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CANSA Eastern Cape

COVID-19 – Information Cancer Patients Should Know

The COVID-19 virus will not cause serious problems for most people. However, certain groups of people are more at risk for serious complications resulting from the virus. These include the elderly; people with serious chronic diseases such as heart disease, diabetes or lung disease; and people with weakened immune systems, such as cancer patients and cancer survivors, because cancer and cancer treatment can affect their immune systems. (1) (3)

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COVID-19 Risk Factors for Cancer Patients and Survivors

Guidelines for Palliative Home Care during COVID-19 Pandemic

Cancer Patients at High Risk

Cancer patients and survivors are among those at higher risk of serious illness from an infection because their immune systems are often weakened. (2) The immune system protects the body against illness and infection caused by viruses like coronavirus. Most people diagnosed with cancer have a weakened immune system which reduces their ability to fight infections, because some cancer treatments, like chemotherapy and radiotherapy, can stop the bone marrow from making enough white blood cells. White blood cells are part of your immune system. Lower white blood cell counts is most likely to happen during a course of cancer treatment, but the effects can last for some time afterwards. Some types of cancer can also lower your ability to fight infection. This is usually cancer that affects your immune system like leukaemia or lymphoma. When your ability to fight infection is lowered the symptoms of any infection can be much more severe and may become dangerous. (1)

Especially at risk are (5):

  • People having chemotherapy, or who have received chemotherapy in the last 3 months
  • People having immunotherapy or other continuing antibody treatments for cancer
  • People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors
  • People having intensive (radical) radiotherapy for lung cancer
  • People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • People with some types of blood cancer which damage the immune system, even if they have not needed treatment (for example, chronic leukaemia, lymphoma or myeloma).

Cancer patients who completed cancer treatment a few years ago or longer, have immune systems that have most likely recovered, but each person is different. It’s important that all cancer patients, whether currently in treatment or not, talk with a doctor who understands their situation and medical history if they are concerned about having contracted the COVID-19 virus. It’s also important that patients and their caregivers take precautions to lower their risk of getting COVID-19. (2)

How to Lower Risk of Infection

In most cases cancer patients or those in remission, and caregivers or loved ones of cancer patients need to attend to the same things in order to lower risk of infection, as the general population. Lower the risk of picking up infections by (1) (3) (5) (7):

  • Live healthily to boost your immune system, through eating healthily (enough fruit and veg) and exercise regularly. It is important to try to get 6 to 8 hours of sleep per night too. Make sure you have an outlet for stress.
  • Get the flu vaccine and make sure that any chronic health conditions are under control
  • Avoid smoke or smoking
  • Wash your hands thoroughly and frequently, often (wash your hands with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place)
  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol
  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, trolley handles – use a tissue or your sleeve to cover your hand or finger if you must touch something
  • Make use of antibacterial wipes to disinfect trolley and basket handles when doing shopping. Wipes are available at most large retailers.
  • Collect the antibacterial wipe and then collect a trolley or basket
  • Avoid touching your face (nose, eyes, mouth)
  • Practice good respiratory hygiene (cover your cough or sneeze with a tissue, then throw the tissue in the trash, or sneeze into your elbow)
  • When greeting others avoid hugging, shaking hands and kissing
  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and cell phones)
  • Keep space between yourself and others
  • Avoid contact with people who are unwell
  • Avoid crowded environments, especially in closed-in settings with little air circulation
  • Limit social interaction
  • Stay home as much as possible to further lower your risk of being exposed
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time – or consider ways of getting food brought to your house through family, social, or commercial networks
  • If at all possible avoid public transport – if you have to make use of public transport try to distance yourself from others and wear a scarf to cover your mouth and nose
  • Avoid all non-essential travel especially cruise and air travel
  • Have a plan for if you get sick – contact your healthcare provider ahead of the time to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time
  • Rather make contact telephonically than spending time in hospital departments whenever possible
  • Stay home when you are sick

If You Suspect You have Contracted the Virus

The symptoms of coronavirus are similar to the common cold or flu.

