Alissa Eckert, MS; Dan Higgins, MAM
This page is reviewed daily and updated as needed.
The global pandemic of the coronavirus disease, called COVID-19, continues to have a serious impact on many people, including cancer patients, their families, and caregivers. As studies are beginning to come out looking at how this illness may impact cancer patients, it’s still too early in this outbreak for any definitive answers. As some states continue to relax or lift stay-at-home orders and are allowing certain businesses to re-open, health officials continue to stress the importance of staying home and social distancing (keeping at least 6 feet away from others), as well as wearing a face covering if you go out in public.
Cancer patients are among those at high risk of serious illness from an infection because their immune systems are often weakened by cancer and its treatments. Most people who were treated for cancer in the past (especially if it was years ago) are likely to have normal immune function, but each person is different. It's important that all cancer patients and survivors, whether currently in treatment or not, talk with a doctor who understands their situation and medical history.
It's also important that both patients and their caregivers take precautions to lower their risk of getting COVID-19. The US Centers for Disease Control and Prevention (CDC) has specific recommendations for people at risk for serious illness from COVID-19 infection.
While the news about this outbreak is changing daily, knowing some basic facts about what can and cannot be done to help protect you and others from getting sick can be very empowering.
What is COVID-19?
COVID-19 is the name of the illness caused by a new coronavirus that has led to a large outbreak, which was first reported in China in December 2019. The name of this coronavirus is “SARS-CoV-2.”
Coronaviruses are a family of viruses that can cause common colds, as well as more serious respiratory diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The first coronavirus was discovered in the 1960s.
How does the virus spread?
According to the CDC, the virus spreads mainly from person-to-person:
- When somebody who is infected 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 6 feet), 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 eyes, mouth or nose. However, this is not thought to be the main way the virus spreads, according to the CDC.
Some people who do not have symptoms (that is, who are asymptomatic) may still be able to spread the virus. Because of this, it’s important that everyone follow the CDC’s and other health departments’ recommendations on how to protect yourself and others.
How can I protect myself and others from getting COVID-19?
According to the CDC, there are things all of us can do to help lower the risk of being infected (and infecting others):
- Wash your hands frequently with soap and water for at least 20 seconds because it’s one of the best ways to kill germs on your hands and prevent the spread of germs to others. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
- Avoid touching your eyes, nose, and mouth because if you picked up the virus, you could infect yourself by allowing the virus to enter your body.
- Avoid close contact – being within 6 feet (about 2 arms-length) of anyone, especially people who are sick, coughing, or sneezing.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash, or cough or sneeze into your elbow.
- Avoid shaking hands.
- Stay at home as much as possible and avoid gathering in groups or crowded places.
- Stay home when you are sick.
- Clean and disinfect frequently touched objects and surfaces daily using a regular household cleaning spray or wipe. Always read the directions of the products closely to make sure you are using them correctly. Cleaning and disinfecting products should not be used directly on skin, taken by mouth, or inhaled into the lungs, and bleach should not be used on food.
- Avoid non-essential travel. Check with the authorities in your area or state. If you were planning on going outside the US, the CDC recommends that travelers avoid all non-essential international travel.
- If you are a cancer patient, survivor, or caregiver, talk to your cancer care team about whether there are any additional precautions you should take.
People are encouraged to take advantage of telehealth services, if they are available, and "see" their doctors without going in person for an office visit. Medicare has temporarily expanded its coverage of telehealth services. Some health insurance providers are doing the same.
People with cancer who are getting infusions at the clinic or hospital should talk to their doctor about alternate treatments that might be available, like oral medicines or infusions at home.
Should I wear a face mask?
The CDC is recommending that if you need to go out somewhere where you might be close to other people (such as in a grocery store or pharmacy), wear a cloth face covering (something that covers your nose, mouth, and much of your face) or a face mask (if you already have one). The face covering is meant to help protect other people, because you could spread the virus if you are infected and don’t have symptoms. At the same time, when someone else wears a face covering, it can protect you too. Together, this can help slow the spread of COVID-19.
It’s important to understand that wearing a covering or mask is not a substitute for social distancing. It’s still very important to stay at least 6 feet away from others, even while wearing a face covering or mask, and to continue to wash your hands frequently.
If you want to make a cloth covering or mask at home and aren’t sure how, the CDC has instructions on how to make basic sewing and non-sewing versions. Friends and family might also be able to help you find or make masks.
Remember to wash your hands before putting on your face covering, to not touch your face while wearing the covering, and to wash your hands right after taking it off.
