Important Information on COVID-19 (Coronavirus 19) for Our Patients

We can’t hear this important advice often enough. Dr. Pagel riffs on what Dr. Byrd, the CDC and the WHO have been saying in his wise counsel for CLL patients.

Swedish Cancer Institute Center for Blood Disorders and Stem Cell Transplantation

Important Information on COVID-19 (Coronavirus 19) for Our Patients

The COVID-19 (Coronavirus 19) is potentially more dangerous to patients with blood cancers and disorders due to the deficits in their immune systems. We want you to know that your health and well-being is our number one priority at the Swedish Cancer Institute. We would like to partner with you to keep you healthy and safe.

COVID-19 is a “novel” or “new” virus. This means no one has built up antibodies in their lifetime to protect themselves against this particular virus. However, patients with blood disorders are at increased risk for having a more significant illness when exposed to COVID-19.  Many of our patients are considered at higher-risk for severe illness due to COVID 19 due to their age.  Additionally, many of our patients may have “low blood counts”.  All blood disorder patients are at some increased risk of serious illness with this virus, no matter what phase of treatment you are in or even if you are a cancer survivor. Additionally, your age and any other health issues may increase your risk of illness. If you have questions that are not answered by this document please don’t hesitate to contact your team nurse. The electronic medical record may be a good way to communicate with your medical team at this time.

Finally, we recognize that COVID-19 is an additional stress in your life that may be causing anxiety, fear, loneliness, and other emotional as well as practical concerns. Please contact your local oncology social work department to see what help they might offer.

To help protect you during this time off the COVID- 19 outbreak, we have compiled a list of recommendations for patients and we would like to share them with you below:

1. Avoid anyone with direct exposure to an infected COVID-19 person or symptoms of this virus, at this time, it is not clear how long patients with COVID-19 remain infectious.
2. Avoid anyone returning from personal airline travel, regardless of location, or returning from a high-risk area, regardless of mode of transportation, for at least 14 days.
3. Frequent handwashing is crucial. Avoid door knobs and handles in public places or use a tissue to limit contact with surfaces. Do not touch your face, eyes, mouth, or ears.  Avoid handshaking; rather practice foot tap or elbow bumps as a way of greeting others, if needed. Carry hand sanitizer when travelling if you can.
4. If you work in a high-risk job such as teaching/supervising/interacting with children, service work where you are exposed to many individuals, direct health care providers (including physicians), consider taking a leave of absence or using your sick leave (after advice from your personal physician).  We are giving people with these high-risk activities notes to allow isolated work at home, off site, or in a place away from others.  If this is not possible, ask your employer if it is possible for you to have work isolated from these high exposure risks such as doing desk work.
5. Clean shared work surfaces at work after each use.  This includes wiping down the keyboard, computer mouse and phone with alcohol wipes or other sanitizing wipes (Lysol, etc). If you see someone not doing this, please remind them of it.  This is a very good practice at all times, but especially now.
6. All face-to-face group meetings of more than 10 (some would chose a lower number) people should be canceled.  Video conferencing as an alternative that should be considered.
7. Practice social distancing as the best way to limit the spread of disease, especially around anyone who appears ill or has a cough. Apply this principle at work, home, and in your social network.  It is a good idea to avoid large group events during the time of this pandemic including sports events, church, club meetings, weddings, family reunions, etc.
8. Encourage people not to come to work or to activities when sick!  Notify your healthcare provider or PCP if you have the symptoms of coronavirus COVID-19 (cough, muscle aches, shortness of breath and fever greater than 100.4º).  If in doubt about your symptoms or starting to get sick, please stay at home.
9. If you develop influenza or COVID-19 and have low immunoglobulins, we may be recommending that you receive IVIG therapy to replace this.  Application of IVIG in this setting can potentially help protect you from developing bacterial pneumonia as a complication following a viral infection. It will likely not help the COVID-19 itself.
10. Know how you can help others with our good advice.  We are all thinking of our friends and loved ones at this time as well.  The recommendations above are what we are telling others who ask us.  If you have parents, grandparents or friends that are older than 70, our advice would be to not visit them during the next two to four weeks and encourage them to stay at home.  They should avoid contact with younger people (including children).  Children and young adults may have the virus without showing symptoms and pass it on to elderly patients at risk.  This is the biggest risk population for being harmed by the COVID-19 virus infection (older patients).
11. If you are not being treated currently, and have had stable blood counts, or if your disease is very stable (for example stable on same oral medicine for >6 months), regardless of your treatment status, it may be better to discuss with your doctor about postponing your routine follow up visits to your doctor for at least 1-3 months while the initial wave of COVID-19 infections are being dealt with. Hospitals or doctor’s offices are much more likely to have sick patients who could have this and we are trying to limit exposure to all patients.  We are following up with patients by phone in this setting to determine any new symptoms and when necessary having them get their counts checked.
12. Patients on active treatment that is given at the hospital or the treatment center or receiving treatment on clinical trials should still be seen as scheduled by their physician and health care team.

Check the CDC website regularly for the most accurate and up-to-date information.