Most people who get sick with COVID-19 experience a local infection in the cells that line the airways in the lungs. That triggers an immune reaction that eradicates the virus and allows recovery. Symptoms may include fever, cough and shortness of breath, but they are temporary.

The elderly and those with other illnesses such as cancer, heart disease, lung disease, and diabetes may have a dysfunctional immune system that leads to an uncontrolled immune response. This can lead to pneumonia, and severe lung damage from pneumonia can result in acute respiratory distress syndrome (ARDS), which in turn can cause septic shock. ARDS and sepsis are the primary causes of death in people with COVID-19.

Cancer patients should take the same precautions they/you are probably already taking and that everybody can do to avoid getting the flu or a cold, according to the CDC and WHO:

  • 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.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash, or sneeze into your elbow.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Stay home when you are sick.
  • Avoid close contact with people who are sick. Keep a distance of at least 3 feet (1m) from someone is coughing or sneezing.

The American Cancer Society recommends the following things to help prevent infection and illness when one’s immune system is weak due to cancer and/or cancer treatment:

  • Wash hands often with soap and warm water. Be sure to wash hands before eating and before touching face or mucous membranes (eyes, nose, mouth, etc.).
  • Wash hands after using the bathroom, blowing nose, coughing, or sneezing.
  • Wash hands after touching animals, collecting trash, or taking out garbage.
  • Wash hands after visiting a public place or touching items used by others.
  • Carry an alcohol-based hand sanitizer to clean hands when you’re out.
  • Use moist cleaning wipes to clean surfaces and things that you touch, such as door handles, ATM or credit card keypads, and any items that are used by other people.
  • Avoid large crowds of people such as at schools, travel, shopping, social events, and public gatherings. If you have to be around a crowd, wear a mask.
  • Stay away from anyone with a fever, the flu, or other infection.
  • Get a flu shot every fall. Encourage other members of your household to get it, too. DO NOT get the nasal mist flu vaccine. Ask your doctor if you should get any other vaccinations , such as the pneumococcal vaccine to prevent pneumonia, or Hepatitis B vaccine to prevent Hepatitis B.
  • If your cancer care team has told you that you have a weakened immune system and that you are at high risk for infection, you might be advised to stay away from children and limit visitors during the respiratory virus season.
  • Bathe every day. Be sure to wash feet, groin, armpits, and other moist, sweaty areas.
  • After bathing, look for redness, swelling, and/or soreness where any tubes or catheters go into your body.
  • Wear gloves when gardening and wash hands afterward.
  • Brush teeth twice each day using a soft toothbrush. Ask your doctor or nurse if it’s OK to gently floss your teeth. Tell them if your gums bleed. Your doctor or nurse may give you a special mouthwash to help clean your mouth. Do not use alcohol-based mouthwashes.
  • Keep groin and anal areas clean. Use soft moist tissues such as disposable baby wipes or bathroom towelettes after using the toilet and anytime you notice irritation or itching. Tell your doctor about any bleeding, redness, or swelling (lumps) in this area.
  • Do not get manicures or pedicures at salons or spas (you can use your own personal and well-cleaned tools at home). Do not use false nails or nail tips.
  • Do not wade, play, or swim in ponds, lakes, rivers, or water parks.
  • Do not get into hot tubs.
  • Wear shoes all the time – in the hospital, outdoors, and at home. This helps you avoid injury and keep germs off your feet.
  • Use an electric shaver instead of a razor to avoid cuts and nicks. Do not share shavers.
  • If you cut or scrape your skin, clean the area right away with soap and warm water. Cover the area with a clean bandage to protect it. If the bandage gets wet or dirty, clean the area and put on a new bandage. Tell your doctor if you notice redness, swelling, pain, or tenderness.
  • Prevent constipation and straining to move your bowels by drinking the recommended amount of fluid each day.. Exercising each day can help, too. Ask your doctor how much fluid you should drink daily and if it is safe for you to exercise. Let your doctor or nurse know if you are having bowel problems. If needed, your doctor may give you a bowel softener medicine. Do not put anything in your rectum, including enemas, thermometers, and suppositories.
  • Women should not use tampons, vaginal suppositories, or douche.
  • Use water-based lubricants during sex to avoid injury or abrasion of the skin and mucous membranes. Use latex or plastic condoms to reduce the risk of sexually transmitted infections.
  • Do not keep fresh flowers or live plants in your bedroom.
  • Do not clean up droppings from your pets. Do not clean bird cages, litter boxes, or fish or turtle tanks. Have someone else do this for you.
  • Do not touch soil that may contain feces of animals or people.
  • Do not change diapers, but if you do, wash your hands very well afterward.
  • If you use disposable gloves to avoid touching things like soil or waste, wash your hands after you take off the gloves. (Gloves can have tiny holes that you can’t see.)
  • Stay away from all standing water, for example, in vases, denture cups, and soap dishes. If you store your dentures in a cup, wash the cup and change the water with each use.
  • Use hot water or a dishwasher to clean your dishes.
  • Do not share bath towels or drinking glasses with anyone, including family members.
  • Stay away from chicken coops, caves, and any place where dust from the ground is being blown into the air, such as construction sites.
  • Talk with your doctor or nurse if you are planning any travel during this time.

As a health/fitness professional, make sure that you cancel sessions if you are feeling under the weather. In your gym or studio, use antibacterial wipes on surfaces and mats, provide clean towels to place on top of shared equipment, and encourage your client to drink from their own water bottle rather than a public water fountain.

***Also remember that those who have had lymph nodes removed and/or irradiated will have a higher risk of lymphedema when their body is fighting an infection or their immune system is compromised.