Participating in clinical trial during COVID-19
Last updated Sept. 15, 2022
Safety and Visitation
MD Anderson monitors COVID-19 cases in our community and may change our visitation rules to ensure they best protect our patients, their families and our workforce. Before your visit, review our current COVID-19 safety and visitation rules below.
- Patients should contact their care team before they arrive if they have fever, cough, shortness of breath, have had a positive COVID-19 test in the last 14 days or have had a household member who has tested positive in the past 14 days. See more below about COVID-19 testing.
- Everyone is required to pass entry screening and must wear the MD Anderson-issued face mask. Patients who are admitted to our hospital are asked to wear face masks during transport and procedures, and when a staff member is within 6 feet.
- Visitors should not accompany patients if they have tested positive for COVID-19 in the past 7 days, are symptomatic or have had a household member who has tested positive in the past 14 days.
Our patient visitation policy may vary depending on care needs and location and is subject to change. If you have questions about our visitor policy, contact Patient Advocacy.
Outpatient visitation details
- Adult patients coming for clinic appointments, outpatient procedures/surgeries, or care in the Acute Cancer Care Center may bring one adult visitor. All visitors must pass COVID-19 entry screening. The patient visitor must be able and willing to wear the provided mask.
- Pediatric patients are allowed up to two parents or guardians. Parents of pediatric patients should talk with their care team to learn more about pediatric patient visitation.
Due to safety concerns, patients or their visitor should not bring anyone else with them to an appointment. This includes children under 18 and adults who are unable to care for or move themselves. Appointments will be rescheduled if a patient or visitor arrives with someone who is dependent upon them for care.
Visitors are not allowed to accompany patients scheduled for symptomatic testing.
In outpatient surgery and procedural areas, the patient’s visitor should remain in a waiting room during the patient’s procedure. Our clinical teams will allow patient visitors in our pre-operative and Post-Anesthesia Care Unit (PACU) by exception only. The day before a procedure, the care team will call the patient to confirm their procedure start time.
If a patient must be admitted to the hospital, their caregiver may accompany them when they are admitted to the hospital at any time of day. Visitors of hospital patients must pass entry screening and check-in at entry. See more details below.
Visitors of hospital patients
- Each hospital patient (also called an inpatient) may have one adult (age 18 or older) caregiver at the bedside at all times. This person may accompany the patient when they are admitted to the hospital at any time of day.
An additional adult may visit during patient visitation hours:
- Monday through Friday: 1-9 p.m.
- Weekends and Institutional Holidays: 10 a.m.-9 p.m.
The bedside caregiver may stay multiple days or the daily visitor may switch out with the bedside caregiver on a daily basis. Only one visitor or caregiver is allowed entry per day and they are asked to stay in the patient rooms whenever possible. If the daily visitor leaves MD Anderson during the day of their visit, they will not be permitted back into our facilities until the following day during visiting hours. This requirement is important for limiting the number of people coming in and out of the hospital and protecting our patients with weakened immune systems. (Please note: The Rotary House is not considered part of the hospital and would require re-entry screening.)
All inpatient visitors will receive a wristband with the entry date on the band. No visitor is permitted on the inpatient units without a wristband.
- Hospitalized patients with COVID-19 may have one adult caregiver visit during specific, limited hours. These identified caregivers must comply with appropriate safety protocols, including wearing a face shield and mask at all times. Patients with COVID-19 and their loved ones should talk to their care team for more details.
Tips for inpatient visitor parking:
- Monday through Friday: Park in Garage 2 and enter through the Main Building Pavilion entrance.
- Saturday and Sunday: Park in Garage 10 and enter through the Main Building Aquarium entrance.
Valet service is available seven days a week at both entrances from 6 a.m. to 11 p.m.
These entrances are open for inpatient visitors during visitation hours.
MD Anderson provides inpatient deliveries of personal items Monday through Friday only from 8 a.m. to 3 p.m. We encourage patients to have their daily visitor bring any items they need when they come to visit. Inpatient deliveries are not available during institutional holidays or on weekends.
Spiritual health visitors
Patients’ personal clergy or chaplains may visit them in the hospital at any time without it counting towards their one visitor per day. Clergy will need to show identification from their organization to the entry screening team and have the name of the inpatient they’re visiting, as well as the room number.
When you arrive, you will be given a face mask and asked to sanitize your hands. Everyone who enters patient care areas – including patients and their daily visitor – must pass entry screening.
You will see the following COVID-19 screening questions and be asked the following questions:
- Do you have a temperature more than 100.4°F/38°C today?
- Have you had a fever (more than 100.4°F/38°C) or chills in the past 7 days?
- Do you have a cough more than usual, sore throat, or shortness of breath?
- Do you have a pending coronavirus disease (COVID-19) test that was done for symptoms?
