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NSW Health has comprehensive information, updates and extensive processes to carefully assess and manage patients with the novel coronavirus (COVID-19). Protective measures are also in place to prevent the virus from spreading.

Visit NSW Health COVID-19 for the latest information.

What are the symptoms?

Symptoms of COVID-19 include fever, cough, sore/scratchy throat and shortness of breath.

Other reported symptoms of COVID-19 include loss of smell, loss of taste, runny nose, muscle pain, joint pain, diarrhoea, nausea/vomiting and loss of appetite.

In more severe cases, infection can cause pneumonia with severe acute respiratory distress.

For more information see: Frequently asked questions –​ About Covid-19: What are the symptoms?

If your symptoms are severe or of an urgent nature, call 000.

Other options for seeking medical advice include:
  • your GP – it is important you phone ahead to your GP’s practice to discuss your symptoms instead of presenting directly to the practice
  • call the Coronavirus Health Information Line for advice (24/7): 1800 020 080
  • call Healthdirect hotline (24/7): 1800 022 222.

Attending the clinic

It is very important that you call the clinic ahead to discuss any symptoms (no matter how mild) and if you have been tested before presenting to the hospital or haematology outpatient clinic.
  • during business hours: contact your haematologist or BMT nurse
  • outside business hours: contact the haematology doctor on call via your hospital switchboard.

How do I get tested for COVID-19?

Samples for testing can be taken:
  • directly by GPs
  • at a range of private pathology sites across the state that are suitable for collection of COVID-19
  • public COVID-19/fever clinics at public hospitals across NSW.

A number of COVID-19 specific clinics have been set-up throughout the state. For an up-to-date list please refer to COVID-19 Clinics.

Haematology/BMT patient FAQs

Does my condition make me more likely to get COVID-19 or have a more severe form of COVID-19?

Patients with cancer are thought to be at higher risk than the general population of being infected with COVID-19. Those having active treatment for cancer are possibly at higher risk than those who are in remission. Patients who are in the first year after stem cell transplantation or cellular therapy could be also be at higher risk for complications if they get infected with COVID-19. Those who are beyond one year after transplantation and are still considered to have lower immunity (e.g. on steroids/ IVIg) and may remain at an elevated risk for complications.

What are other risk factors?

Risk factors for severe COVID-19 infection include age (above 60 years for men, above 70 years for women), diabetes, smoking, high blood pressure, chronic lung disease and heart disease. Other vulnerable groups include Aboriginal and Torres Strait Islanders, pregnant women, very young children and babies.

What should I do if a family member develops symptoms?

If family members develop an illness, it is important that they and you wash hands frequently. Keep surfaces clean and maintain distance from them if possible (e.g. sleep in different rooms, don't eat at a common table, use separate bathrooms where possible etc.) to minimize the risk of infection. We empathize that this can be very difficult for families with children - however, having a candid discussion with the family about recommended preventive steps could be helpful.

Do I need to wear a mask?

If you have symptoms of a cold — cough, runny nose, sore throat or shortness of breath — please wear a surgical mask (especially when in a clinic or a public place) to limit spread to others. For healthy individuals without any symptoms, wearing a mask in public just to protect yourself from coronavirus infection is not currently recommended due to limited mask availability.

Do we know how COVID-19 affects cancer patients?

We are still learning how this virus may impact those who have cancer. So far, data from China suggests that patients with cancer have a higher risk of complications.

If I have chemo or stem cell transplant scheduled, should I postpone it?

Please discuss this with your treating team as the best timing for your treatment would depend on your individual circumstances. Generally speaking, if you have no symptoms, feel well and have had no contact with anyone diagnosed with COVID-19, the treatment may be able to continue without interruption as determined by your doctor. However, there may be other factors including the capacity of the hospital and availability of key departments involved in your care (e.g. intensive care beds) which may influence whether your treatment is able to proceed. If your treatment needs to be rescheduled you will be advised by your doctor.

Who should get tested for COVID-19?

Blood and marrow transplant recipients (patients)

The BMT+CT Network recommends all recipients (autologous or allogeneic) receiving a stem cell transplant are screened and tested for COVID-19. Discuss with your treating doctor or nurse the best timing for this to occur.

Donors

Donors​ are initially screened for COVID-19 risk by a questionnaire as part of the work-up process.

