Can someone please help me with this question, having just watched the latest on how we should protect ourselves against catching corona virus the experts in this field mentioned the people at high risk, and who should self isolate, people with leukaemia was mentioned because of a compromised immune system, I just want to know should we be taking any care steps or just be careful. I work regular nights in the uk.
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I watched the same PM address, and noted the exact sound bite you are referring to. It’s unclear what sort of group they were talking about ... it may have been directed more at AML patients undergoing treatment, or recently diagnosed CML patients. They obviously can’t call out every disease and stage but of course when leukaemia patients were referenced it was hard not to notice.
The address did note people who would normally be advised to take the flu jab each year - and that would be us. But it would be a lot of other people too.
I’m not suggesting what was said was wrong, or right, but just that a short speech like that cannot capture the nuance of the situation for each patient group.
I would urge you to look at the guidance from the clinicians at iCMLf which is posted here.
The key piece of guidance is:
Therefore, we recommend CML patients under TKI therapy to be extremely cautious and to strictly follow the most restrictive measures suggested by health authorities of their respective countries, in order to avoid the risk of contamination and to prevent the spread of infection.
Personally, I am isolating myself and my family until there is more clarity on what is required. I may well end up overreacting, but with two small and vulnerable babies at home I am not going to take any chances that I don’t need to take and would be very relived to be wrong.
There is further guidance on the www.gov.uk website
Anyone with leukaemia regardless of the stage of treatment is classed as having a serious underlying health condition and is in the highest risk group.
The advice is to follow guidance for the over 70s in the meantime (i.e. social distancing) and further bespoke guidance will be issued by your GP next week.
I was on public transport on my way home from work today and a passenger sat behind me was continually coughing, so clearly voluntary self-isolation isn’t working. The irony is that I arrive home to find out the Prime Minister advises I am in the highest risk group and will have to self-isolate for at least the next 12 weeks. I will have to phone work tomorrow to tell them I won’t be coming in for the foreseeable future.
I am meant to have my 3 monthly hospital appointment next week and will run out of medication just after this, so hopefully my GP will provide further guidance on this.
These are really difficult times. Please keep in touch with each other using this forum and take care.
As a free society where our freedoms have long been tested by enemies we can see, it is hard to fight against an enemy you can not see. The Caronavirus is not new in and of itself. We have been plagued with virus induced pandemics throughout time. Only a few dozen years ago measles, mumps, smallpox killed millions. Polio rendered many crippled. Reading history, it was astounding what our ancestors lived with in the absence of modern medical care. In 1955, polio, for example was conquered with Jonas Salk's vaccine. Understanding of how the body develops immunity and fights invading pathogens exploded shortly after. Today we can de-code new virus' (as has been done with Covid-19) before an epidemic peaks. And we have learned much.
It is important to know that 99% of people who get infected with Covid-19 recover - fully. China is already recovering dramatically giving insight that this disease has a two month run. And we are coming into stronger sunlight. Young people especially children seem to be immune. There have been zero deaths of children under 15 due to Covid-19. This is unusual in that flu-like virus' affect the young and old alike. The RNA sequence of Covid-19 differs only slightly from that of other carona-like virus (of which flu is part). This is also interesting. Our ability to develop immunity against Covid-19 seems to prevent relapse and re-infection. In other words, as this infection moves through the population, we are getting inoculated. By this time next year, we will also see a vaccine.
In the mean time - it is important not to panic. Covid-19 is most dangerous against people with very weakened immune systems. Anyone undergoing chemotherapy of the traditional kind must be isolated from the general public during this time. Anyone with respiratory issues (smokers, COPD and similar) are particularly vulnerable - and just like they would be with flu. What kills is not covid-19, but the follow-on pneumonia enabled by covid-19's ravaging of the lungs membranes.
In the case of CML patients who are in deep remission - chances are our immune system is actually quite strong. First, as I mentioned in other posts, our blood system is largely brand new having been replaced as CML was killed off. Also - for those who have been pro-active with their nutrition - having plenty of blood level vitamin D, vitamin C and other vitamins and minerals is helping you resist viral infections even without any vaccine. For those who are just now starting TKI treatment and have high CML burden, this virus is a risk until your blood system returns to normal - but as it returns to normal, your blood system is brand new and strong. Keep that in mind.
I look forward to the day when I meet David, Sandy and others on this forum and shake their hands, without any fear of contagion. That day will come.
Just to say a massive thanks to you all for giving me your take on this strange, stressful situation every one is in, but yesterday’s broadcast by are prime minister with his advisers when they mentioned leukaemia just bought it home, where not out of the woods by a long way. Again many thanks and to all Cml members please look after yourself. Peter
Hi, I'm a newcomer to the forum! My husband has had a MMR for nearly eight years now, but obviously we were very concerned when we saw the advice last night, as he's also a teacher! We emailed his consultant and they replied saying at the moment there is very little specific data to go on and the numbers involved are very small, so in my husband's case the risk factor is not clear. It looks like it's dependent on your CML profile and my husband is also in his forties, so age is less of a factor for him. For now he's not self-isolating but is continually risk assessing.
The consultant did say many of their patients are self-isolating though. My husband is due to have an interim blood test in April because his medication has been dropped to 20mg per day and they want to check his BCR-abl reaction, but she said he should leave it for now because it's not wise to go to the hospital.
Please read the current advice from NCRI CML Subgroup pinned at the top of this page which I will update later today. We are certainly entering an era of profound behavioural change. There will be many challenges ahead for us all. I have included below a snip from the Imperial COVID19 response team who are advising the UK government. It may be an unsettling read but I think it better to try to understand the challenges ahead. It is not going to be easy for any of us, either for the short or longer term, but we must remain positive and hopeful that we will get through this, eventually!
Imperial College COVID-19 Response Team - 16 March 2020
Impact of non-pharmaceutical interventions (NPIs) to reduce COVID- 19 mortality and healthcare demand
Summary: The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic. Here we present the results of epidemiological modelling which has informed policymaking in the UK and other countries in recent weeks. In the absence of a COVID-19 vaccine, we assess the potential role of a number of public health measures – so-called non-pharmaceutical interventions (NPIs) – aimed at reducing contact rates in the population and thereby reducing transmission of the virus. In the results presented here, we apply a previously published microsimulation model to two countries: the UK (Great Britain specifically) and the US. We conclude that the effectiveness of any one intervention in isolation is likely to be limited, requiring multiple interventions to be combined to have a substantial impact on transmission.
Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely. Each policy has major challenges. We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.
We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism.
The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.................
We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.
Our analysis informs the evaluation of both the nature of the measures required to suppress COVID- 19 and the likely duration that these measures will need to be in place. Results in this paper have informed policymaking in the UK and other countries in the last weeks. However, we emphasise that is not at all certain that suppression will succeed long term; no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time. How populations and societies will respond remains unclear.
As the COVID-19 pandemic progresses, countries are increasingly implementing a broad range of responses. Our results demonstrate that it will be necessary to layer multiple interventions, regardless of whether suppression or mitigation is the overarching policy goal. However, suppression will require the layering of more intensive and socially disruptive measures than mitigation. The choice of interventions ultimately depends on the relative feasibility of their implementation and their likely effectiveness in different social contexts.
Read the full report here