: Scientists are learning more about the virus every day, and health experts are updating their information daily. source: cancer.org