- Have you had a positive COVID-19 test in the past 14 days?
- Has anyone in your household tested positive for COVID-19 in the past 14 days?
If you answer yes to any of the above questions, a team member will help you with next steps. Patient appointments may need to be rescheduled if you have tested positive for COVID-19 in the past 14 days, are symptomatic or have had a household member who has tested positive in the past 14 days. Following the 14-day quarantine requirement ensures the safety of other patients and our care teams.
Temperature checks are no longer required. We have temperature kiosks and handheld thermometers if needed.
Patients and visitors may enter at the following locations on our Texas Medical Center campus:
- Main Building, The Pavilion valet entrance
- Main Building, The Aquarium valet entrance
- Main Building, Garage 10, Floor 3 skybridge
- Mays Clinic, East Lobby valet entrance
- Faculty Center, Floor 3, near Garage 17 entrance
Download the TMC Entry Points map.
The Rotary House skybridge is open so patients and visitors can walk between the Rotary House and the Main Building after being screened. The Rotary House skybridge is open Monday through Friday, 6 a.m. to 10 p.m.
Patients who have symptoms should reach out to their care teams in MyChart.
Patients who test positive for COVID-19 need to quarantine for 14 days before they can return to MD Anderson, provided they have been fever-free without the use of fever-reducing medicines for 24 hours and other symptoms are improving. Care teams will reschedule appointments until after patients complete their 14-day quarantine. The test date is considered Day 1 of the 14-day quarantine.
COVID-19 testing before some procedures and treatments
To ensure safety, clinical teams order MD Anderson COVID-19 testing for patients before their surgery and some procedures, and certain treatments. COVID-19 vaccination does not eliminate the need for testing in these medical situations.
Your care team will let you know when testing is required.
In addition, we will accept certain types of COVID-19 tests done at a local pharmacy or doctor’s office to replace MD Anderson testing in some situations. Tests must be performed and submitted within 4 days of your procedure or treatment.
The types of test accepted are:
- Polymerase chain reaction (PCR)
- Nucleic acid amplication tests (NAAT)
All PCR/NAAT tests must be performed with a nasal or nasopharyngeal swab.
If you choose to be tested outside of MD Anderson, remember to leave enough time to send the results to your care team. You can take a picture of your results and send them in a MyChart message or fax them. The photo must include:
- Patient’s name
- Type of test (PCR or NAAT)
- Method used (nasal or nasopharyngeal swab)
- Test result
Your care team will review the results to make sure they meet criteria.
If you need to be tested before you are admitted to the hospital, you must have your test done at MD Anderson.
All café services are grab-and-go or customer assisted. Salad bars and self-service of bulk foods remain closed. Utensils and meal accompaniments will remain individually packaged or server assisted. Cashless payment is encouraged.
Physical distancing continues to be recommended as a way to ensure your safety.
The Learning Center patient library in Mays Clinic, Floor 2, and in the Main Building, Floor 4, are open for patients and their visitors. They are open Monday through Friday from 9 a.m. to 4 p.m. Patients and visitors will be asked to keep their distance and sanitize hands before reviewing materials to reduce the spread of infection.
Get vaccinated to reduce your risk of severe infection and complications from COVID-19. The protection provided by the vaccines far outweighs any mild side effects that you may experience at the time of your vaccination.
- COVID-19 vaccines are safe and recommended for cancer patients.
- MD Anderson is offering COVID-19 vaccines to MD Anderson employees and patients, including additional doses for immunocompromised individuals and booster doses of the Pfizer-BioNTech and Moderna COVID-19 vaccine for those who are eligible.
- Patients should get the vaccine wherever it is available to them. If you have received the vaccine, use MyChart to submit your vaccination details and a picture of the vaccination card so your care team can add it to your electronic medical record.
For the most up-to-date information, resources and to learn about additional vaccine doses, visit our COVID-19 vaccine page.
More ways to prevent COVID-19 infections:
- Wear a mask.
- If you have symptoms or a known or suspected infection, stay home and get tested.
- Refraining from touching your eyes, nose or mouth with unwashed hands.
- Washing your hands often for at least 20 seconds with soap and water or using an antiseptic hand gel.
- Keep your distance. Avoid crowded areas.
MD Anderson is providing safe and effective COVID-19 vaccinations to
the Houston community.
You’ve been vaccinated for COVID-19, but is it time for your next booster? Which type of booster should you get, and is there an age limit? What if you’ve recently been infected with the SARS CoV-2 virus that causes COVID-19? And let’s not forget it’s flu vaccination season. Can you get the COVID-19 and flu vaccinations at the same time?
