That was the bottom line advice for MPN patients Drs. Ruben Mesa and Aaron Gerds at a Webinar session Tuesday. The session was sponsored by MPN Advocacy & Education International.
Masks, not gloves. Mesa, MPN specialist with the Mayo Clinic, and Gerds, MPN spcialist at the Cleveland Clinic, both advised patients to continue wearing masks when out and about, but said gloves were not advised. "It's not about your hands, it's about your face," Mesa said. Gloves may give people a false sense of security because germs can be passed if gloves come in contact with the face.
Mesa explained that COVID19 enters the body through the eyes, nose, and mouth. A mask can provide some barrier protection and remind wearers not to touch their faces. Use hand sanitizer before taking off masks, Mesa said. Wash hands frequently (20 seconds with soap and warm water.)
General health precautions probably sufficient for ET patients. Eating a healthy diet and even taking a multivitamin may be helpful to boost immunity, Mesa said. He also said that "adequate sleep is important to help immunity." He also suggested stress control measures like meditating, limiting news intake, and getting fresh air.
Gerds added that for ET patients, general precautions from the CDC are probably sufficient: Avoid exposure by making unnecessary trips, wash hands, and wear a mask where people are not social distancing.
Don't be afraid to go to the doctor. Mesa also said is is now generally safe to seek routine health care at clinics and doctor's offices as masks, gloves, gowns, and protocols are now more widely available and in use. (You may want to check with your local lab and doctor's office to see what kind of procedures before showing up for routine appointments or lab work.)
What if you get sick? If MPN patients do become sick with COVID19, they should call their hematologists, but NOT go off or reduce their regular dose unless a doctor tells them to, said Mesa. He also mentioned that interferon drugs may actually give patients an edge against some COVID19 complications.
Patients sick enough to be admitted to the hospital, Mesa said a hematologist needs to be consulted. Some hospitals give some patients heparin (a blood thinner) to reduce clot risks, and decisions to administer blood thinners (other than low-dose aspirin) should be made with a hematologist's input.
ET and COVID19: Lots of unknowns. Aside from practical tips, Mesa noted that there are still many unknowns about how COVID19 affects MPN patients. Gerds said that statistics on COVID19 and patients with blood ailments were being compiled by the American Society of Hematology (ASH), but that as of May 21, only 15 of 141 patients had been reported to its registry. For now, it is not known whether those with MPNs are at higher risk for getting sick or for getting a more severe infection if they do get sick.
The assumption in the face of these unknowns is that MPN patients probably have some increased risk in the pandemic, especially those who are sicker or are undertreated for their MPN, and that they are at higher risk from complications, specifically clots.
Gerds called clot risks "additive." That is clot risk increases with age, MPN, any viral infection, severity of the infection, etc. (I've talked about how ET patients should try to reduce controllable clot risks with healthy eating, exercise, getting vaccinations, etc. elsewhere on the blog.)
Gerds noted that ruxolitinib (Jakafi) and interferons are being looked at as a a treatment in the general population against the inflammation that attacks the lungs in some people with COVID19.
When will things get back to normal? Gerds said not until there is a vaccine for COVID19. He and Mesa noted that it was probable that any virus would be "killed virus," which is generally safe for ET patients.
Tuesday's Webinar may be posted on the organization's YouTube Channel for those who want to see the whole thing.
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ET is a serious disease that requires specialist care. Discuss anything you read here with your doctor. No comments promoting "alternative" or "natural" cures (yes, this includes Rick Simpson's Oil) will be published.