The ways we need to live our lives in the midst of this global COVID-19 pandemic is changing daily as federal and provincial governments ask us to hunker down, schools and businesses are shutting down or moving to virtual settings. We continue to hear every day from Canadians affected by blood cancers about how they should navigate their treatment and care in this confusing time. 

You asked and we’re responding. To pick up from this previous post, we are tackling some more questions for you today.  And remember, we’re here for you!

What is the difference between self-quarantine and social distancing, and shelter-in-place? What kinds of activities are permitted for each of these? 

Self-Quarantine: People who might have been exposed to the new coronavirus COVID-19 should practice self-quarantine by isolating themselves from other people. This includes anyone who has been out of the country and anyone awaiting COVID-19 lab results.  

To stay safe, you must remain in self-quarantine for at least 14 days to make sure you are not sick. You should stay home and stay at least six feet away from others in your household and do not enter any public areas where you risk exposing other people.  Be certain your doctor is aware of your exposure and your need to self-quarantine.  

To protect family members, you should avoid physical contact, wear a mask, and clean all surfaces you come in contact with.  The virus is spread by droplets, (saliva, nasal secretions, sneezing) and can remain on hands and surfaces leading to exposure of others.  If you’re self-quarantined in a building with common spaces, stay out of those areas. Your doctor will advise you of the length of time you should self-quarantine.  

Social distancing: This applies to people who have not knowingly been exposed to somebody with the virus, but are taking steps to prevent the virus from spreading. Social distancing involves deliberately avoiding crowds, keeping at least six feet of distance from others, and generally remaining away from others. Working from home, closing schools, conducting classes virtually, and restricting businesses to only what is considered essential are all part of social distancing. Conferences, sports events and concerts have all been cancelled. 

While practicing social distancing, you can still go outside to take a walk, work in your garden or enjoy the fresh air on your back porch, but avoid crowded areas. If you live in an apartment, you should be conscious that all surfaces that other people touch (elevator buttons, door handles, and communal washing machines) may possibly have been touched by someone with the virus.  You can wear gloves, touch with something that you can throw out afterwards (such as a paper towel), and ALWAYS wash your hands thoroughly when coming back inside.  

Shelter-in-Place: This emergency measure requires you to stay in your home unless running out for essential items. You should especially follow the information above for avoiding communal surfaces, and if you cannot remain more than six feet from another person (e.g. grocery store check-out) consider wearing a mask.  This is primarily to protect others if you are asymptomatic but have the virus.  

Everyone should be conscious about avoiding touching their eyes, nose or mouth with their hands if they have touched a communal surface.  

I have a blood cancer and still have to go to work, what should I do? 

People living with a blood cancer, people in remission from a blood cancer, and blood cancer survivors are not at greater risk of catching COVID-19. Right now, everyone is at risk, but your diagnosis might put you at a greater risk of getting sicker if you do get the virus. You should be particularly vigilant about precautions such as hand washing and avoiding crowds, and touching surfaces others touch.   

We know that people who are immunosuppressed may get sicker if they contract COVID-19.  If the nature of your job makes social distancing difficult and working from home is not an option for you, you should discuss alternatives with your employer, such as working in areas of the facility where you are not physically interacting with potentially infected individuals. Remember, asymptomatic people may still spread the virus.  It is particularly important that you practice social distancing.  You should be diligently following Health Canada guidelines:  being strict about regularly cleaning surfaces that are frequently touched, not touching your face, and strict hand washing.  

As a caregiver, what precautions do I need to take when caring for my loved one who is in treatment or is a survivor of a blood cancer? 

You should take the same precautions as we would advise for a person with a blood cancer: diligently wash your hands with soap and water for 20 seconds and limit your exposure to potentially infected individuals by practicing social distancing. 

Should I be concerned about drug shortages? 

To date, drug shortages are not presently a concern for blood cancer medications but this could change.  We continue to monitor the situation and will provide updates if we learn of any.     

If I need to get treatment with blood products (red blood cells, stem cell rescue, and platelets) should I be concerned about possible contamination? 

In healthcare settings across Canada, donated blood is a lifesaving, essential part of caring for people being treated for many conditions, including blood cancers. The need for donated blood is constant, and Canadian Blood Services and Héma-Québec are open and in need of blood donations.  

Health Canada encourages people who are well to continue to donate blood if they are able, even if they are practicing social distancing because of COVID-19. Canadian Blood Services and Héma-Québec are taking extra precautions to keep donors and staff safe, including social distancing of donor spaces, thoroughly adhering to environmental cleaning practices, and asking donors to make donation appointments ahead of time.   

At the current time, the blood supply is felt to be safe.  We will continue to monitor the situation.  You should discuss the potential risks with your doctor.  

After testing positive for coronavirus, how long do I have to remain in isolation? 