Use these answers from Chief Infection Control Officer Roy Chemaly M.D., and Ann Klopp, M.D., Ph.D., medical director for MD Anderson’s COVID-19 vaccine clinics, to help you decide when and how to schedule your vaccinations.
Am I due for a COVID-19 booster?
Recently, the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) authorized updated, bivalent formulations of the Pfizer and Moderna COVID-19 vaccines for booster doses in the U.S. This bivalent booster replaces the original formulation of the booster vaccine.
That means the bivalent boosters are now the only type of boosters you can get if you are age 12 or older. (Children ages 5 through 11 still get the original monovalent booster). The good news is the updated bivalent boosters provide the best available protection against the virus circulating most in the U.S. right now, the BA.5 Omicron subvariant.
The previous booster recommendations considered older age, immunocompromised status, and recommended time intervals between the first and second boosters. But these no longer apply. As long as you are age 12 or older, you are eligible to receive the bivalent booster if it has been at least two months since your last COVID-19 booster or primary series vaccination.
You can use the CDC’s schedule for staying up-to-date with your COVID-19 vaccinations.
Should I wait to be vaccinated if I’ve recently had COVID-19?
If you recently recovered from COVID-19, the CDC says you may consider waiting 3 months to be vaccinated from when your symptoms started or, if you had no symptoms, when you first received a positive test. That’s because reinfection may be less likely in the weeks after infection. It depends, however, on personal risk factors such as your risk of severe disease should you get reinfected, the level of COVID-19 in your community, and the transmissibility of the current COVID-19 variant causing infections.
It’s best to follow CDC guidelines for vaccination if you are moderately or severely immunocompromised.
Is it better for me to get an additional primary dose or a booster?
When it comes to COVID-19 vaccines, additional primary doses and boosters are not interchangeable. People who are moderately or severely immunocompromised need an additional primary dose as part of the primary vaccine series. This dose should be administered within a few weeks of the second dose of your primary series, depending on which vaccine product you received (e.g., Pfizer or Moderna). Since it is part of the primary series, it is the same monovalent vaccine formulation as the first two doses of your primary series.
Conversely, all COVID-19 booster vaccinations now are with the updated, bivalent formulations of the Pfizer or Moderna COVID-19 vaccines. So, if you need a booster, you’ll get the bivalent COVID-19 vaccine, regardless of whether you’ve had a booster dose before.
Follow the CDC’s COVID-19 Vaccination Schedule to know when you are eligible for your next dose or use the CDC’s Booster Tool to know when it is time for your first or next booster. If you are moderately or severely immunocompromised, be sure to look at the CDC’s specific vaccine booster recommendations for you.
Can I get my COVID-19 and flu vaccinations at the same time?
Yes, but it also depends on your personal circumstances. For most people, the CDC says it is safe to get your COVID-19 and flu vaccinations at the same visit as long as the injections are at least 1 inch apart.
However, there are additional considerations for those receiving a COVID-19 vaccine and another type of vaccination like a vaccine to protect against monkeypox. Also, some pharmacies in the community are requiring people who are immunocompromised to space out their COVID-19 and flu vaccinations by a few weeks to support the immune system’s response to the vaccinations.
If you’re a patient at MD Anderson, you can schedule your COVID-19 vaccine via MyChart.
If you or someone you know has had COVID-19 recently, you may have heard of PAXLOVID. Maybe you’ve even heard about a so-called COVID-19 rebound in people who’ve taken this antiviral therapy.
So, what is PAXLOVID and why does the Centers for Disease Control and Prevention (CDC) recommend it for people who are immunocompromised? We asked Chief Infection Control Officer Roy Chemaly, M.D., what patients with cancer need to know about the antiviral treatment and EVUSHELD, the antibody therapy available to high-risk patients for the prevention of COVID-19.
What is PAXLOVID, and who can receive it?
PAXLOVID is the brand name for a combination antiviral medication that can lessen symptoms in patients who have mild or moderate COVID-19. It is intended for those who are in the early stages of infection and are at risk of getting severely worse.
Patients with cancer are eligible to receive PAXLOVID with a prescription from their doctor and they will need to start it within 5 days of the onset of their COVID-19 symptoms. If you are in the hospital, more aggressive therapy may be needed to help you fight the infection.
How does PAXLOVID work to fight an infection?
PAXLOVID contains nirmatrelvir, which works to inhibit the SARS-CoV-2 virus from replicating in the body. It also contains ritonavir, which boosts the effects of nirmatrelvir, helping it work better. The combination of these antiviral medications helps reduce the risk of hospitalization for people who have mild-to-moderate COVID-19.
What are the side effects of PAXLOVID?
Some people report having a metallic or otherwise altered taste in their mouth when taking PAXLOVID. Your doctor also should consider the health of your kidneys and liver before prescribing it. For most people, reported side effects have been mild.
