This information is specific to Northwest Territories (NWT) cancer patients who may be receiving care at either an Alberta cancer centre and/or Stanton Territorial Hospital (STH). Your main source of information on COVID-19 and health is the Department of Health and Social Services website and their webpage on the Coronavirus.

The global COVID-19 pandemic is changing daily. We will update this information as things change.

As a cancer patient, am I more likely to get COVID-19?

At this point, we cannot be sure if cancer patients are more likely to get sick with COVID-19, but you may be at higher risk for more severe symptoms of COVID-19 if your immune system is weaker from the cancer and treatment. To better understand how to keep yourself safe, follow the COVID-19 Prevent and Prepare document.

Cancer and the COVID-19 Vaccine

Vaccines are a critical way to limit the spread of COVID-19. They are safe and effective. Immunization protects your health, as well as the health of your loved ones and the community.

I am currently having cancer treatment, should I get the vaccine?

Yes, in most cases you should get the COVID-19 vaccine as soon as possible. This applies to people having radiation treatment, surgery, systemic treatment (chemotherapy, targeted therapy, immunotherapy/check point inhibitor therapy or hormone therapy).

I had cancer treatment in the past. Should I get the vaccine?

Yes, get the COVID-19 vaccine as soon as possible.

Should my close contacts be vaccinated?

Yes, all of your close contacts should be vaccinated against COVID-19.

3rd Dose of COVID-19 Vaccine

You should get a 3rd dose of the vaccine (8 weeks after your 2nd dose). If you are:

• Starting or currently on systemic treatment like chemotherapy, targeted therapy, immunotherapy/checkpoint inhibitor therapy, or other biologic therapies.
• Are receiving chimeric antigen receptor (CAR-T) cell therapy.
• If you are hematology patient or had Stem Cell Transplants, refer to your hematologist.

Outside of the above requirements 3rd dose boosters are available after a minimum of six (6) months following the 2nd dose of a COVID-19 vaccine.

• If you have specific questions about the vaccine discuss with your oncology care provider.

To book your 3rd dose of COVID-19 go to: https://www.nthssa.ca/covid-vaccine

What happens after I get the vaccine?

Currently, there is not enough evidence on how long the vaccine will protect you and how well it will reduce the spread of COVID-19. While the vaccines being delivered have shown a very high effectiveness in clinical trials, no vaccines provide 100% protection.

After you are vaccinated, it is very important that you continue to wear a mask, practice physical distancing, wash your hands and follow all other public health guidelines.

For information on the COVID-19 vaccine visit: https://www.gov.nt.ca/covid-19/

Cancer Care Preparation for an Outbreak

Are Cancer Care Alberta (CCA) and the Northwest Territories Health and Social Services Authority (NTHSSA) prepared if a COVID-19 outbreak happens at one of the Alberta cancer centres or the STH Chemotherapy Unit?

Health care facilities in Alberta and the NWT are taking action every day to keep staff and patients safe from COVID-19. Even with many precautions in place, some outbreaks have happened in hospitals.

We will do everything we can to prevent an outbreak. An outbreak does not necessarily mean services will change. If there is an active outbreak of COVID-19, CCA and the NTHSSA cancer care staff will continue to offer support and treatment to cancer patients and families. If your treatment is affected by an outbreak your cancer care team will talk to you about what change is recommended and why, and the impact of that change on your treatment(s).

Our priority is to continue to offer NWT residents the same level of service we always have.

What if my treatment(s) and/or surgery is delayed and I am concerned that my cancer is getting worse?

Talk with your family doctor/nurse, cancer navigator, contact the CCA cancer centre or the STH Chemotherapy Unit.

Symptoms

If you are experiencing any of the following symptoms:

• Difficulty breathing (e.g. unable to finish sentences because of your breathing, short of breath at rest, unable to lie down because of difficulty breathing);
• Chest pain;
• Having a very hard time waking up;
• Fainted or lost consciousness; OR
• Difficulty managing your daily life because of breathing difficulties.

Please call 911 or go directly to your nearest Emergency Department or Health Centre if you are in a smaller community. Click here for contact information for regional NWT Health Centres.

If you think that you have COVID-19, please tell 9-1-1 or call the Health Centre before you go, so that they are prepared for your arrival.

Chemotherapy

I am on chemotherapy and I have a fever. What should I do?

If you have a temperature of:

• 38.3°C (100.9°F) or higher at any time or
• 38.0°C (100.4°F) to 38.2°C (100.8°F) for at least 1 hour

Follow the directions you were given from your CCA cancer centre or the STH Chemotherapy Unit.

Go to your nearest Emergency Department or Health Centre. When you get there, give the nurse your emergency triage letter and tell them that you are a cancer care patient.

Immunotherapy (Checkpoint Inhibitors)

I am on immunotherapy and have developed a cough, shortness of breath or fever. What should I do?