First, you should discuss this with your doctor and care team, as each case might be different. Following guidance from Health Canada, you should be prepared to remain in self-isolation for at least 14 days if you have been diagnosed with COVID-19.   

I’m getting a stem cell transplant or bone marrow transplant but my donor lives overseas – now that there are travel bans everywhere what do I do? 

Canadian Blood Services Stem Cell Registry is a member of the World Marrow Donor Association (WMDA) – an international network of registries and cord blood banks that share a global database where all potential donors and cord blood units are listed. As cases of COVID-19 continue to emerge across the world, WMDA launched a special COVID-19 webpage that is publicly available and updated regularly when new information is shared by member organizations, professional societies and courier companies. 

The stem cell registry will continue to coordinate searches in Canada, as well as other international registries to help get stem cells to people who need transplants. Any critical information is being communicated to the corresponding transplant centre and/or registry to ensure that life-saving products are safely transported. Stem cell donors are always screened for active infections and travel history.    

How long am I considered immunocompromised after I’ve completed treatment? 

You should discuss this with your doctor and care team as each individual case is different. We really don’t know the extent of immunosuppression after you complete treatment, so you should be taking all precautions, including practicing social distancing and avoiding crowds, diligent hand washing, and keeping surfaces clean.   

How do I manage disruptions in my treatment and care due to doctors working limited hours or being more difficult to contact? Can I still go to my clinic for regularly scheduled infusions? 

You need to discuss the risks and benefits with your doctor and care team, and discuss what your care regimen is going to look like for the next few months, and what adjustments can safety be made without jeopardizing your treatment and health. For non-critical appointments, more doctors are using virtual options. 

Can you discuss risks and benefits of wearing masks, gloves and respirators? 

N95 respirators and surgical masks (face masks) are examples of personal protective equipment that are used to protect the wearer from airborne particles and from liquid contaminating the face. Health Canada is advising the public, as well as healthcare professionals, to use caution when considering the use of homemade masks to protect against the transmission of COVID-19. 

Health Canada does not recommend the routine use of these masks outside of workplace settings if you are a healthy individual. Most often, spread of respiratory viruses from person-to-person happens among close contacts (within six feet). Instead, take everyday preventive actions to prevent the spread of respiratory viruses, such as avoiding people who are sick, avoiding touching your eyes or nose, and covering your cough or sneeze with a tissue. People who are sick should stay home and not go into work or crowded public places, or visit people in hospitals. 

Your health care provider may recommend you wear a mask if you are experiencing symptoms of COVID-19 while you are seeking or waiting for care. In this instance, masks are an appropriate part of infection prevention and control measures. The use of face masks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility). 

What treatments are currently available to treat COVID-19 and is a vaccine currently available to treat the disease?  Will vitamin C offer me protection against COVID-19?  

To date, there is no specific medicine recommended to prevent or treat COVID-19. However, those infected with the virus should receive appropriate care to relieve and treat symptoms, and those with severe illness should receive optimized supportive care. Some specific treatment, such as antiviral medicines and vaccines, are under investigation, and will be tested through clinical trials. 

If you have received a flu vaccine, it will not protect against coronaviruses. 

If I had a different type of Coronavirus, is this a protective factor and will it offer me immunity against novel coronavirus?  

There is still much we need to learn about this novel coronavirus and whether getting the infection or a related infection offers immunity from future infections.    

Can my pet get or transmit COVID-19?

The current spread of COVID-19 is a result of human-to-human transmission. There is no evidence to suggest that pets or other animals play a role in transmitting the disease to humans. Scientists are still trying to understand if and how it affects animals. 

Pets contribute to our overall happiness and well-being, especially in times of stress. If you are feeling well (no symptoms of COVID-19) and are not self-isolating because of COVID-19 illness, spending time with your pet can contribute to keeping both you and your pet healthy. 

As a precautionary measure, Health Canada recommends that people with COVID-19 symptoms or those who are self-isolating due to contact with a COVID-19 case, should follow similar recommendations around animals as they would around other people. 

However, since animals can spread other diseases to people, it’s always a good idea to practice healthy habits around pets and other animals, such as washing your hands and maintaining good hygiene. You should avoid others touching your pet if you take the animal outside.   

It is not recommended that animals be tested for COVID-19 at this time.  

Is it possible to test negative and later test positive? 

A negative test result means that the virus that causes COVID-19 was not found in the person’s sample. In the early stages of infection, it is possible the virus will not be detected. If you have been exposed, you should still self-quarantine.  

For COVID-19, a negative test result for a sample collected while a person has symptoms likely means that a different type of infection is the cause their current illness. 

Please know that the Leukemia & Lymphoma Society of Canada remains open for business. Although our offices are closed, our staff are working from home. You should continue to contact our Community Engagement Managers at 1-833-222-4884 or by email.