COVID-19 (CORONAVIRUS) AND LYMPHOMA/CLL
A/Prof Chan Cheah - Lymphoma & COVID-19 - what does that mean for me??
STAY HOME - community message from Lymphoma patients and families
Dr Jason Butler - COVID-19 & Lymphoma/CLL - an update for patients & families
WHAT IS COVID-19
is a respiratory illness caused by a novel (new) coronavirus that was
identified in an outbreak in Wuhan, China, in December 2019. Coronaviruses are a large family of viruses
that can cause mild illnesses, such as the common cold, to more severe
diseases, such as Severe Acute Respiratory Syndrome (SARS).
disease can spread from person to person, through small droplets from the nose
or mouth that may spread 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. There is currently no vaccination to prevent
or treat COVID-19, however health authorities are currently working on this.
COVID-19: HOW TO REDUCE
RISK OF BEING INFECTED
Active treatment for lymphoma
& CLL can reduce the effectiveness of the immune system. While we continue
to learn more about COVID-19 each day, it is believed that patients with all
cancers and the elderly are at a higher risk of becoming unwell with the virus.
People who have weakened immune systems are at greater risk of getting infections
but there are a number of steps that can be taken to reduce the chances of
getting an infection.
YOUR HANDS with soap and water for 20 seconds or use alcohol-based
hand wash. Wash your hands when you come into contact with others, before eating
or touching your face, after using the bathroom and upon entering your home.
CLEAN AND DISINFECT YOUR HOME to remove germs. Practice routine cleaning of
frequently touched surfaces such as; mobile phones, tables, doorknobs, light
switches, handles, desks, toilets and taps.
SAFE DISTANCE between
yourself and others. Maintain social distancing outside of your home by leaving at least a one-meter
distance between yourself and others
PEOPLE WHO ARE UNWELL If you are in
public and notice someone coughing/sneezing or visibly unwell, please move away
from them to protect yourself. Ensure that family/friends do no visit if they
are displaying any symptoms of illness such as fever, coughing, sneezing,
CROWDS especially in poorly ventilated spaces. Your risk of
exposure to respiratory viruses like COVID-19 may increase in crowded,
closed-in settings with little air circulation if there are people in the crowd
who are sick.
ALL UNESSENTIAL TRAVEL including plane trips, and especially avoid embarking on cruise ships.
If a COVID-19 outbreak
happens in your community, it could last for a long time. An outbreak is when a
large number of people suddenly get sick. Depending on how severe the outbreak
is, public health officials may recommend community actions to reduce people’s
risk of being exposed to the virus. If COVID-19 is spreading in
your local community, it is important that you stay at home as much as
LYMPHOMA/CLL AND COVID-19
People who have lymphoma or CLL are at a higher
risk, especially when:
Receiving chemotherapy, or who
have received chemotherapy in the last 3-12 months
Receiving immunotherapy or other
continuing antibody treatments for cancer
Receiving other targeted cancer
treatments which can affect the immune system, such as protein kinase
inhibitors (eg.ibrutinib, venetoclax)
Those who have had a bone marrow
or stem cell transplant in the last 6-12 months, or who are still taking
People with lymphoma or chronic
lymphocytic leukaemia which can damage the immune system, even if they have not
needed treatment or are in remission with a compromised immune system.
Patients who are receiving IVIG (immunoglobulins)
are receiving these as your immune system is compromised.
If you have a low-grade
lymphoma/CLL and have not had treatment you are at a lower risk than someone
who has had treatment, although you need to be diligent with infection
People who are over 65 years or
have co-morbidities (eg. Cardiovascular disease, lung disease or diabetes)
speak to your doctor to know your individual risk
ARE THE SYMPTOMS OF COVID-19?
infected can develop mild to severe symptoms, however some people who are
infected may not develop symptoms. Common symptoms can include:
Flu like symptoms such as coughing, sore throat and fatigue
Shortness of breath
WHO IS AT
RISK OF COVID-19 INFECTION?
currently considered to be at risk of contracting COVID-19 infection are those
who have fever and respiratory symptoms such as cough or sore throat AND:
Have returned from overseas
travel in the last 14 days, OR
Have been in close contact
with a confirmed COVID-19 case, OR
Believe they have been in
close contact with a person at risk of COVID-19.
WHAT DO I DO IF I BECOME UNWELL?