According to the World Health Organisation the most common symptoms and the percentage of people who had them are as follows:

  • Fever: 88%
  • Dry cough: 68%
  • Fatigue: 38%
  • Coughing up thick phlegm, from the lungs: 33%
  • Shortness of breath: 19%
  • Bone or joint pain: 15%
  • Sore throat: 14%
  • Headache: 14%
  • Chills: 11%
  • Nausea or vomiting: 5%
  • Stuffy nose: 5%
  • Diarrhoea: 4%
  • Coughing up blood: 1%
  • Swollen eyes: 1%

COVID-19 is a lower respiratory tract infection, which means that most of the symptoms are felt in the chest and lungs. That’s different from colds that bring on an upper respiratory tract infection, where you get a runny nose and sinus congestion. Those symptoms seem to be mostly absent for people with COVID-19, though they’re not unheard of.

As with any infection, coronavirus is more likely to progress at a greater speed in a cancer patient. It is important to seek the expert opinion of an oncologist at an early stage, and to intervene early so as to best deal with the impacts of falling ill. (6)

A sudden fever (feeling very hot, or very chilly and sweating) can be a sign of many different types of infection and requires medical advice. Infections during cancer treatment are unfortunately common and may not necessarily be caused by coronavirus. All infections in cancer patients must be thoroughly investigated due to the risk that they may become more serious. (6) In the case of COVID-19, fever may be accompanied by tiredness, and a dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea. (4)

If a you are being actively treated for cancer and develop signs of infection, for example high temperature (fever), chills and sweating (fever), coughing or shortness of breath, you should urgently make contact with your oncology unit. (6)

If you have not recently received treatment for cancer and show signs of infection, you should follow the usual advice of making contact with your healthcare provider or GP. (6)

Presenting at emergency departments is NOT recommended due to the high likelihood of coming into contact with other infections in such areas, as well as the possibility of an infection being transmitted to other people who are unwell or to medical staff. (8) The National and Provincial Departments of Health will have the most up to date information on the situation in your area. Calling in advance will allow your healthcare provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections. (4)

If you are worried you might have been in contact with someone with confirmed coronavirus, or that you are infected, please call the CORONA VIRUS OUTBREAK HOTLINE NUMBER: 0800 029 999. The toll-free number is available from 08:00 to 16:00 to attend to any concerns you may have.

You can also add the following WhatsApp number to your contacts – 060 012 3456 – and type “Hi” in the message block. You will then receive an automated response.

Stay Informed:

Stay aware of the latest information on the COVID-19 outbreak, available on the websites and social media of the national Department of Health (www.health.gov.za), National Institute for Communicable Diseases (www.nicd.ac.za) and World Health Organization (www.who.int).

One vitally important resource is providing no data cost access to the official SA coronavirus website https://sacoronavirus.co.za for all South Africans thanks to the biNu #datafree Platform.

#datafree access to the website via https://coronavirus.datafree.co allows all South Africans to discover the latest information, resources, and stats on coronavirus. The biNu #datafree Platform is powering digital inclusion by removing the barrier of cost to accessing the official COVID-19 website, which is beneficial in the spread of facts and to prevent false information circulating.

https://coronavirus.datafree.co is available on any device across all mobile network operators, no airtime is deducted, and it can be accessed with SIM cards that have no airtime or data balance.

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FAQ’s COVID-19 Virus

What is COVID-19?

Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause infections of the lungs and airways ranging from the common cold to more severe diseases. The most recently discovered coronavirus causes coronavirus disease COVID-19. (4)

How does the Virus Spread?

The virus spreads mainly from person-to-person (1):

  • 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 1.8 metres), 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.

Studies to date suggest that the virus that causes COVID-19 is mainly transmitted through contact with respiratory droplets rather than through the air. (4)

How long is the Incubation Period for COVID-19?

The “incubation period” means the time between catching the virus and beginning to have symptoms of the disease. Most estimates of the incubation period for COVID-19 range from 1-14 days, most commonly around five days. (4)

Pandemic

The World Health Organization (WHO) has announced that the spread of COVID-19 has reached the level of a pandemic. The CDC describes a pandemic as an “epidemic that has spread over several countries or continents, usually affecting a large number of people.” The overwhelming majority of early cases were in China, but other countries, including South Korea, Iran, and Italy, have also had significant spread of COVID-19. This new coronavirus has also spread across the United States. (2)

Common Symptoms

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea. These symptoms are usually mild and begin gradually. (4)

Is there a Vaccine against the COVID-19 Virus?