The BMT+CT Network also recommends routine testing of all NSW donors for allogeneic transplants and where possible overseas and interstate donors for COVID-19. Testing should done in a way that ensures that the results are back prior to the recipient (patient) starting conditioning. It is recommended donors self-isolate for at least 14 days prior to donation to avoid the risk of exposure to COVID-19.

In general

Criteria for testing is frequently being updated to reflect the rapidly changing situation of the COVID-19 pandemic. For the most updated COVID-19 testing recommendations, please visit the Frequently Asked Questions.

Should I keep my follow-up appointments, or is it better to avoid the hospital for the time being?

It is important for your health that you receive regular follow-up from your treating team and there are many options other than attending in person at hospital. Your treating team will be conducting remote consultations (phone/video) where possible. In some cases you will need to see your treating doctor in person and you will be contacted by the treating team if this is required.

My friends/relatives would like to visit me at hospital and they do not have COVID-19. Is it safe to do so?

We kindly ask hospital patients and their families to limit visitors (please check hospital/ ward requirements) to reduce transmission of the virus. Visitors must perform proper hand hygiene and respiratory etiquette as an extra precautionary measure to protect yourself, our staff and our other patients. We also remind people not to visit if unwell. We know this restriction can be challenging and we understand each family’s situation is different. For exceptional circumstances, we encourage families to speak to their family member's nursing team for further advice.

Please do not visit if:

  • you have a fever, sore throat, runny nose, cough or any other flu-like symptoms regardless of how mild the symptoms are
  • had close contact with someone who has been diagnosed with COVID-19 or is being self-isolated for suspected COVID-19
  • you have returned from overseas in the past 14 days
  • had contact with anyone who has recently returned from overseas.

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What is hand hygiene and respiratory etiquette?

Hand hygiene and respiratory etiquette are two terms that you may have heard of when you have heard about how to reduce your risk of COVID-19. This refers to washing your hands properly and often, and using proper sneezing and coughing practices (covering your nose and mouth with a tissue or coughing or sneezing into your upper sleeve and elbow).

What should I do about work?

You should be guided by the current advice from NSW Health and the Australian Government regarding restrictions for non-essential and essential workers. If you are well enough to consider returning to work as advised by your doctor, please consult current advice on the following websites:

If you are considered at greater risk of severe COVID-19 disease you should work your employer to reduce your risk of being exposed to COVID-19.

How can I deal with my anxiety over this virus?

It is most likely that this virus will be circulating in the community for some time, increasing the chances of infection. However, by washing your hands frequently, regularly disinfecting high touch areas in your home, physical distancing (including of family members if they are ill) and avoiding travel and crowded places, you can minimize the chances of contracting COVID-19. We also have a strong team of supportive care experts who can provide support as needed. Please see the resources section for organisations that provide support.

Can I get vaccinated against COVID-19?

At this point, there is no vaccine against COVID-19 but significant research has gone into developing a vaccine.

What do I do about other vaccinations?

BMT patients will be routinely given a post- transplant vaccine schedule 6 months after transplant or when their haematologist deems appropriate. As is the case for all our patients we recommend vaccination for influenza (for both the patient and family members/caregivers) — it is still circulating in the community and it is also a major cause of illness in patients with compromised immune systems.

Refer to the Agency for Clinical Innovation - Vaccination Record or Vax2Date App to ensure other vaccinations are up to date, in particular your pneumococcal vaccines. These vary depending on how far you are down the track from your transplant:
  • up to 3 doses of 13vPCV if you had your transplant less than 12 months ago
  • 23vPPV if you are at least 12 months post transplant – doses are due at 24 months post-transplant then boosters at 5 year intervals.

How many doses of the flu vaccine do I need - one or two doses?

It is very important that you are immunised for influenza especially given the current COVID-19 pandemic.
  • If you had your transplant less than 12 months ago, you need 2 doses of the flu vaccine given 4 weeks apart.
  • If you had your transplant more than a year ago, then you only require 1 dose of the flu vaccine.

Please note: You can be immunised for influenza even if you are have not yet reached 6 months post-transplant – please ask your GP to liaise with your treating doctor to discuss best timing.

BMT patients are eligible to receive flu vaccinations free of charge under the National Immunisation Programme (NIP)

There are multiple influenza vaccines available – which one should I be given?

