WHAT IS COVID-19 (CORONAVIRUS)?
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.
WASH 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.
KEEP A 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
AVOID 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, headache, etc.
AVOID 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.
AVOID 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 possible.
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 immunosuppression drugs
- 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 precautions.
- People who are over 65 years or have co-morbidities (eg. Cardiovascular disease, lung disease or diabetes)
- Please speak to your doctor to know your individual risk
WHAT ARE THE SYMPTOMS OF COVID-19?
Those 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?
People 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 organised.
Most cancer 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.
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 infections
- Eat a healthy balanced diet to help strengthen your immunity
- Ensure you wash and cook food thoroughly
- 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 THEM SAFE?
- 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 VISITS?
- 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
In the video attached, Professor Chan Cheah answers the most common questions that we have been asked about COVID-19 vaccinations and what does this mean for you.
What is COVID-19
What are the two vaccines, and the difference?
Are there risks? What is the data?
How many doses do I need?
Is it safe for those with lymphoma? What is the effectiveness in trials?
Should I get it? Do I get to choose which vaccine?
Will it interfere with my treatment or my disease? Is it safe to have while in treatment?
What if I have had a transplant?
The national HSANZ and ANZTCT positions statements on vaccination:
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
For more information and real time updates please visit:
Coronavirus Health Information Line on 1800 020 080
Australian 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 SITUATION)
Centres for Disease Control and Prevention
For further questions you can contact the Lymphoma Nurse Support Line T: 1800 953 081 or email: firstname.lastname@example.org