The CDC does not recommend that people in the general public wear surgical or N95 masks. These are in short supply in many areas and should be saved for healthcare workers who need them when caring for people who are sick.
It is also best to check with your local authorities to see if your area has specific guidelines about wearing a face covering in public.
Are there different recommendations for cancer patients and caregivers?
The CDC does not have specific recommendations on masks for people who have or have had cancer and their caregivers. But for many people being treated for cancer, especially with treatments like chemotherapy or stem cell (bone marrow) transplants that can weaken the immune system, doctors often recommend patients wear a mask to help lower exposure to germs that might cause infections. If you’re not sure if you or your caregiver should be wearing a mask, contact your doctor or another member of your cancer care team.
What about eye protection?
While the CDC recommends the use of eye protection (goggles or face shields) for health care workers (doctors, nurses, technicians, dentists, and others) in certain settings, it is not recommended at this time for the general public. A recent review of published studies suggested wearing eye protection might help reduce the spread of the coronavirus in the community, although more research on this is still needed.
What are the symptoms of COVID-19?
The most common symptoms of COVID-19, which may appear 2-14 days after being infected, are:
- Fever of at least 100.4o F (38o C)
- Cough
- Shortness of breath
- Chills
- Muscle aches and pains
- Sore throat
- New loss of smell or taste
- Feeling very tired
- Headache
- Diarrhea
- Nausea or vomiting
- Runny nose
Contact your doctor or local health department if you have any of these symptoms.
If you or the person you’re caring for has any of the following serious signs and symptoms of COVID-19, get medical attention right away:
- Trouble breathing or shortness of breath
- Constant pain or heaviness in the chest
- New confusion or being hard to wake up
- Bluish lips or face
Some people with COVID-19 might have signs or symptoms of blood clots such as bluish toes (also referred to as “COVID toes”), swelling of the lower leg, chest pain, shortness of breath, or stroke symptoms (slurred speech, weakness or numbness of an arm or leg). The reasons for this are being still studied, but it's important to tell your doctor right away if you are having any of these symptoms.
Children in particular might have fewer symptoms from COVID-19. However, there have been recent reports of children with symptoms such as a fever and rash similar to Kawasaki disease, as well as severe body inflammation, which might be related to the coronavirus. The CDC is keeping track of this syndrome, called multisystem inflammatory syndrome in children (MIS-C), to learn more about it and its relationship to the coronavirus infection.
It’s important to know that some people who are infected with the virus might not have symptoms, but they could still spread the virus to others. Because of this, it’s important that everyone follow the CDC’s recommendations on how to protect yourself and others.
What else do cancer patients need to know about the coronavirus?
The COVID-19 outbreak is fairly new, and doctors are still learning information about this coronavirus for cancer patients. But they do have a lot of information regarding the risk of infections in general for cancer patients.
Avoiding being exposed to this virus is especially important for cancer patients, who might be at higher risk for serious illness if they get infected. This is particularly true for patients who are getting chemotherapy or a stem cell (bone marrow) transplant, because their immune systems can be severely weakened by the treatment.
“We're in a time where there are significant disruptions in the care of patients with cancer,” says Dr. Len Lichtenfeld, Deputy Chief Medical Officer for the American Cancer Society. “Depending on the COVID-19 situation where you live, it may mean a delay in having cancer surgery or care that’s meant to keep cancer from returning. You may need to reschedule appointments."
Lichtenfeld says cancer care teams are going to do to the best they can to deliver care to those most in need. However, even in those circumstances, it won’t be life as usual. “It will require patience on everyone’s part as we go through this pandemic,” Lichtenfeld adds. “It is important to maintain contact with your cancer care team to determine the best course of action for you. This may involve talking to your care team virtually [online or over the phone] and not physically going to the clinic." As parts of the country re-open, many clinics and infusion centers have made changes to allow you to come in safely for an in-person visit as well as treatment. These might include screening for COVID-19 symptoms ahead of your visit, proper spacing of waiting room and infusion chairs, and spacing out appointments to limit the number of people in the waiting room at one time. So, it’s important to know who to call to reach your cancer care team to find out how to proceed.
Lichtenfeld adds, “These circumstances will take months to resolve, and even then, we will continue to have changes in the way cancer patients receive their treatment.”
In the meantime, doctors need to learn more about cancer patients and COVID-19. Registries such as the COVID-19 and Cancer Consortium and studies such as the NCI COVID-19 in Cancer Patients Study are actively collecting data . Early studies from registries in the US and around the world, have looked at outcomes for cancer patients who develop COVID-19 with symptoms as well as if certain anti-cancer treatments change these outcomes. These initial study results are helpful, but it is very important to gather more data and analyze it over a longer time to better understand the effects of COVID-19 on current and former cancer patients. You should contact your doctor if you are interested in participating in a registry or study.