For 2020, all influenza vaccines offered on the National Immunisation Programme (NIP) are quadrivalent (i.e. provides protection against 4 different strains of flu).
  • Your age will determine which of the influenza vaccines available for 2020 would be most appropriate for you.
  • For those 65 years old or older, the adjuvant influenza vaccine is preferred (Fluad Quad).

There are many different types and brands of flu vaccines available. This Australian Government website has updated information for you and GP regarding which flu vaccine would be best suitable for you. Please discuss with your GP or treating team.

COVID-19 general FAQs

If you have a smartphone, download the Australian Government “Coronavirus Australia” app or join the Coronavirus What’s App group for up to date information and advice. Refer to Resources for additional guidance.

What are the symptoms?

Patients may have fever, cough, runny nose, shortness of breath and other symptoms. In more severe cases, infection can cause pneumonia with severe acute respiratory distress. Less common symptoms also include headaches, extreme fatigue, diarrhoea, abdominal discomfort without any respiratory symptoms or fever.

What is the difference between COVID-19 and the flu?

The first symptoms of COVID-19 and influenza (flu) infections are often very similar. They both cause fever and similar respiratory symptoms, which can range from mild through to severe disease, and sometimes can be fatal. Both viruses are also passed on in the same way, by coughing or sneezing, or by contact with hands, surfaces or objects contaminated with the virus.

As a result, the same public health measures, such as hand hygiene (hand washing), good respiratory etiquette (coughing into your elbow or into a tissue and immediately disposing of the tissue) and good household cleaning are important actions to prevent both infections.

The speed of transmission is an important difference between the two viruses. Influenza typically has a shorter incubation period (the time from infection to appearance of symptoms) than COVID-19, which is up to 14 days. The proportion of people with severe disease also appears to be higher for COVID-19 than influenza. While most people have mild symptoms, approximately 15% of people have severe infections and 5% require intensive care in a hospital ICU.

How can I reduce my risk of contracting COVID-19?

  1. Wash hands often with soap and running water, for at least 20 seconds. Dry with paper towel or hand dryer.
  2. Avoid touching your eyes, nose or mouth.
  3. Cover your nose and mouth with a tissue when you cough or sneeze. If you don’t have a tissue cough or sneeze into your upper sleeve or elbow.
  4. Buy an alcohol-based hand sanitiser with over 60% alcohol, if available otherwise use soap and water to wash your hand regularly
  5. Isolate yourself at home if you feel sick. If you take medication ensure you have adequate supplies.
  6. Clean work and food preparation areas thoroughly before use.
  7. Continue healthy habits: exercise, drink water, get plenty of sleep, and now is the time to quit smoking. Call the Quitline on 137 848.
  8. Shaking hands should be avoided!
  9. Apply rigorous physical distancing:
    • work from home if possible
    • avoid contact with individuals with a known diagnosis of COVID-19 or has had any exposure to an infected patient
    • avoid anyone who has returned from overseas, regardless of location, in the last 14 days
    • do not visit parents, grandparents or friends over 60 unless essential
    • consider online shopping and/or medication deliveries – these should be left at the door to minimize contact.
Other practical tips for managing your health during the COVID-19 pandemic:
  • phone your GP first if you need medical attention - they will tell you what to do.
  • have your medical consultations by telehealth or by phone if your specialist is able to.
  • get the flu shot
  • ensure you have adequate prescription and over-the-counter medications.
Hospital reminder: We request all patients and family members to be calm, kind, patient and courteous to all hospital employees at all times, especially in this stressful and difficult health crisis when a lot of rapid changes are needed to counter and manage the disease. Abusive and aggressive behaviour will not be tolerated.

Resources

Document information

Developed by

  • Agency for Clinical Innovation
  • Blood and Marrow Transplant and Cellular Therapy Network (BMT+CT) based on guides developed by Royal North Shore Hospital
  • BMTSANZ
  • NSW and Australian Government
  • A/Prof Julia Maclean
  • Oncology/ENT speech pathologist at St George Hospital, Sydney.

Consultation

  • Blood and Marrow Transplant Programs of NSW
  • Clinical Excellence Commission (CEC).

Endorsed by

Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning.

For use by

  • BMT / Haematology patients and donors
  • Post of ACI and Cancer Institute websites. ​​​​​​​
Page Updated: Wednesday 10 June 2020
Contact page owner: Health Protection NSW