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Caring for someone with cancer has become even more serious because of the coronavirus pandemic. The person you care for may be at high risk of infection with COVID-19 because cancer and cancer treatments often weaken their immune systems. You may be at higher risk yourself if you are older or have an underlying health condition. Staying healthy protects you and the person you¡¯re caring for. That means taking extra steps to keep both of you from getting sick.

People with certain cancer types, including lymphomas, multiple myeloma, and most types of leukemia are at the highest risk for infections. These cancers cause changes that make the immune system unable to work as well as it should. People who have recently had surgery for cancer and those in active treatment who are getting chemotherapy, radiation, targeted therapy, or immunotherapy may also be at higher risk. Some treatments, such as stem cell or bone marrow transplants, involve giving high doses of drugs that may cause long-term weakening of the immune system. But most people who have finished treatment (especially if it was years ago) probably have an immune system that¡¯s back to normal.

If you aren¡¯t sure whether the person you¡¯re caring for has a weakened immune system, ask their health care team. It¡¯s also a good idea to find out if their insurance covers telehealth, and if the cancer care team is using it to help communicate with patients during this time.

Have a back-up plan ready in case you, the person you¡¯re caring for, or someone else in the household gets sick.

Lower the risk of illness

Stay home as much as you can and have contact with as few people as possible. Stay in touch with the cancer care team and be ready for possible changes to treatment plans. Read our list of questions you may want to ask.

Take these extra steps to protect yourself and the person you¡¯re caring for:

• Don¡¯t travel. Follow your state and local rules about traveling and leaving your home. Avoid crowds and public places. Go out as little as possible. Ask the cancer care team if medical appointments should be kept or postponed. If you do need to go out, take hand sanitizer with at least 60% alcohol to clean your hands and then wash with soap and water when you get home.
• If the doctor wants to keep treatment appointments, only one caregiver should go along. No one who is sick or has any symptoms should go to a cancer treatment center. Be prepared to be screened at the door or to have to wait outside because some centers may not allow caregivers in the building at all.
• At home, use household disinfectants regularly on things that you touch a lot, such as door handles, cell phones, remote controls, computer keyboards, and any items that are used by other people.
• If you have to go out, wash your hands with soap and water as soon as you get home, wipe down the items you¡¯ve brought home (including your purse, wallet, and cell phone), and wash your hands again after wiping them down.
• When at home, wash your hands often with soap and water for at least 20 seconds, especially before eating and before touching your face.
• Wash your hands after using the bathroom, blowing your nose, coughing, or sneezing.
• Wash your hands after touching animals, collecting trash, or taking out garbage.
• Wash your hands after touching items used by others.
• Read more about more ways to help someone with cancer lower their risk of infection.

If you¡¯ve been exposed to coronavirus

If you find out you¡¯ve been exposed to coronavirus, notify your doctor and the cancer care team of the person you¡¯re caring for right away. They will help guide you in your next steps.

If coronavirus symptoms develop

If you or the person you¡¯re caring for has symptoms of COVID-19, call your doctor and the cancer care team and let them help you. The most common symptoms that need medical attention are fever, cough, and feeling short of breath. Some people may also have diarrhea or nausea before these other symptoms occur.

Some symptoms are more serious and mean you need to get help right away. If you notice the following symptoms in either yourself or the person you¡¯re caring for and feel you need to go to an emergency room, call the doctor or 911 first. This way you, the person you¡¯re caring for, the first responders, the medical staff, and other people in the emergency room can be protected. Serious signs and symptoms of COVID-19 include:

• Trouble breathing or shortness of breath
• Constant pain or pressure in the chest
• New confusion or being hard to wake
• Bluish lips or face

If anyone in the household gets sick with mild symptoms and the doctor tells them to stay at home, follow the guidelines from the Centers for Disease Control and Prevention (CDC):

• Have the person stay in one room, away from other people, as much as possible.
• Have the person use a separate bathroom and bedroom if possible, and avoid sharing personal household items including dishes, utensils, towels, and bedding.
• If facemasks are available, have the person wear a facemask when they are around others.
• Have the person wash their hands often or use hand sanitizer with at least 60% alcohol if they cannot get up to use soap and water.
• Wash your hands often, especially after you¡¯ve been with the sick person, and avoid touching your eyes, nose, and mouth.
• Regularly clean all surfaces that are touched often, such as counters, tabletops, phones, and doorknobs.
• Wash laundry thoroughly. Wear disposable gloves while doing laundry if you have them. After you take the gloves off, wash your hands.

What else you can do

Almost everyone has some risk of getting sick from the coronavirus. But staying informed and having healthy habits can help. This goes for you as well as?the person you¡¯re caring for.

• Stay informed about local, state, and federal information to help guide your daily activities.
• Get plenty of sleep. The CDC recommends adults get between 7 and 9 hours each night.
• Eat a healthy diet, with lots of fruits, vegetables, and whole grains. Eat less refined grains, red meat (beef, pork, and lamb) and processed meat (hot dogs, ham, bacon, sausage, and some deli meats), desserts, high-fat dairy products, and fried foods.
• Drink more water, less sugary drinks, and less alcohol.
• Keep getting your regular amount of exercise. Add a little more if you can.
• Stay in touch with family and friends.
• Take care of your emotional health.

COVID-19 and Cancer ECHO for Cancer Caregivers?