Does health insurance cover coronavirus testing and care?
You may or may not have out-of-pocket costs if you get tested for coronavirus or if you need medicines or other care for COVID-19. You’ll need to check with your health insurance company about coverage. Here are some tips and resources to get you started:
- Call the toll-free number on the back of your insurance card
- Read about Medicare coverage of coronavirus-related needs
- See Medicaid’s frequently asked questions about COVID-19
- Learn about coronavirus and your Marketplace health plan coverage
Should people still get screened for cancer during this pandemic?
Health officials in most places are still urging people to stay home as much as possible to reduce the spread of COVID-19. At the same time, health centers in some parts of the country are starting to schedule screening tests and exams again, typically with measures in place to help maintain social distancing as much as possible. So, what should you do if you’re due (or overdue) for a cancer screening?
This is a complex topic because even though stay-at-home orders in many places are being relaxed or lifted, the pandemic is not over. The answer to the question of whether it’s safe to be screened again might not be the same for everyone, so it’s important to talk to your doctor, nurse practitioner, physician assistant, etc., to find out what’s best for you. Some important things to consider:
- What is your risk for the type of cancer you’re being screened for? Is the risk of postponing cancer screening bigger than the risk you face from COVID-19?
- What type of screening test would you have? (Some types of screening tests are more involved than others.)
- How common is COVID-19 in your area, and what are local health officials recommending about getting health care services right now?
- What is your risk for having complications if you are infected with COVID-19 (based on things like your age and if you have other serious health conditions)?
- What measures is the center taking to help protect you and others from COVID-19 (such as pre-screening patients for COVID-related symptoms before appointments, allowing for physical distancing between patients and for longer appointment times if needed, cleaning equipment and surfaces after each patient visit, and having staff wear personal protective equipment)?
Talk to your health care provider about the risks and benefits for you of being screened, and whether or not it might make sense to postpone it at this time. Remember that cancer screening can save lives, so it's important to not just forget about it. Getting back on track with cancer screening at some point should still be a priority.
Screening tests are different from tests your doctor might order if you have symptoms that could be from cancer. If you’re having symptoms you’re concerned about, contact your health care provider about the best course of action for you at this time.
More on coronavirus and cancer:
How serious is the COVID-19 illness?
“The vast majority of individuals who contract the novel coronavirus, they will experience mild to moderate symptoms and their treatment will be to remain at home, treating their symptoms the way they would a severe cold or the flu,” said Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health in a statement. “For some individuals, a smaller percentage, especially those who may be medically fragile, they will require medical attention including possibly hospitalization.”
According to the CDC, people who may be at greater risk for serious complications if they are infected with this new virus include:
- Older adults (aged 65 or older) or people living in nursing homes or long-term care facilities
- People with weakened immune systems**
- People with chronic lung disease (including moderate or severe asthma)
- People with serious heart conditions
- People who are very obese
- People with medical conditions such as diabetes, kidney failure, or liver disease
**Many conditions can weaken the immune system, such as cancer and its treatment (including a bone marrow transplant), smoking, having had an organ transplant, being born with an immune deficiency, having poorly controlled HIV or AIDS, and taking medicines that weaken the immune system, such as long courses of steroids.
Can I get COVID-19 from a blood transfusion?
According to the American Red Cross, there is no evidence that this new coronavirus can be transmitted through a blood transfusion.
Donating blood is still possible for those who are healthy and feel well, and it’s greatly needed, according to the Red Cross. The COVID-19 outbreak and resulting social distancing has led to canceled blood drives and dramatic blood shortages in many parts of the country.
The US Food and Drug Administration (FDA) has information on donating blood and other things you can do to help during this pandemic.
Can I get tested to see if I’m infected (or was infected in the past)?
Tests for the virus that causes COVID-19 can be done on samples taken by swabbing inside the nose or throat or on saliva samples. The testing field is changing almost daily, as the FDA continues to allow new tests onto the market. But not everyone needs to be tested for COVID-19.
The CDC has issued guidance for state and local health departments and for doctors on how to prioritize who should be tested, because testing resources are still limited in some places. But it’s up to each health department and doctor to use their best judgment when deciding if someone needs to be tested, based on things like:
- If the person is having symptoms
- If the person is likely to be exposed to the virus (as is the case for many health care workers)
- If the person is in the hospital or is at higher risk for complications if they’re infected
If you are having symptoms that might be from COVID-19 or have been exposed to someone who has it, call your doctor or health department to discuss whether you need to be tested.
