COVID -19 FAQs FOR CHILDREN WITH CANCER

COVID -19 FAQs FOR CHILDREN WITH CANCER – GHANA

Coronavirus disease (COVID-19) is an infectious disease caused by the novel coronavirus. Worldwide, over 838,445 confirmed cases have been reported as at 31^st March, 2020 with over 41,355 deaths. In Ghana, 161 cases have been confirmed with 5 confirmed deaths. New cases are being diagnosed every minute. The situation is dire and will need us all to join hands to fight it. 

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness and are in the vulnerable group.

Is my child in the extremely vulnerable group?

This group includes all children and young people with the following:

• Undergoing active chemotherapy for any diagnosis
• Receiving treatment for leukaemia or lymphoma
• Patients undergoing active radiotherapy
• Receiving targeted cancer treatments eg imatinib

What should I do if my child is in the extremely vulnerable group?

Guidance from the literature recommends “shielding” for the extremely vulnerable group. These practices will protect the extremely vulnerable people from coming into contact with the coronavirus. These practices are as follows:

Shielding means:

• Strictly avoid contact with someone who is displaying symptoms of coronavirus infection (COVID-19). These symptoms include high temperature and/or new and continuous cough (See section on symptoms).
• Do not leave your house apart from essential medical visits to the hospital for treatment as advised by your own team
• Home visits from nurses who provide essential support should continue as advised by your own team
• Do not attend any gatherings. This includes gatherings of friends and families in private spaces for example family homes, weddings and religious services.
• Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
• Keep in touch using remote technology such as phone, internet, and social media with the health personnel.

Attn: Families and siblings of the patient should follow the strict rules about staying at home as recommended for the whole population.

Is my child in the vulnerable group?

This group includes all children and young people:

• Up to 6 months after completion of chemotherapy 
• Who have received radiotherapy to the whole abdomen or to the spleen
• Who are on long term maintenance steroids
• Who have completed treatment for cancer but have ongoing chronic lung, heart, kidney or neurological conditions

What should I do if my child is in the vulnerable group?

Current recommendations for the whole population should also be followed for children in the vulnerable group. It includes following strict rules about staying at home and staying away from others. Social interaction should be reduced to curtail the transmission of COVID-19 and social distancing is very important..

Social distancing means:

• Requiring people to stay at home, except for very limited purposes
• Closing non-essential shops and community spaces
• Leaving at least 2 metres in interactions with your neighbour

Siblings and other household members should also stay at home and stay away from others. Current advice recommends we should all be taking steps to stop social interaction between people in order to reduce the transmission of coronavirus (COVID19).

How is the disease spread?

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes

What are the symptoms?

The symptoms of this new coronavirus (COVID-19) include cough, fever, tiredness, shortness of breath, or flu-like symptoms, aches and pains, sore throat, diarrheoa. The current evidence is that most cases in children and young people appear to be mild.

Is treatment available?

There is currently no vaccine to prevent COVID-19 acute respiratory disease. The best way to prevent infection is to avoid being exposed to the virus. Anti-viral medications have not yet been shown to be effective against coronavirus.

How might coronavirus affect my child who is undergoing cancer treatment?

Children and young people undergoing cancer treatment have a weakened immune system which will make it harder for the body to fight off infections such as COVID-19.

It is important for children with cancer and their families to follow steps to protect themselves where possible.

What precautions should we take?

Following precautions are important for children and young people undergoing treatment and their families.

• Wash your hands often – with soap and water for at least 20 seconds. Use an alcohol-based hand sanitiser that contains at least 60% alcohol if soap and water are not available. This is particularly important after taking public transport.
• Try to help your child avoid touching their eyes, nose, and mouth with unwashed hands where possible
• Avoid contact with people who are known to be unwell          Try and cover your child’s cough or sneeze with a tissue, then throw the tissue in a bin and wash hands immediately after disposal.
• Clean and disinfect frequently touched objects and surfaces in the home and work environment

What should I do if my child develops a fever or any other symptoms?

You should follow the normal guidance for attending hospital if your child develops a fever. Your child will be assessed and treated as per your local hospital policy. If you are concerned that your child has symptoms of COVID-19 or has a known COVID-19 contact, it is essential that you inform the treating hospital before your arrival so necessary arrangements can be made.

What if someone in our household develops symptoms?

If other household members develop symptoms (either high temperature or a new continuous cough), the person should self-isolate for 14days. Staying at home for 14 days will greatly reduce the overall amount of infection the household could pass on to others in the community. 

Self-isolation does not apply to children undergoing treatment for cancer who will need to be assessed in hospital first if they develop symptoms. But inform your healthcare providers prior to arrival so that necessary arrangements can be made for the child.

Should my child continue taking oral chemotherapy?

It is recommended that your child’s chemotherapy should be continued.

In view of the escalating numbers of cases, children with cancer need to be closely monitored and the healthcare providers called in case he develops any symptoms. Stay home and stay safe.

Adapted from WHO and CCLG recommendations

Written by Dr Vivian Paintsil & Prof Lorna Renner