If you have:

• a fever or 38.9°C (102°F ) or higher
• a cough or
• difficulty breathing

Follow the directions you were given from your CCA cancer centre or the STH Chemotherapy Unit.

Go to your nearest Emergency Department or Health Centre. When you get there, give the nurse your emergency triage letter and tell them that you are on immunotherapy and a cancer care patient.

Radiation

I am on or just finished radiation treatment in Alberta and have a cough related to treatment. What should I do?

If you are having treatment to the chest or lungs, a cough can be a normal side effect from treatment.

If you are still receiving radiation treatment at the CCI Radiation Department here is some additional information:

• If your cough has not changed and you have no new symptoms you will go to the radiation department for your scheduled treatment. Staff at the screening desk may consult with someone from the treatment area before sending you to your appointment.
• If your cough has changed and is different than before, you should report it as a new symptom to the staff at the screening desk. The cancer care team will talk with you about next steps.

Anxiety and Stress

There are mental health resources and supports available to help with anxiety and distress.

For community wellness supports available in your region visit: https://www.nthssa.ca/mental-health

Appointments

Clinic Visits (Follow-up and Treatment)

To lower the chances of COVID-19 for our patients and staff, and limit the number of people at the cancer centres, your cancer care team is reviewing your care before your appointment and you may be offered a telephone pre- treatment appointment or follow-up appointment.

I am worried about getting COVID-19. Do I have to travel and/or come in for my follow-up appointment?

Depending on the reason for your appointment, your cancer care team may offer you a "virtual" visit (over the phone or computer). We will only offer this as an option if it is safe to do so. You may still need to travel for required diagnostics (CT scan) in advance of your appointment. Please let your care team know if you have any concerns.

Tips on making the most of your “virtual” visit are found here

Treatment Appointments (Radiation and Systemic)

Should I still go to my cancer treatment appointment?

Treatment appointments are still scheduled. Please plan to go to them. If you do not feel well, call the Alberta cancer centre (CCI) or the STH Chemotherapy Unit first using the contact number you were given.

What happens if my treatment appointment needs to be cancelled because I am sick?

If you have COVID-19 or other symptoms that keep you from going to your treatment appointment, a member of your cancer care team will talk to you about the next steps.

Should I still go to my cancer treatment appointment?

Arriving at a Alberta cancer centre or the Stanton Territorial Hospital’s Chemotherapy Unit

Screening for COVID-19

You may receive a pre-appointment screening phone call before your appointment at the STH Chemotherapy Unit or Alberta Cancer Centre.

Please note: It is very important that you answer all screening questions as honestly and fully as possible. You will still get the care that you need.

Answering honestly helps us:

• Provide you with the best possible care for your cancer and any symptoms you have
• Keep our cancer care teams as healthy as possible so they can continue to provide care
• Help limit the spread of COVID -19

What can I expect when arriving at an Alberta cancer centre or Stanton Territorial Hospital’s Chemotherapy Unit?

• Use the hand sanitizer immediately upon entering the Hospital.
• You will be given a medical mask and must wear it until you leave the hospital.
• Screening staff at the front entrance will ask you and your support person screening questions.
• There may be line-ups. Please come 5-10 minutes earlier than you normally do. This will allow time for the screening questions and help you get to your appointment on time.
• Please respect the need to stay 2 meters or 6 feet away from others at screening desks, reception desks and in waiting areas.

*At STH go straight to the Chemotherapy Unit after screening, no need to stop at registration, you will be registered on the unit.

What will happen if I have symptoms when I arrive at the Alberta cancer centre or the STH Chemotherapy Unit?

If you have symptoms, call the Alberta cancer centre or the STH Chemotherapy Unit before you come so you can be assessed first by phone.

If you do arrive with symptoms that may be from COVID-19, you will be asked to wash your hands and put on a mask. A healthcare provider will be contacted to assess you and they will then contact a cancer care provider to make a safe plan with you.

Visitation

Am I allowed to bring visitors or a support person with me?

Alberta Cancer Centres:

Local restrictions on support persons will depend on what is happening with COVID-19 at that location. Any support person that is able to enter the cancer centre will be screened at the entrance and given a medical mask to wear until they leave.

Stanton Territorial Hospital – Chemotherapy Unit:

Yes, you may bring one (1) support person to the STH Chemotherapy Unit. They will be screened when entering the hospital and given a medical mask to wear until they leave.

Additional information/questions

I live with someone who is self-isolating. Do I have to self-isolate as well?

Follow the NWT self-isolation guidelines.

Am I at higher risk of COVID-19 if I am a cancer patient who smokes?

With COVID-19 affecting the lungs, it seems likely that cancer patients who smoke are even more vulnerable to severe COVID-19 symptoms. We recommend you stop smoking. For help with quitting smoking, visit NWTQuitline or if in Yellowknife contact the Tobacco Cessation Clinic: https://www.nthssa.ca/en/services/tobacco-cessation-clinic-yellowknife