If you have cancer, your doctor will consider all of the medications you are taking to ensure there are no interactions between medicines used to treat COVID-19 (such as PAXLOVID or dexamethasone) and cancer-related therapies like prophylactic antimicrobials and other medicines.
Why do some people need a second round of PAXLOVID treatment?
PAXLOVID is the first oral antiviral medication to be authorized for emergency use by the Food and Drug Administration (FDA) for the treatment of COVID-19. That makes it an investigational medication. Your doctor may prescribe it based on your COVID-19 symptoms and response to the medication.
Some people experience a relapse of COVID-19 – sometimes called a COVID-19 rebound – even after taking an entire course of PAXLOVID. For instance, after Dr. Anthony Fauci tested positive for COVID-19, he received two courses of PAXLOVID to help him stay out of the hospital.
What is EVUSHELD, and how is it different from PAXLOVID?
Vaccination should be considered the first line of prevention against COVID-19. However, some patients with cancer may be unable to mount a protective response with COVID-19 vaccines and remain at risk for severe COVID-19 should they become infected.
EVUSHELD is a combination antibody therapy to prevent COVID-19. For people who are eligible to receive it, the FDA recommends receiving it every six months for ongoing protection against COVID-19.
If I haven’t gotten sick yet, should I consider EVUSHELD to prevent infection? Who is eligible for EVUSHELD today?
EVUSHELD can be used in high-risk immunocompromised patients who are too sick to get a COVID-19 vaccine or too immunocompromised to benefit much from vaccination. Patients with cancer should talk with their doctor about their eligibility. EVUSHELD is more widely available today than when it first came on the market late last year.
The Omicron subvariants BA.4 and BA.5 are behind an increase in COVID-19 infections and hospitalizations. We spoke with MD Anderson’s Chief Infection Control Officer, Roy Chemaly, M.D., to learn about these new and highly contagious subvariants.
What exactly are the BA.4 and BA.5 Omicron subvariants?
They’re the most transmissible and immune-evasive strains of the COVID-19 virus to date. Today, they’re causing around 80% of COVID-19 cases in the U.S.
BA.5 is the more transmissible of the two and is causing 65% of cases, while BA.4 is causing 17%. They are subvariants of the coronavirus’s Omicron variant.
Variants and subvariants … what’s the difference?
Ever since it first emerged in 2019, the SARS-CoV-2 virus that causes COVID-19 has been shape-shifting, making slightly altered versions of itself. These new versions that keep appearing are called variants. Scientists identify them with Greek names, including Alpha, Beta, Gamma, Delta, and the latest variant – Omicron.
These variants, too, make new versions of themselves, called subvariants. BA.4 and BA.5 are the newest subvariants of the Omicron variant – the most dominant variant today.
What are the symptoms of the Omicron subvariants BA.4 and BA.5?
Based on what we’re seeing so far, the BA.4 and BA.5 subvariants are causing upper-respiratory symptoms, including:
- persistent cough
- runny nose
- sore throat
This is further testament that vaccines are still effective at preventing severe disease. The current rise in hospitalizations may simply be attributed to the volume of infections in the community, not the severity of the disease.
Why are BA.4 and BA.5 so transmissible?
BA.4 and BA.5 are similar to earlier Omicron subvariants, but they have one important difference: mutations in their spike proteins make it easier for them to penetrate human cells and cause infection.
These mutations can also help BA.4 and BA.5 escape disease-fighting antibodies created by past COVID-19 vaccines and prior infections.
This, along with the natural waning of vaccine protection and the fact that many communities are lifting COVID-19 restrictions, sets the stage for the virus to spread.
If BA.4 and BA.5 can dodge antibodies, do the COVID-19 vaccines still provide protection?
Even with the mutations in their spike proteins, these variants are still close enough to the original virus to respond to the COVID-19 vaccines. Your immune system may have a harder time identifying BA.4 and BA.5, but it will still red-flag these subvariants.
The current vaccines target the original virus, not the variants. So being vaccinated doesn’t offer as much protection as it once did against infection. But the vaccines do – and this is crucially important – prevent severe illness, hospitalization and death. If you become infected with the COVID-19 virus after being vaccinated, your symptoms are much more likely be mild.
What about updated vaccines that are in the works?
On June 30, the Food and Drug Administration (FDA) recommended modifying new booster shots for the fall to directly target BA.4 and BA.5.
Manufacturers are already designing and testing the new COVID-19 vaccines, and regulators have already planned how to fast-track the approval process. When they’ll be available is still up in the air, but mid-October to December is the goal.
Should those who haven’t gotten vaccinated or haven’t gotten boosted wait for the updated COVID-19 vaccines?
No. The risk for infection is currently very high, so don’t delay. If you’re eligible to get a vaccine or booster shot, do it now. Though it may not be a perfect match, the original vaccine will still protect you from severe illness.
