National Center for Health Research: April 1, 2020
The coronavirus can infect anyone, young or old, healthy or frail. People with cancer and other serious health conditions, and their loved ones, need to be especially careful. Here’s what you need to know.
Some cancer treatments, such as chemotherapy, targeted therapies, immunotherapy, and radiation, can weaken the immune system and possibly cause lung problems. People who have weakened immune systems or lung problems are more likely to have serious symptoms if they become infected with this virus. Anyone with cancer in the lungs (whether lung cancer or cancer that has spread to the lungs) is especially at risk if they develop COVID-19.
If you had scheduled surgery, screening, or other procedures that were considered not urgent or not immediately life-threatening, those might have been postponed. This is for everyone’s protection. Many hospital staff, including doctors, nurses, receptionists, and cleaning staff, have been exposed to the virus and don’t know whether they can infect others. If you are battling cancer or doing follow-up after successful treatment, you don’t want to be exposed to the coronavirus when you go in for surgery or testing procedures. And, you don’t want your medical center to be less able to fight the coronavirus at a time when it is spreading throughout your community.
The coronavirus is spreading in all 50 states, in urban, suburban, and rural areas, so it is important to listen to health experts (and governors or mayors) who tell you to stay home, limit contact with others, and keep a distance of 6 feet away when you or your family members or caregivers go grocery shopping or other essential activities.
What is coronavirus?
Coronaviruses are a large group of viruses that can cause respiratory illness. The new (novel) coronavirus is called SARS-CoV-2 and the illness it causes is called coronavirus disease 2019, which is why it’s abbreviated as COVID-19. Since it is new, nobody has immunity from it.
How does COVID-19 spread between people?
The virus usually spreads through close contact with other people, especially through droplets when a person coughs or sneezes – or even when they breathe normally. These droplets can travel through the air and can be inhaled or get into the noses, mouths, or eyes of people nearby.
It is most contagious when the person has symptoms, but it is possible to catch the virus from infected people who have no symptoms at all. In addition, these droplets (as well as fecal matter containing the virus) can end up on surfaces where it can survive for hours or even days. When you touch these surfaces and then touch your face, you can be exposed to the virus. That’s why it’s important to wash your hands regularly. If you don’t have antiseptic wipes, you can wipe down surfaces in your bathroom, kitchen, and other rooms with bleach of rubbing alcohol to help prevent exposure. However, most of the time the virus is spreading through close contact with people who have it.
What about food or food packaging? The risk of catching the virus from packaging is very low, but since the virus can survive for up to 24 hours on cardboard and up to 3 days on plastic and stainless steel, it’s a good idea to wash your hands for at least 20 seconds after handling mail, takeout containers, and packaging from groceries. You can also disinfect food packages using a cleaning product that kills viruses, but don’t use disinfectants on food.
What are the symptoms of COVID-19?
Symptoms tend to start between 2 and 14 days after coming into contact with the virus. Although some people have compared the symptoms to a cold or flu, there are some differences.
The most common symptoms are:
- Fever (this can come and go)
- dry cough
Other symptoms include:
- shortness of breath
- aches and pains
- sore throat
- trouble breathing
- chest pain or pressure
- pink eye (conjunctivitis)
- loss of sense of smell (and sense of taste)
These symptoms are less common but can be signs of COVID-19:
- runny nose
- nausea or vomiting
- abdominal discomfort
Most people who are infected with this coronavirus have mild symptoms and can recover at home in about 2 weeks. However, symptoms can become severe. These are the ones that require immediate medical attention:
- difficulty breathing or shortness of breath
- persistent chest pain or pressure
- confusion or inability to awaken
- blueish color in the lips or face
People who are older than 60, and people who have existing serious health conditions, such as heart disease, lung disease, and diabetes, are more likely to develop severe illness and complications from COVID-19. This includes people who are receiving cancer treatments that can weaken the immune system. The most serious complications include pneumonia, organ failure, and death.
How can I protect myself and others?