There’s no vaccine available yet against the virus that causes COVID-19. Several pharmaceutical companies are working on vaccines and treatments. However, it will likely be at least a year or a year and half before a vaccine might be available (1). The World Health Organization (WHO) is coordinating efforts to develop vaccines and medicines to prevent and treat COVID-19. (4)

Can Antibiotics be used to treat COVID-19?

No. Antibiotics only work to treat infections caused by bacteria, not viruses. No medicines have been approved specifically to treat COVID-19 at this point, although some medicines might be helpful in treating symptoms from the disease. (1)

Should I Wear a Mask to Protect Myself?

People with no respiratory symptoms, such as cough, do not need to wear a mask. The WHO recommends the use of masks for people who have symptoms of COVID-19 and for those caring for individuals who have symptoms, such as cough and fever. The use of masks is crucial for health workers and people who are taking care of someone (at home or in a healthcare facility). (4)

Sources

1: https://www.cancer.org/latest-news/common-questions-about-the-new-coronavirus-outbreak.html
2: https://about-cancer.cancerresearchuk.org/about-cancer/cancer-in-general/coronavirus-and-cancer
3: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html
4: http://www.health.gov.za/index.php/outbreaks/145-corona-virus-outbreak/465-corona-virus-outbreak – http://www.health.gov.za/index.php/component/phocadownload/category/607
5: https://www.cancerresearchuk.org/sites/default/files/one_cancer_voice_advice_on_coronavirus_for_people_with_cancer.pdf
6: https://www.cancer.ie/cancer-information-and-support/coronavirus-and-cancer-info-for-patients-families-volunteers/coronavirus-advice-for-for-people-receiving-cancer-treatment
7: https://www.fredhutch.org/en/news/center-news/2020/03/coronavirus-what-cancer-patients-need-to-know.html?
8: https://www.cancer.ie/cancer-information-and-support/coronavirus-and-cancer-info-for-patients-families-volunteers/coronavirus-advice-for-former-cancer-patients

We Need Your Support More Than Ever

CANSA, as a leading cancer-control organisation, has proudly delivered our life sustaining services for nearly 90 years. We have a solid foundation from which we continue to build the hope of a world without cancer. Public support and our partnerships with you are at the heart of CANSA’s success.

The safety and health of our cancer patients, volunteers and staff is paramount. As one of our most valued partners, we assure you that CANSA is taking all the necessary precautions to minimise the impact of COVID-19. Cancer patients are among those at high risk of serious illness from an infection because their immune systems are often vulnerable.

All current CANSA activities and events are postponed or suspended for now to ensure that we play our part in making sure we protect our communities. It’s best that we practise social distancing and have less physical interaction.

We’ll continue to monitor the situation and will announce a new date for activities and events once we feel it is safe to do so.

CANSA will continue supporting patients virtually via our online support platforms, Toll Free Call Centre 0800 22 66 22 and our WhatsApp lines which are 072 197 9305 English and Afrikaans / 071 867 3530 Xhosa, Zulu, Sotho and Siswati. A list of staff on call during the nationwide lockdown will also be posted on the CANSA website.

Furthermore, CANSA may be contacted via our social media platforms:

While we may not be able to host face-to-face events at the moment, the role of providing care and support to those affected by cancer must continue. Cancer patients continue to stay at our 11 CANSA Care Homes with protective measures and strict infection procedures and while the public hospitals are open and receiving patients. CANSA Care Homes cater for patients receiving cancer treatment with accommodation, transport and meals.  CANSA’s TLC Lodges for children and families affected by cancer also remain operating with protective measures and support via phone and online platforms. We still need your support now more than ever so please consider making a safe and secure online donation towards our CANSA Care Homes and TLC Lodges.

CANSA will continue assisting stoma and ostomy patients with orders and deliveries that will be processed once a week on Thursdays. Patients and survivors can mail thavenga@cansa.org.za or stomapta@cansa.org.za or WhatsApp 078 942 9290.

We appreciate it deeply if you would continue to be our partner in any way you can, so our valuable work may continue. Your help eases the burden and anxiety of the people who living cancer in so many different ways and for this, we are enormously thankful.

CANSA salutes all caregivers, nurses and medical staff for remaining dedicated to their loved ones or patients, regardless of personal risk, at this time.


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