If I get the current vaccine now, can I also get the updated one in the fall?
Yes, you can. The U.S. has pre-ordered 105 million of the updated shots, so there will be plenty to go around. If you get vaccinated today, you should still be eligible to get the variants-specific vaccine when it becomes available. You can have both vaccines.
In the meantime, what are our best defenses against BA.4 and BA.5?
The best way to stay safe from these subvariants is to follow the COVID-19 precautions that we know work, including:
- Stay up to date with your COVID-19 vaccinations and boosters
- Wear a mask
- Avoid large gatherings, particularly indoors
- Wash your hands and avoiding touching your face
Are there any extra precautions that cancer patients and other immunocompromised individuals should take to protect against BA.4 and BA.5?
The same precautions that benefit everyone apply to cancer patients. But I would add that, to protect people with cancer from COVID-19, it’s important that their family members, loved ones, and caregivers get vaccinated and follow the same recommended COVID-19 precautions.
Will the virus mutate again?
Yes. Viruses automatically reproduce by making carbon copies of themselves. But they aren’t perfect at it. Mistakes occur, resulting in a new version of the virus. If one of these mistakes works to the virus’ advantage and makes it easier for the virus to survive, then this new-and- improved version of the virus thrives while the older version dies.
Already, a new variant, BA.2.75 is emerging. It’s another super-contagious Omicron mutant. Whether it will outcompete BA.5 is yet to be determined. The World Health Organization has not yet named BA.2.75 a variant of concern, but virologists fear it could fuel a new wave of cases around the world.
Any last thoughts about COVID-19?
We’re all pandemic-weary, but now is not the time to become complacent. The pandemic isn’t over, and these new subvariants are concerning. It’s likely that the COVID-19 virus, in whatever form, will be with us for some years to come.
At-home COVID-19 antigen tests can be very convenient. A positive result can confirm a COVID-19 infection in minutes and help you protect others from infection. And while a negative antigen test result should be confirmed with a PCR test, rapid antigen tests can be a starting point, especially if you have flu-like symptoms.
“A PCR test is always going to be more accurate, but an antigen test can be an option in a pinch,” says laboratory medicine expert Micah Bhatti, M.D., Ph.D.
Looking back a year ago, Bhatti says many of the logistical issues with antigen tests have improved. “Earlier in the pandemic, we had concerns with the antigen test: how to do it, how to interpret what you get and how to capture results, but we’ve come a long way,” he says.
Consider these eight things to
ensure you’re getting the most out of your at-home antigen test.
1. Use an FDA-approved test. “The FDA is making sure that the tests that are out there are appropriate for the variants that are circulating,” Bhatti says. Based on the limited data we have to date, antigen tests can detect COVID-19, including the omicron variant. However, it is important to only use antigen test that have undergone rigorous assessment by the FDA and have been granted emergency use authorization. To ensure you’re using an accurate antigen test, check the FDA’s list of antigen tests that have received emergency use authorization.
2. Follow instructions for swabbing. Bhatti emphasizes that each test is different, so to get the best sample, you need to follow the manufacturer’s instructions. “The sensitivity of the assay is highly dependent on getting a quality specimen based on the test’s instructions,” he says.
3. Don’t reuse or share a swab. Antigen tests aren’t always readily available, but using a swab more than once won’t help you get more out of a test kit. It will tamper with results and possibly lead to an infection. “The swabs are sterilized when boxed for your safety and to ensure there aren’t any external factors influencing the results,” Bhatti says. Also, if you’re positive and then share a swab, the other individual is highly likely to get infected if they weren’t already.
It’s also important to only use the swab provided in the test kit. While the swab looks like an ordinary cotton swab, it is made of unique material that has been shown to be compatible with the test. Using a different swab for sample collection will lead to an incorrect result.
4. Avoid moving the test around. Bhatti says antigen tests are designed to be sturdy tests, but he recommends you perform yours in a dedicated space to avoid distractions. “If you accidently bump the test, it will likely be fine, but if drops on the floor, the internal test strip may get damaged,” Bhatti says. He says it's best to not move the test card until after you’ve read the results.
5. Check the results at the recommended time – only. Giving the test more time than stated in the instructions won’t help with sensitivity. In fact, it can actually distort the results. Bhatti recommends you read the results when the time is up and don't come back to it later. “We've seen instances of false positives and false negatives when the tests are allowed to overdevelop,” he says.
6. Dispose of it properly. The materials of an at-home antigen test are safe to be thrown away in your household trash after you’ve read your results, says Bhatti. While the tests materials are safe, make sure not to splash any in your eyes or ingest the contents. “Always read the test kit instructions for proper safety guidance,” Bhatti s.
