Covid19: Advice to multiple myeloma patients

Danielle Barron ReportsWhat do we know about the virus?

• Covid19 is the illness caused by a novel coronavirus, which originated in China in late 2019. Because it’s a brand new virus, none of have immunity to it, making it very infectious.
• The main symptoms are fever or chills, and respiratory symptoms such as a dry cough. Other symptoms people have reported include headache and aches and pains. Unlike the seasonal flu, the symptoms come on gradually. Some people may be positive for the virus but have no symptoms.
• Some 80% of people who contract the virus will have a mild to moderate illness, but some 20% will have more severe disease and may have to be hospitalised. About 5% will require critical care.
• Data from areas where they have been large outbreaks such as China and Italy suggest certain categories of people may be more vulnerable to complications of the virus, including pneumonia. This includes those aged over 70, those with underlying conditions such as lung disease, heart disease, diabetes, and those who are immunocompromised, including those who have or have had cancer, or are being treated for it.

According to the World Health Organisation: “People can catch COVID-19 from others who have the virus. The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales. These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose, or mouth. People can also catch COVID-19 if they breathe in droplets from a person with COVID-19 who coughs out or exhales droplets. This is why it is important to stay more than 1 meter (3 feet) away from a person who is sick.”

What does the virus mean for people with multiple myeloma?

• Multiple myeloma patients are well aware of the need to reduce their risk of exposure to infection due to their immunocompromised state.
• Cancer patients appear to be at increased risk for complications from Covid-19. A small study published in The Lancet in mid-February 2020 patients with cancer might have a higher risk of COVID-19 than individuals without cancer, while the authors also found that patients with cancer had poorer outcomes from COVID-19. This was a very small study, however, and scientists are still finding out how the disease impacts different groups of people.
• This DOES NOT mean every patient with cancer will definitely contract Covid-19, nor that they will definitely have a poorer outcome. However, they are considered a vulnerable group and should take extra precautions during this time.
• Those with multiple myeloma, due to the nature of their disease and treatment, may be at particular risk.

Dr Steve Pergam, a clinical and infectious disease researcher at Fred Hutchinson Cancer Research Centre in the United States said: “Patients with haematologic [blood] malignancies we believe will have the biggest risk,” he said. “Also, patients who are in active chemotherapy and bone marrow transplant patients. Those are the ones with the most profound immune deficits.”

What can I do to prevent myself from getting Covid-19?

• The same things everyone else is doing – hand hygiene, cough etiquette, and social distancing. People are being advised to stick to their own family unit. Multiple myeloma patients should adhere strictly to these recommendations.
• If you have symptoms such as fever (high temperature), coughing or difficulty breathing, self-isolate immediately and call your GP as soon as possible. He or she will arrange a test for Covid-19.

How will this affect my treatment for multiple myeloma?

• It shouldn’t. You should keep your normal hospital appointments, unless you are contacted to reschedule.
• Hospitals are reorganising their services to deal with the expected surge in Covid-19 patients
  but cancer treatment is an essential service and will not be disrupted in as so far as is possible.
• If you are experiencing symptoms such as fever, shortness of breath, or cough before attending an appointment, do not go, but instead call your GP and explain your symptoms.
• The important thing is to keep well – hydration, nutrition and exercise are still key.

  HSE/National Cancer Control Programme advice on coronavirus for those with cancer can be found HERE.