Testing is also now available in some areas (often in a drive-thru setting) without the need for a doctor’s order. If you feel you should be tested, your state or local health department may have information on testing places available in your area.
The results of your test might change what you need to do (such as isolating yourself from other people if the test is positive), but they might not change your treatment. For example, if you have mild (or no) symptoms, you may not need treatment even if the test is positive.
If you do get tested and are negative for COVID-19, it doesn’t mean you can’t be infected at a later date. It’s still important to do what you can to lower your risk of infection, such as continuing to practice social distancing.
Are at-home tests an option?
For most of the COVID-19 tests in use, the samples need to be obtained by a health care professional. But the FDA is now allowing the samples for some tests to be collected at home:
- Most at-home tests use swabs to collect samples from inside the nose
- Some tests use samples of saliva
With any at-home test, once the samples are collected, they need to be shipped to a lab for the actual testing, so the results won’t be available right away. These tests still require a doctor’s order before they can be done. For some tests, you can answer questions about your symptoms and exposures on the test’s website, which a doctor will then review to see if you are eligible for testing. There are no tests authorized by the FDA that can be done at home and give quick results (without needing to send the sample to a lab).
What about antibody (serology) tests?
These tests look at a person’s blood for specific antibodies (immune system proteins) that would show that the person has been exposed and had an immune response to the virus. Antibody tests do not look for the virus itself, so they can’t be used to tell if someone is currently infected. They can only tell if a person has been exposed to the virus at some point.
It's not clear how useful the results of antibody testing are at this time. While many different antibody tests are now being used, the results from some of them might not be as accurate as others. And even with an accurate test result, experts aren’t yet sure if having a positive test means that you can’t be infected again.
The FDA has more information about the different types of COVID-19 tests now in use.
Is there a vaccine against the new coronavirus?
There are no vaccines available yet against the virus that causes COVID-19. Several pharmaceutical companies are working on vaccines. The first clinical trial for a COVID-19 vaccine started in mid-March, and trials testing other potential COVID-19 vaccines in people are now under way as well. However, it will likely be at least a year or a year and half before a vaccine might be available, according to the NIH’s Fauci.
Are there medicines to treat (or prevent) COVID-19?
At this time, there are no FDA-approved drugs to treat or prevent COVID-19, although some medicines might be helpful in treating symptoms from the disease.
The drug remdesivir is being studied in people with COVID-19. It works by stopping the coronavirus from making copies of itself. The FDA is now allowing remdesivir to be used in adults and children hospitalized with severe COVID-19 disease, because in a recent clinical trial it appeared to shorten the recovery time in some people. Side effects of remdesivir can include abnormal liver tests and reactions when the drug is given, such as low blood pressure, sweating and chills. Other studies are still going on to learn more about how safe and effective remdesivir is in treating COVID-19.
The drugs chloroquine and hydroxychloroquine, which are already used to treat malaria and some other conditions, are also being studied as possible treatments for COVID-19. Because they are already available to treat other diseases, some doctors are trying them in certain patients with COVID-19. These medicines can sometimes cause serious side effects, such as heart rhythm problems, so they should only be taken under the close supervision of a doctor. In fact, the FDA has cautioned against the use of these drugs to treat COVID-19 unless a person is taking part in a clinical trial. According to the FDA, “Hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19.” Clinical trials are still needed for doctors to truly know if these drugs are safe and effective.
People who have fully recovered from COVID-19 might want to consider donating their plasma at a designated blood collection center. People who have had COVID-19 have antibodies in their blood, and studies are looking to see if these antibodies might help fight the COVID-19 infection in people who now have the disease. The FDA has more information about how this type of treatment (known as convalescent plasma) might work, who can donate plasma, and where they can go to do this.
Many other drugs that might help treat or prevent COVID-19 are now being studied in clinical trials.
Despite claims now appearing online and in social media, it’s important to know that there are no supplements or other treatments available online or in stores that have been proven to prevent, treat, or cure COVID-19.
The WHO has a list of myth busters to debunk some claims you may have heard about how the new coronavirus may be transmitted or treated.
Bottom line: Scientists are learning more about the virus every day, and health experts are updating their information daily.
For the latest information, including more detailed responses to some common questions, please visit the following websites:
This story was first published on March 3, 2020 and is updated regularly.
Fonte: ACSÉ muito importante (sempre) procurar mais informações sobre os assuntos.
Nenhum comentário:
Postar um comentário