7. Know how you’re going to share your results, if needed. If you’re required to take a rapid antigen test and share those results, consider how you’ll do so. “At MD Anderson, we accept outside positive test results,” Bhatti says, noting that outside negative test results will not replace MD Anderson COVID-19 testing if your care team determines you need it. Patients should take a photo of their results with their smartphone and upload them to MyChart to share with their care team.
Patients with a positive result from an antigen or PCR test aren’t retested at MD Anderson for 90-days because they are considered protected from reinfection. In addition, PCR tests are so sensitive, a person who has had COVID-19 can test positive sometimes weeks after being infected, even when they’re no longer contagious.
8. Confirm negative results with a PCR test. If you're experiencing symptoms and a rapid antigen test says you're positive, treat it as a positive result. But if you're symptomatic and you have a negative test, you’ll need a molecular PCR test to be 100% sure, says Bhatti.
Some at-home rapid antigen tests recommend testing twice. Bhatti says the intent of doubling up on the test is to capture the ideal window of viral load. Early in an infection, you may not have enough virus. But testing again 48 hours later gives the virus the chance to replicate and produce more proteins that would make the test more sensitive
“It may be helpful to test again if you're symptomatic in a day or two, as there may be more viral antigens,” Bhatti says. Even with two or more negative results from antigen tests, you should consider yourself positive until you can confirm you’re negative with a PCR test.
If you’re testing repeatedly without a good indication, the odds of getting a false result are more likely. Bhatti says it’s like throwing darts.
“Eventually, you’ll hit a bullseye, but that doesn't mean you're an expert. It just means you got lucky and in this case, not in a good way,” he says. He worries that routinely screening for infection in asymptomatic individuals with an antigen test, such as before sending your kid to school or before seeing an immunosuppressed loved one, could result in a false sense of security.
“Even with a negative antigen test, you should wear a mask when in indoors, practice social distancing and wash your hands,” Bhatti says.
Request an appointment at MD Anderson online or by calling 1-877-832-6798.
If you’ve caught and recovered from
, you might be wondering what
that means. Are you
to the virus now? Can you go
out in public without
wearing a mask
? Is it
safe to travel
or attend large gatherings? Do you still need to
We checked with our Chief Infection Control Officer Roy Chemaly, M.D. He shared these five Dos and Don’ts to help guide you.
1. DON’T assume you’re immune from COVID-19
The most important thing to do is NOT assume you’re immune to the coronavirus, even if you’ve had a confirmed COVID-19 diagnosis before.
“We’ve already seen at least four different variants crop up — alpha, delta, mu, and omicron — in the last two years,” says Chemaly. “Some have caused worse disease than others, but one consistent feature of all of them is that they’ve become more adept at evading our bodies’ defenses. So, even if you had a severe case of an earlier strain and made a full recovery with no complications, other circulating variants could still infect you. And brand new variants may still be on the horizon.”
2. DO get vaccinated and boosted against COVID-19
Whether immunity stems from a vaccine or actual exposure to the virus, experts now know that the protection it provides is only partial — and temporary. Scientists have confirmed that antibody response wanes over time, which means that people will continue to need supplemental doses and booster shots to provide on-going protection.
"We actually have data now proving that immune response starts off strong after vaccination and then tapers off after a while,” adds Chemaly. “So, even if you have some immunity built up from a natural infection, it won't last forever.”
The COVID-19 vaccines are still doing exactly what they’re intended to do, though, which is to prevent severe illness and death, in most cases. COVID-19 vaccines won’t necessarily prevent transmission, especially as immunity wanes, but boosting still provides people with the most protection possible. So, it’s important to stay up-to-date with your COVID-19 vaccinations.
You can get a COVID-19 vaccine as soon as you’re eligible to leave isolation, but if you received monoclonal antibodies while you were recovering from a COVID infection, you should wait 90 days first.
It’s also important to remember that cancer patients, survivors, and others who are immunocompromised may not develop any antibodies at all — whether in response to natural infection or to COVID-19 vaccines.
“That makes it even more critical NOT to assume you’re safe from
reinfection if you fall into one of these categories,” says Chemaly.
“But patients who were fully vaccinated before receiving CAR T cell therapy or a stem cell transplant should still make sure they
3. DO keep taking all the recommended COVID-19 precautions
It’s equally important to continue practicing all the behaviors experts recommend to prevent possible reinfection, such as wearing a mask, physical distancing, and washing your hands. This does more than just set a good example for others. It also protects the most vulnerable among us if there’s even the slightest chance you might still be contagious.