- If you are mildly unwell, have viral symptoms (e.g. fever and
cough) and believe you may have been exposed to the coronavirus, but are not on
active chemotherapy or known to have a low white cell count or be neutropenic,
please contact the Coronavirus Health Information Line and your GP as a first
step. Appropriate screening for coronavirus will be organised through
these services, but you should highlight that you have an underlying
cancer. Your GP can contact your treating team for further advice as required.
For the safety of other patients, please do not present to your cancer centre with
these symptoms. When you call your cancer centre, they can rebook your
appointments when you ring to let them know about your illness.
- If you are known to be neutropenic or are having treatment
expected to cause neutropenia, and you become unwell or develop fevers >38C
for 30min you should follow the usual precautions for febrile neutropenia and
present to the emergency department.
PLEASE NOTE: If you have cough or shortness of breath
you should phone ahead to your hospital, so appropriate triage can be
patients in this situation will have a cause other that COVID-19, however
precautions will be in place until this is excluded. Please understand
that this may result in changes to previous pathways, but it is done with the
safety of all patients in mind.
- If you are very unwell you should call an ambulance and organise immediate transfer to the emergency department as you usually would.
OTHER PRACTICAL TIPS TO KEEP HEALTHY
- Be sure you have over-the-counter medicines and medical
supplies (tissues, etc.) to treat fever and other symptoms.
- Ensure you have two-three weeks
supply of prescribed medication
- Practice good hygiene to prevent
- Eat a healthy balanced diet to
help strengthen your immunity
- Ensure you wash and cook food
- Get plenty of sleep
- Physically active if safe to do so
- Manage your stress
- Drink plenty of fluids
- Reduce visits to the supermarket or
crowded areas by stocking a week or two at a time (not hoarding)
- Face masks prevent the spread of
viruses when infected. For those with
compromised immune systems, avoiding contact with the general public is the best
way to avoiding infection.
- You and your family should receive
the flu vaccination once it is available to protect yourself from other flu
infections – speak with your doctor
IF I’M CARING FOR SOMEONE WITH CANCER, HOW DO I KEEP
Practice good respiratory hygiene by covering your mouth and nose with a flexed elbow or
tissue when coughing or sneezing, discarding used tissues immediately into a
closed bin. Please note you do not need to wear a face mask if you are healthy.
Try and organise alternative care/carers if you are unwell.
- Cleaning your hands with alcohol-based hand
rub or soap and water for 20 seconds.
- Avoiding close contact with anyone who has cold or flu-like symptoms;
- If you suspect you may have coronavirus symptoms or may
have had close contact with a person who has coronavirus, you should contact
the Coronavirus Health information Line. The line operates 24 hours a day, seven days a week (below).
- It is recommended
by health officials that children remain at school unless they are unwell. We understand that many are concerned that
their children can bring the virus into your home. You need to make a decision that feels right
to you. If they do go to school, ensure
they wash their hands and change clothes as soon as they return home, so as to
reduce the risk of touch exposure.
WHAT THIS MAY MEAN FOR YOUR CANCER CENTRE
- You may need to change
clinic or treatment appointments at short notice
Clinic appointments may be
converted to telephone or telehealth appointments
Before your hospital visit
consider if you have travelled overseas within 14 days, had contact with
persons with or suspected of having COVID-19 AND if you are unwell with
respiratory symptoms including cough, fever, shortness of breath – let your
cancer centre know
*It is important that you still attend your
Cancer Centre for your appointments unless advised by your doctor or nurse.
DOWNLOAD THE COVID-19 & LYMPHOMA FACT SHEET
For more information and real time updates
Health Information Line on 1800 020 080
Government Health - Coronavirus information
The Government has released important resources around
coronavirus specifically – connect with these resources to stay aware of any
developments that come to light.
HEALTH ALERT (SUMMARY OF CURRENT COVID-19
Disease Control and Prevention
QUICK FACTS (WHAT YOU SHOULD KNOW)
USE OF SURGICAL MASKS
GUIDANCE ON ISOLATION (SELF-QUARANTINE)
INFO FOR EMPLOYERS (WHAT TO TELL STAFF)
HEALTH AND RESIDENTIAL CARE WORKERS
For further questions you can contact the Lymphoma
Nurse Support Line T: 1800 953 081 or email: firstname.lastname@example.org
Lymphoma Australia Fact sheet
Last reviewed and updated 17 April 2020