The best way for anyone to protect themselves is to avoid being exposed to it. There are no proven medications or vaccines, so don’t be fooled by false claims (especially those made by telemarketers).
“Social distancing” or “physical distancing” refers to staying away from other people because it is impossible to know who has the virus. The safest people in your life are the ones you are living with who are not exposed to others who might have the virus (in other words, they are not going to work or spending time close to other people). Staying at home and not seeing your loved ones is not fun, but it is essential for your own safety and for everyone else’s. If everyone does that now, the spread of this virus will be reduced sooner, and some of these restrictions will no longer be necessary in a few weeks.
- stay at home
- avoid public spaces
- avoid public transportation and unnecessary travel
- avoid social gatherings
- work from home
- stay at least 6 feet away from people when out in public
- avoid physical contact in social situations, such as shaking hands, hugging or kissing
- wash your hands using soap and water for at least 20 seconds, especially after being out in public
- use alcohol-based hand sanitizer when soap and water aren’t available (or wash your hands as soon as you get home)
- avoid touching your face when your hands aren’t clean or you are out in public
- avoid contact with people you don’t know very well
- clean and disinfect surfaces you touch daily, including things you might not think of like doorknobs, light switches, faucet handles, and phones. Make sure you use a cleaning agent that is effective for killing viruses.
What about a face mask? Experts say that you only need to wear a face mask if you have the virus, to avoid infecting other people you must come in contact with. It is not clear that it protects you unless you are in close contact with someone with the virus. If you want to be extra cautious, since the masks that doctors and nurses use are in short supply, you can use homemade masks or scarves to cover your face when you are out in public. But you should NOT be out in public except when absolutely essential.
If you are undergoing cancer treatment that can weaken your immune system or cause lung problems, here are extra steps to protect yourself:
- Make a plan with your doctor to monitor for symptoms
- Avoid friends and family except those you live with or depend on for essentials. Otherwise, rely on your phone to maintain contact.
- Have a plan with your loved ones or caregiver if you or they get sick
- Have the medications you rely on and order any you need in advance (to be delivered, if possible)
- Ask a friend or family member to shop for groceries for you
- Wash your hands (20 seconds with soap and water) even more often if you are exposed to others
What should I do if I develop symptoms?
If you develop a fever, cough, or shortness of breath, call your doctor. If you are currently receiving chemo, a fever is a medical emergency. Other severe symptoms, such as difficulty breathing, persistent chest pain or pressure, confusion or inability to awaken, or blueish color in the lips or face, means you need to call 911. Tell the 911 operator that you think you have COVID-19 so the responders can take the necessary precautions to protect themselves.
People who experience mild symptoms can usually stay home and will recover in about 2 weeks. But, if you are receiving treatment for cancer, be sure to tell your doctor. Do not just show up at the doctor’s office with symptoms: Call them first so you have tell them about your symptoms and they can help decide what to do. If you do become sick, you can take the following steps to protect others:
- Stay home, unless you need essential medical care
- Wear a facemask when you are near others. (People caring for you should also wear a facemask).
- Stay away from others in your home as much as possible
- Cover your mouth and nose when you cough or sneeze, properly dispose of tissues, and wash your hands
- Monitor your symptoms and temperature
If you were not tested for COVID-19, you should follow those steps until at least one week has passed since you first noticed symptoms or your fever goes away for 3 full days without fever-reducing medicine. If you have been diagnosed with COVID-19 based on test results, you should follow these steps until you have 2 negative test results taken 24-hours apart, your fever goes away without fever-reducing medicine, and your symptoms improve.
What if my cancer treatment is delayed?
When a person is diagnosed with cancer, they are likely to want treatment as soon as possible. Treatment or testing may seem more urgent than it really is, especially with cancers that often grow slowly, such as prostate cancer or breast cancer. And, if you don’t have COVID-19, you don’t want to be exposed to it during cancer surgery, testing, or follow-up appointments. Talk to your doctor about what is the best strategy to get the treatment you need when it is safe to do so.
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