As the world reopens-what is okay vs. not okay?

[Roz]

I have been thinking about this nonstop.

In my state, Massachusetts, they will begin to open up some retail stores, and restaurants with outdoor seating. 

Supposedly, people will be social distancing and wearing cloth/paper masks.

How do we know what is okay to do, vs. not okay?

For example, if you go to the beach and stay at least 6 feet apart from others, you are okay? But if you need to use the restroom, are you okay to do that?

What about if you sit out on someone's back deck (let's say elderly parents), and wear a cloth mask. Is that okay? Again, what if you have to go inside to use the bathroom? How long can you sit out?

I have STAGE IV NSCLC and I know there's no way I want to get COVID. However, on a daily basis, my husband goes to work and wears a mask to see people for eye exams. But, he grew a beard during the pandemic and won't shave it. Is he safe? Am I safe when he comes back home?

These and so many more questions keep popping into my head. The biggest one is, how do I keep myself safe but be reasonable? 

 

To anyone that responds-thank you!!!

 

Best, 

Ro

[Tom Galli]

Ro,

That is a very good question and tough to answer also. The best answer will come from your doctor. But, since this virus point of attack is the lungs, here are some general principles one can use to construct a useful response.

If one is in active chemotherapy, radiation therapy or immunotherapy such that red and white blood cell counts are diminished, I would think it best to isolate and take all measures to protect from COVID exposure.

If one is recovering from thoracic surgery without adjuvant chemotherapy, then seek surgical guidance on COVID exposure.

If one has recently completed the aforementioned treatments and is still having scheduled blood work and or monthly scans to check for recurrence, then isolation and protection against COVID exposure is suggested.

If one has a compromised immune or pulmonary system as a residual side effect from lung cancer treatment, then continued isolation is suggested.

If one is NED from treatment but has a pre-existing condition like COPD, heart disease, diabetes and the like, then continued isolation may be prudent.

If one is NED, no longer in active treatment, and has functioning immune and pulmonary systems, there may be an opportunity to participate in reopening of activities. But, I would suggest avoiding crowds, wearing a mask, and practicing strict social distancing.

I wouldn't know about facial hair and COVID transmission probability. Logic suggests however that facial hair possesses the same properties as the hair on one's head and no one is suggesting removing hair as a way of reducing exposure. My wife returned to work also. She is an RN who works as a nurse injector. She positions a change of clothes in the laundry room and removes her scrubs in the laundry room to wash before entering the house after work. She wears a mask at work but her customers unmask during treatment. She also wipes everything down with a bleach solution that enters the house including mail, Amazon boxes, groceries, and fresh fruits and vegetables.  We do not use laundry bleach but buy commercial bleach (much stronger concentration) at the hardware store. Here is how we mix our concentration. She mixes enough to produce a gallon and uses a spray bottle for application.

Stay the course.

Tom

[Deb W]

Hi Ro & Tom:

I have been very concerned about this as well.  I now have Stage IV NSLC.  My surgery was for Stage 1B with no treatment other than surgery in 3/2019.  It turns out the cancer is now in couple of lymph nodes and there is pleura involvement.  Yet, in October there  was no evidence of disease.  This doesn't sound slow growing to me.   I'll begin my second round of chemo on Tuesday.  My son is moving back to Illinois and I have two grandchildren ages 2 and 3...I can't wait to see them, but I worry about COVID.  I am going to ask my oncologist what he thinks.

[Rower Michelle]

Hey Ro, 

I'm totally with you, I want my life back. So what does that look like???  As you know, I'm Stage IV as well, but stable, taking targeted therapy.  My lab work looks perfect (ironically it's better now that what it was when I was "healthy").   

My husband works for UPS in a warehouse with mostly youngsters (under age 25).  We've got a similar procedure to Tom and Martha. Tim has the laundry room designated for decontamination.  Here's something interesting his PCP has recommended: low dose, once a week hydroxycholoronique.  The PCP was concerned about Tim's exposure to all these young fearless kids and my condition.   The idea being if he becomes exposed, the illness duration would hopefully be mild and brief.   On Tuesday he heads off for an antibody test and we'll go from there.   The PCP has found an antibody test that he's finally satisfied with, the results so far are stunning.  Ten percent of the "healthy" people tested came back with antibodies.  Fifty percent of those people who presented with symptoms  between December and March came back positive.  So 60% of patients tested in  this PCP's practice had COVID antibodies.  I believe the virus has been circulating around the US in late Nov/Early December, where we were blissfully unaware.  

In our county, the virus is dwindling, only 3.9% of the tests are coming back positive.  I am going to dip my toe into civilization this week.  I've got a haircut where I will wear a mask and a dental appointment.  I'm also going to move my boat back into the boat yard.  Not saying I'm going back to rowing, but I think I'll be able to get back out there soon. I need something to look forward to with all our trips canceled for the rest of the year. 

We did visit with some friends outside at a lake in lawn chairs, eight feet apart.  They've in a similar position to us and are very cautious.   I felt super comfortable being outside visiting with them.  Church is a totally different story.  Services resumed (with singing, but no communion) about three weeks ago.  Shockingly, no one is wearing a mask.  That to me is too risky.  

I guess it comes down to what your doctor thinks and what's trending in your community.   I think we can all agree, this is getting old, but one thing we have in common is that we are survivors willing to do whatever it takes......   

Michelle 

[LUNGevityKristin]

This article is not specifically for lung cancer survivors but it gives a risk level to common summer activities.  We found it very helpful for what we are willing to do this summer as things open back up.  https://www.npr.org/sections/health-shots/2020/05/23/861325631/from-camping-to-dining-out-heres-how-experts-rate-the-risks-of-14-summer-activit

[Roz]

Thanks for this article!

I appreciate it!

 

Ro

[Roz]

Tom,

Thanks for your suggestions. My oncologist said to continue to isolate. I am not in treatment but I'm waiting for a trial due to continued progression.

Makes sense to keep at least 6 feet away and keep a mask on outside. I think we will know better as the world opens back up and where the virus levels go up.

I'm hoping to get some beach time in and plan to be as far as I can from others while there. Outdoor dining doesn't seem "safe enough" yet to me. 

I appreciate your help. 

Be well,

Ro

[Roz]

Michelle,

I agree with everything you said. I will also take a very cautious approach.

I plan to try out the beach this summer and go from there. This is tough on so many levels, but knowing there's others out there really helps.

I'm still waiting for a trial. It has been a long wait. 

I'm so glad your treatment is working!! Keep it up!!

 

Best,

Ro

[Roz]

Deb W,

If you are in treatment I'm guessing your oncologist will suggest you continue to isolate.

It's better to be too cautious!

Hoping your chemo treatment works for you!

 

Best,

Ro