How do you determine if that applies to you? According to Centers for Disease Control and Prevention (CDC) guidelines:
- General public/mild or asymptomatic infections: Otherwise healthy individuals who did not have severe infections are deemed safe to be around others if 10 full days have elapsed since the initial onset of symptoms and they’ve been symptom-free for at least 24 hours. Both that group and those who tested positive but remained asymptomatic can leave isolation after 5 days, provided they continue to mask well for an additional 5 days.
- Immunocompromised/severe infections: People who are immunocompromised and/or had a severe infection should wait up to 20 days from the onset of symptoms and be symptom-free for at least 24 hours before being around others.
- Severely immunocompromised: These individuals should consult their care teams before they start socializing again.
Remaining committed to preventive strategies is especially critical if you’re caring for a cancer patient or someone who is immunocompromised. Because even if you have immunity, notes Chemaly, they might not. And, you could still pick up a different strain or other germs in public and then bring them back to your household, inadvertently exposing — and infecting — your loved ones.
“Take the same precautions you would as if you had not had COVID-19,” says Chemaly. “Avoid large gatherings of people, and act as if reinfection is still a possibility. Because we know now that it absolutely is.”
4. DON’T forget to disinfect your home
Be sure to clean and disinfect your home thoroughly after you emerge from isolation. This will help protect the people who live with you from any stray virus droplets that might be lingering on surfaces.
Still, says Chemaly, “You don’t need to wear a mask or stay socially distanced from people living in your own household, once you’ve met the CDC’s criteria for ending isolation.”
5. DO quarantine yourself again if you’re re-exposed to COVID-19
One of the hallmarks of viruses is that they never stop mutating, or changing over time. And just because you’ve developed antibodies to one strain of the coronavirus doesn’t necessarily mean they’ll be effective against later versions.
That’s why it’s still a good idea to quarantine yourself if you think you may have been exposed to someone else who has COVID-19, especially if it’s been more than three months since you recovered from an infection yourself.
“Every mutation changes the landscape again, so there are no guarantees,” says Chemaly. “If you're exposed to someone with COVID-19, follow the CDC's quarantine guidelines, just to be on the safe side.”
- At-home COVID-19 tests and the omicron variant
- Breakthrough infections and COVID-19's omicron variant
Mixing and matching COVID-19 boosters: Should you
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Blog posts related to MD Anderson's response to COVID-19
Last updated May 31, 2022
Figuring out how to travel safely has never been more confusing — especially for cancer patients and their families.
Though most of the United States now has low transmission levels of SARS-CoV-2, the virus that causes COVID-19, at least five sub-variants of omicron are currently circulating around the globe — with more mutations likely.
Masking is no longer required on airplanes or other forms of public transportation. But summer is right around the corner with all of its weddings, family reunions and vacations.
So, how can cancer patients stay safe while navigating their summer plans? And what should immunocompromised patients know now, two years into the pandemic? We went to Chief Infection Control Officer Roy Chemaly, M.D., for answers.
What’s the most important thing for people to know right now?
The main message is that this virus is still circulating. And people can still get infected with SARS CoV-2. So, they can’t just forget about it. They have to stay vigilant and be cautious.
What should cancer patients do to keep themselves and their loved ones safe?
We’re in a much different place now than we were in 2020, or even in 2021. For one thing, we have several effective, FDA-approved COVID-19 vaccines available. We also have treatment options that weren’t around at the start of the pandemic.
That being said, COVID-19 is still something that cancer patients and immunocompromised people should try to avoid. Because if they get it, they may not do well, especially if they have other underlying problems.
That’s why all of the same guidance still applies:
- wear a mask
- avoid large gatherings
- practice physical distancing
- get tested before and after traveling or if you have symptoms and follow the CDC's guidelines as to how long to stay home
Also, if you’re not fully vaccinated, get vaccinated. If you’re already fully vaccinated, get boosted. And if your care team says to get a second booster shot, get one. COVID-19 vaccinations have proven their value over and over again in terms of preventing serious illness, hospitalization and death.
How important is the masking piece right now?
Just because you can do something, doesn’t necessarily mean you should. So, even if it’s not required anymore, I still think it’s smart to wear a mask on public transportation — whether that’s a city bus, a taxi or an airplane. The Centers for Disease Control and Prevention (CDC) still recommends it, too.
I also think it’s wise to wear a mask at airports and anywhere else you might be exposed to a crowd. Again, it’s not just about protecting yourself. It’s about protecting others, too, including your immunocompromised loved ones.
Anything else cancer patients and their families should keep in mind?
For cancer patients, prevention of COVID-19 is of the utmost importance. So, talk to your doctor to see if you’re eligible to receive Evusheld (tixagevimab and cilgavimab), the EUA-approved monoclonal antibody combination that’s been somewhat effective in preventing infection by the omicron variant and its sub-variants.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
And whether it’s a PCR test that you mail to a lab or rapid antigen test that reveals whether you have COVID-19 in minutes, many people are turning to at-home testing options.
