Updated: May 26
Receiving cancer care is hard. Receiving it during a pandemic is even harder.
I’m deeply sorry that you’re experiencing additional stress during these unprecedented times.
I am confident that I can help though. My goal here is to lighten some of the load by helping you prepare for your cancer care in ways that you may not be considering.
This will be a series of posts, each addressing questions regarding cancer care in the time of Covid-19.
#1: As a cancer patient, what precautions should I take? (This post).
For some, this post is pretty darn basic. But it's surely the most important one of the bunch and I urge you to read it, just in case you've missed a few of the key recommendations that have come from the health authorities.
In future posts, I'll progress to more nuanced considerations that you should think about.
If you’re strapped for time, here are the highlights of this post:
1. You should take every precaution that everyone else is taking.
2. Most cancer patients are at increased risk of acquiring Covid and have a harder time fighting it. So, you should take the precautions very seriously.
Covid And The Basic Precautions (That Everyone Should Take)
Understanding the basic precautions to take with Covid is the most simple and impactful exercise that you can take to protect yourself. In other words, this section is the most important section of this entire blog series.
1. Understand how the virus is spread.
This knowledge helps you avoid being exposed to the virus because anything you do to eliminate these threats will help you decrease your risk.
It mainly spreads from person to person through droplets from coughing, sneezing or talking. These droplets can land in one’s mouth or nose—or be inhaled by a person nearby.
It can also live on surfaces; so when a person touches a surface and then touches his or her face, there is potential for spread.
Finally, it’s clear that the virus can be spread by people who are not showing symptoms, so you should assume that everyone is infected.
Anything that you do that stops these modes of transmission will reduce the chance you become infected.
2. Wash your hands frequently.
Soap and water is better than hand sanitizer. Hand sanitizer is better than nothing, as I explained when I was on this show. (Go to 19:58 if you’d like to hear the rationale).
3. Maintain social distancing.
The best way to do this is to stay home. If you must go out, stay six feet away from others to the greatest extent possible and please, please, do not go near any large crowds. A sneeze or cough can push droplets (that contain virus) from an infected person, and at six feet, most droplets will fall to the ground. But the commonly cited six-foot rule is not an absolute. Eight feet of distance is better than six feet and ten feet is better than eight feet. You get the picture.
A quick tangent: for me, this is the toughest aspect of the time we are living in. I like hugging people and people like hugging me. They often say "it feels like I'm hugging a giant teddy bear!" (I always thought of myself as more of a lion, but I'll take it). The point is: I have a lot of sympathy for those who can't hug all of their loved ones right now.
4. Avoid touching your face.
The virus can live on surfaces. If you touch those surfaces and then itch your nose, scratch
around your eyes or pick at your teeth, you are inviting infection.
5. Cough and sneeze into your elbow or a tissue.
If you use a tissue, immediately discard it and wash your hands (to protect other people in case you already have the virus).
6. Use a mask.
Cover your face with a mask when you’re around others, even if you don’t have symptoms.
7. Clean, clean and clean again.
Clean commonly touched surfaces (such as doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets and sinks) frequently with an EPA-approved disinfectant.
8. If you have severe symptoms, seek emergency medical attention.
The CDC says that severe symptoms include (but aren’t limited to) trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face.
9. If you have mild symptoms, stay home.
The CDC says that people with COVID-19 have had a wide range of symptoms reported – and that these symptoms may appear 2-14 days after exposure to the virus: fever, cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste, and new loss of smell.
Seek care when symptoms first appear, via telephone first. Contacting your doctor or your nearest ER via telephone is recommended so that you don’t unintentionally become infected or infect someone else. (You don’t want to go to the ER with mild symptoms in case you are not infected).
10. Stay informed.
Seek regular updates from your county and state health departments; national news may not reflect what’s currently happening in your area.
11. Know that you won't be abandoned.
If all of your attempts to avoid Covid fail, know that the healthcare system will still do everything possible to help you.
Articles written by various comprehensive cancer centers indicate that some of their patients (who acquire Covid) believe that they will not be treated because it’s too risky for the doctors and nurses to do so. That is not true. If you arrive at an ER with Covid, you will receive medical attention.
Covid And Precautions For Cancer Patients
Many cancer patients have been wondering, "Do cancer patients have additional risk?"
The short answer is yes, according to the American Society of Clinical Oncologists' current brief on cancer patient mortality. Because cancer patients often have weakened immune systems, they may not be able to fight off the virus as easily as those who are not immunocompromised.
That news, if you haven’t heard it yet, may be hard to digest. I am not sharing this because I want to scare people; I share it because it may push some of you to take Covid more seriously than you already are.
So, take a deep breath and keep reading for a little perspective on this.
According to the National Cancer Institute, other patients who are at additional risk include those with “asthma, lung disease, heart disease, liver disease, kidney disease, obesity, diabetes, immune deficiencies (including HIV and AIDS), a history of smoking, a history of bone marrow or organ transplantation, and prolonged use of corticosteroids (or other medications) that can weaken the immune system.”
Wow. That's a long list of other patients who are in the same boat.
According to the CDC, more than 42% of Americans are obese, 47% of Americans are at risk for heart disease and 14% of Americans are smokers. Although many of these people overlap, it's clear that more than half of America is at higher risk of acquiring Covid.
So, cancer patients are not unique. You aren’t alone. As a matter of fact, I have an abnormally dilated aorta, so I’m at risk too because the virus aggressively attacks the cardiovascular system.
If you’re anything like me, though, the idea that “I’m not alone” doesn’t reduce my anxiety all that much. Anxiety reduction, for me, requires taking additional precautions.
So what extra precautions should you take as a cancer patient?
If you examine the National Cancer Institute (NCI) Recommendations for cancer patients and compare them to what the CDC and the WHO are saying, you’ll quickly notice that, despite the increased risk, they don’t vary much from the recommendations for everyone else!
The NCI adds one simple instruction: be prepared for a long stay at home. Have extra medication and food on hand. That’s it. That’s the only difference!
So what’s the big takeaway? The extra precaution that cancer patients should take is to take the basic precautions extra seriously!
Sure, that's probably unsatisfying, so we'll take a deeper dive into some things you can do to protect yourself that these organizations, frustratingly, aren't talking about. That'll be the topic of the next post.
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