With rising community concern about the novel coronavirus or COVID-19, Myeloma Australia would like to provide the following information detailing risks and preventative measures specific to the myeloma population.

The coronavirus family are known to cause a range of respiratory illnesses ranging from the common cold to more severe illnesses like Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). COVID-19 is the name that has been given to this particular outbreak of coronavirus that is thought to have originated in Wuhan, China in December 2019.

The name COVID-19 is derived from COronaVIrus Disease 2019.

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How is coronavirus (COVID-19) spread?

The virus is spread through droplets that are sneezed or exhaled by an infected person. These may land directly on the mouth, nose or eyes of another person or onto surrounding surfaces such as door handles and benches. It is then transmitted when someone touches these items and touches their nose, eyes or mouth. It is known that the virus can remain ‘live’ on surfaces. How long it survives varies depending on the material the surface is made from.

Symptoms of coronavirus (COVID-19)

Common Symptoms
  • Fever
  • Dry cough
  • Fatigue
Less Common Symptoms
  • Shortness of breath
  • Sore throat
  • Nasal congestion
  • Runny nose
  • Headache
  • Nausea and vomiting
  • Aches and pains
  • Diarrhoea
  • Red or irritated eyes
  • Loss of taste and/or smell
  • Skin rash or discolouration
Rare Symptoms
  • Difficulty breathing
  • Chest pain or pressure
  • Loss of speech
  • Loss of movement
    *If any of these symptoms occur, call 000 immediately

It is possible to contract coronavirus and not experience any symptoms. 80% of people with coronavirus will recover without needing any intervention. However, those that are most at risk of becoming very ill with the virus are the elderly. Some patients with an underlying medical condition such as lung and heart disease may also be at risk. People whose immune system is already compromised are also at risk, including patients with myeloma. The risk will vary according to their underlying disease severity and current medications.

How to prevent infections like coronavirus (COVID-19)

It is important to mention that while we are on high alert at the moment with this current outbreak, those living with myeloma should always be actively taking measures to prevent infections.

It may not be necessary to wear a face mask. Those that have symptoms of respiratory illness or are in the presence of someone with a respiratory illness and health care workers caring for those infected need to take this measure.

Strategies to reduce the risk of contracting COVID-19:

  • Stay home as much as possible
  • If it is necessary to go out, practice social distancing. This means remaining at least 1.5 metres away from anyone who is not from your immediate household.
  • Washing hands regularly and thoroughly with soap and water or alcohol-based hand gels
  • Maintain excellent food hygiene
  • Regularly and thoroughly clean commonly used items such as mobile phones, TV remotes and door/drawer handles
  • If being in the company of someone with a visible respiratory illness is unavoidable, try to remain at least 1.5 metres away from them to avoid droplet exposure
  • Have an annual flu vaccination and any other vaccines recommended by the doctor (note: the flu vaccine will NOT directly protect from coronavirus). Encourage family and friends to do the same

What to do if coronavirus (COVID-19) is suspected

If symptoms develop and there is concern that there may have been contact with COVID-19, self-isolate and contact the GP for guidance. It is important to call ahead to alert the clinic of the possible COVID-19 infection so they can properly prepare to ensure others aren’t put at risk.

If symptoms are those of a common cold and there has been no known exposure to COVID-19, self-isolate until symptoms resolve.

If experiencing a fever or shortness of breath (with or without a fever), contact the myeloma medical team for advice.

Any general questions about COVID-19 can be directed to the Australian Department of Health National Coronavirus Health Information Line: 1800 020 080

Travel

All international travel is currently on hold. If interstate travel is essential please do so under the guidance of the medical team.

Changes to treatment for myeloma

During this time of required social distancing many people will have noticed changes in the way hospitals are operating. Measures have been put in place to limit the necessity to go to a hospital to decrease the risk of exposure to COVID-19.

Most consultations with the doctor will be done by phone or video call and blood tests will be referred to local pathology centres where possible.

In some cases, those who were planned to have an autologous stem cell transplant will find this has been postponed. Autologous stem cell transplants, while very effective at treating myeloma, involve giving a very large dose of chemotherapy. This effectively wipes out the immune system until the transplanted stem cells have a chance to regenerate healthy infection fighting cells (approximately 2 weeks). Therefore, depleting a person’s immune system during a pandemic carries much higher risk than usual. It is also necessary to preserve hospital resources during this time to cope with increased demand and a depleted workforce. It is completely safe to postpone transplants for some people leaving space and adequate resources for those who are not in a position to wait.

It may also be appropriate to decrease the frequency or cease altogether some other treatments for myeloma if the disease is under good control and it is thought that the treatment might suppress the immune system too much.

Myeloma Australia’s Medical and Scientific Advisory Group lobbied the Pharmaceutical Benefits Advisory Committee (PBAC) to make special consideration for people with myeloma who have commenced or are about to commence induction therapy with bortezomib (Velcade®) in anticipation of an autologous stem cell transplant.

As of 1 April 2020, the PBAC have extended access to bortezomib for up to 6 months during the COVID-19 pandemic. The enables those people to remain on treatment until such time that they can have their transplant.

In some cases, it may also be necessary to limit the use of supportive care medications to keep people out of hospital as much as possible. This may mean that the usual infusion of bone strengthening medication or intravenous immunoglobulin is put on hold where safe to do so.

It is also possible that some hospitals may be changing the way they deliver medicines to allow for more treatments to be given in the home.

It is wise to be extra prepared for limited contact with the hospital. Requesting pathology slips ahead of time and ensuring there is enough medication in the house and repeat scripts are available is advised. Some hospitals and community pharmacies are posting medications to further reduce the need to leave the home.

Changes to clinical trials

In some cases, it has been necessary to delay the commencement of new clinical trials or pause the recruitment to existing clinical trials. Those currently on a clinical trial may also see some changes to the way they are run. The local medical team are best placed to answer any questions relating to specific clinical trials.

Looking after our mind, body and spirit

We are going to be in social isolation for quite some time, so it is important to pay extra attention to our physical and mental well-being. Some people find it helpful to set a daily agenda being conscious of dedicating time to:

  • Exercising outside (maintaining 1.5m from anyone from outside your household)
  • Drinking adequate fluid
  • Maintaining a healthy diet
  • Contacting loved ones via phone or video conferencing
  • Participating in mindfulness activities such as meditation or yoga. There are excellent videos on You Tube and apps to help with mindfulness activities.

There are many businesses continuing their services via virtual platforms. It may be possible to still seek support from physiotherapists or exercise classes online.

We appreciate that these are extremely trying times and invite anyone who would like to speak to an experienced Myeloma Support Nurse, you can do so in confidence Monday to Friday 9am – 5pm AEST by calling our Telephone Support Line: 1800 693 566

Further resources

World Health Organisation
Australian Government Department of Health
Beyond blue – Coronavirus Mental Wellbeing Support Service