Chief Infection Control Officer Roy Chemaly, M.D., shares insights on using at-home tests to detect the omicron variant and what to know to ensure your COVID-19 test results are accurate.
At-home COVID-19 antigen tests aren’t always reliable
While at-home COVID-19 tests can detect the COVID-19’s omicron variant, Chemaly doubts their reliability. “My take on antigen tests — not only for COVID-19 but for other viruses, too — is that they’re not that sensitive to detect the virus consistently,” he says.
There are several factors that influence an antigen test’s accuracy. First, it’s challenging for most people to get a quality sample if they swab themselves.
“The specimen depends on the swabbing and how deep you go in nose,” Chemaly says, calling this “difficult to do on yourself.” The swab should be inserted into the nasal cavity, but it should go deep enough to extract mucus from the sinuses.
That said, Chemaly acknowledges that at-home COVID-19 antigen tests may ease the process for international airline passengers. He cites a situation when a traveler did the antigen test at home while being monitored on a video call by a health care professional contracted with the airline. “It does add a level of quality control and some degree of protection,” Chemaly says.
False negatives are common with at-home antigen tests
Even with a good sample, an at-home test may not be able to always detect the coronavirus. Chemaly says not all at-home antigen tests are quality products.
“The tests are only accurate 80% of the time, and sometimes less,” he says. That means 20% of people who use an at-home antigen test could get a negative test result, despite being infected with COVID-19.
Because the current infection rate of the coronavirus is so high, he notes that if you have negative antigen test, it could be a false negative. If you have COVID-19 symptoms and test negative with an at-home antigen test, it’s important to follow up with a PCR test since you may well have gotten a false negative result.
A positive at-home test result means you have COVID-19
If you get a positive test result on an at-home antigen test, it does confirm a positive infection. “If it's positive, that's it. You have the coronavirus,” Chemaly says. “But if it's negative, that doesn't mean you don't.”
He suggests that if you get a negative result with an antigen test, you follow it with a PCR test from your care provider to confirm the results. “Repeating the same test is not going to help,” Chemaly says. By chance, you may come back with a positive result, but Chemaly cautions that testing multiple times with an at-home antigen test doesn’t improve the accuracy.
“It's not a great test,” he says.
At-home PCR tests may also yield false negatives
The concerns with at-home PCR tests are similar to those with at-home antigen tests. Chemaly doubts the ability to get a quality sample because of the discomfort with doing your own nasal swab.
Even with a quality sample, the factors with transporting the specimen to the lab make the results unreliable. “If it comes back positive, take it as that. But if it’s negative, it doesn’t rule out COVID-19 , in my opinion,” he says.
Get tested two to three days after COVID-19 exposure
Even if you aren’t showing symptoms, it’s still good to know if you’re infected so that you can prevent spreading it to those who are most vulnerable, like immunocompromised people or children too young to get vaccinated.
Chemaly recommends testing two to three days after exposure. “It’s much quicker than we saw with the delta variant,” he says. While the delta variant took on average five days for symptoms to arise, the omicron variant can show symptoms within 48 to 72 hours.
If you have flu-like symptoms, such as a cough, sore throat, fever and/or headache, Chemaly recommends getting tested right away.
Use an at-home home test as a first step if you can’t get a COVID-19 testing appointment
“If you have symptoms and don’t have access to a PCR through a testing site, test yourself at home,” Chemaly says. “But consider it a first step.”
If your at-home test is negative, Chemaly recommends you follow up with a PCR test as soon as you can to ensure it’s not a false negative.
If you have symptoms but can’t
get to a testing site and are unable to find an at-home test,
Chemaly recommends isolation. The Centers for Disease Control and
Prevention (CDC) recommends individuals infected with COVID-19
isolate five days starting the day after their first symptoms
appear. Health care workers should isolate for seven days starting
the day after the first sign of symptoms.
If other individuals in your household don’t have symptoms, it’s important to isolate from them and wear a mask to prevent them from getting infected. “If you’re coughing and sneezing, it has to be considered coronavirus until proven otherwise,” Chemaly says.
After your period of isolation, and when you’ve gone 24 hours without a symptom or back to baseline, you are no longer contagious and can go out, Chemaly says. But he advises it’s still important to wear a mask when you’re around others.
Request a multiplex PCR test if your COVID-19 PCR test is negative and you still feel sick
If you have symptoms and a COVID-19 PCR test shows you’re negative, Chemaly recommends requesting a multiplex PCR test from your health care provider. It looks for 18 other viruses that could be circulating in the community, such as the common cold and the flu.
“There’s other respiratory viruses out there right now, but because the omicron variant is much more prevalent, it’s important to still rule out the coronavirus as number one,” he says.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.