Participating in clinical trial during COVID-19
Last updated Jan. 11, 2022
We are closely watching the increase in COVID-19 cases locally, in Texas and nationwide related to the Omicron variant and taking extra precautions to protect our patients.
- 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 20 days or have had a household member who has tested positive in the past 14 days. See more below about COVID-19 testing.
- Patients can bring one adult visitor or caregiver (18 and older) with them per day.
- 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.
Our patient visitation policy is subject to change. Before your visit, review our current COVID-19 safety processes on this page.
If you have specific questions related to symptoms, upcoming appointments or procedures, we encourage you to contact your care team via MyChart.
Get vaccinated to reduce your risk of infection and complications.
The protection provided by vaccination far outweighs 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.
Our visitation policies prioritize the safety of our patients and may vary depending on care needs and location.
Adult patients can bring one adult visitor or caregiver (18 and older) with them per day. Everyone is required to pass entry screening and must wear the MD Anderson-issued face 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.
To ensure safety, no visitors will be allowed for patients with COVID-19 or possible COVID-19. In addition, visitors are not allowed to accompany patients scheduled for symptomatic testing.
If you have questions about our visitor policy, contact Patient Advocacy.
Minors and dependents
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.
Outpatient visitation details
Patients may be able to change their clinic appointment to a virtual visit. Talk to your care team to see if that is an option for you. Learn more about virtual visits.
Adult patients with outpatient clinic appointments, outpatient procedures or surgeries, and patients receiving care in the Acute Cancer Care Center may bring one adult visitor who passes entry screening. The patient visitor must be able and willing to wear the provided mask.
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 an outpatient or patient in the Acute Cancer Care Center is admitted to the hospital, their visitor may stay with them during hospital visitation hours only or if the patient meets criteria to have a visitor stay overnight with them. 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 visitor or caregiver per day during visitation hours.
Current visiting hours, subject to change:
- Monday through Friday: 3-6 p.m.
- Saturday, Sunday and holidays: Noon-6 p.m.
We encourage visitors to get tested for COVID-19 before coming to the hospital but it is not required. If you have symptoms or a known or suspected infection, stay home and get tested.
We allow one visitor name for the approved inpatient visitor list. Care team members will add the name of one (1) visitor into our system for reference by entry screening staff. Only visitors whose names are in our system are allowed to visit inpatients.
Patients should make sure they give the names of their visitors to their hospital care team. When inpatient visitors arrive, they will need to provide the patient’s first and last name, as well as the patient’s hospital room number. They can also provide the inpatient unit. Our entry screening team will check that the visitor’s name is in our system for that patient, and they’ll ask the inpatient visitor to show identification to verify their name matches our system.
There are specific, limited circumstances where inpatients are allowed to have one adult caregiver stay with them in the hospital. This caregiver is called a boarder. The boarder can stay in addition to the one visitor who is allowed to come during visitor hours.
All inpatient visitors will receive a white wristband with the entry date on the band. No visitor is permitted on the inpatient units without a wristband. Inpatient visitors are asked to stay in patient rooms whenever possible. Once an inpatient visitor leaves the institution for the day, visitation is complete. The visitor can return the next day during visitation hours.
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 will continue inpatient deliveries of personal items during non-visitation hours Monday through Friday from 8 a.m. to 3 p.m. only. 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.
The spiritual health of our patients is important. 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 must pass entry screening.
You will see COVID-19 screening questions posted and you’ll be asked if you can answer no to the following questions.
- Do you have a temperature more than 100.3°F/38°C today?
- Have you had a fever (more than 100.3°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 20 days?
- Has anyone in your household tested positive for COVID-19 in the past 14 days?
If you answer yes, our entry screen team will help you with next steps. Your appointment may need to be rescheduled if you have tested positive for COVID-19 in the past 20 days, are symptomatic or have had a household member who has tested positive in the past 14 days. Following the 20-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.
Each adult patient is allowed one adult visitor per day, and visitors must be able to pass entry screening too. The entry screening team will confirm that the inpatient visitor is on the approved list provided by the patient.
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. To ensure safety, clinical teams may 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.
Outside test results are helpful to your care team but will not replace MD Anderson COVID-19 testing if your care team determines you need it.
If you have been tested for COVID-19 by nasal swab outside of MD Anderson, share a copy of your results with your care team before your appointment. For example, you can attach an image of the result and send it to your team using MyChart.
Patients who test positive for COVID-19 need to quarantine for 20 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 20-day quarantine. The test date is considered Day 1 of the 20-day quarantine. We are using the CDC's maximum quarantine recommendation because it is indicated for people with severe underlying illnesses or immune compromise, which describes many of our patients.
All café services will be grab and go or customer assisted. Salad bars and self-service of bulk foods will remain closed. Utensils and meal accompaniments will remain individually packaged or server assisted. Cashless payment is encouraged.
Distancing continues to ensure 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.
You can protect yourself and prevent the spread of infection by:
- Get vaccinated. The COVID-19 vaccines are safe and recommended for cancer patients and reduce the risk of severe infection.
- 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.
Last updated on Jan. 27, 2022.
When the COVID-19 pandemic began two years ago, so little was known about the SARS-CoV-2 virus that all anyone could really do was treat the symptoms.
Today, however, several options are available to treat COVID-19 and fight the underlying virus that causes it. But which ones are best for cancer patients? How do they work? And are some more effective than others?
We sat down with Chief Infection Control Officer Roy Chemaly, M.D., to learn more. Here’s what he wants cancer patients and their caregivers to know.
What treatments are available for cancer patients right now that specifically target COVID-19?
For hospitalized cancer patients with COVID-19 infections, the main drug we use is called remdesivir (Veklury). It’s an antiviral that’s administered through an IV.
Very ill or high-risk patients could receive remdesivir for up to 10 days. But most will receive it between 5 and 10. Patients who have minimal symptoms and are not at high risk for severe illness could receive it for as few as 3 days. But they would still benefit from it. Remdesivir has been shown to be effective against the coronavirus in many studies, and we’ve had access to it for more than a year.
Steroids have also proven beneficial to some hospitalized patients with COVID-19 who require high levels of oxygen or are on breathing machines. Though they don’t specifically target the virus, steroids can block or reduce the inflammatory responses of SARS-CoV-2 in the lungs.
What about COVID-positive cancer patients who aren’t hospitalized?
For outpatients with COVID-19, we may use two oral drugs to help them avoid being hospitalized. They are:
- molnupiravir (from Merck)
- Paxlovid (from Pfizer)
Both are antiviral pills that are taken by mouth, but supplies are very limited.
How do these antiviral medications work?
They all work slightly differently to prevent the virus from replicating itself. Some bind to a specific viral enzyme (RNA-dependent RNA polymerase) and terminate RNA transcription prematurely (remdesivir). Some introduce errors into the SARS-CoV-2 virus’ genetic code (molnupiravir). And some inhibit the function of a particular SARS CoV-2 protein (paxlovid).
What about monoclonal antibodies? How do those work? And are they effective against COVID-19?
Three different monoclonal antibodies have been granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) to try to prevent hospitalization. They are:
- bamlanivimab and etesevimab (made by Eli Lilly)
- casirivimab and imdevimab (made by Regeneron)
- sotrovimab (made by GlaxoSmithKline/Vir)
These monoclonal antibodies target the spike protein of SARS-CoV-2, and are designed to block the virus’ ability to attach to and enter human cells.
Under EUA rules, monoclonal antibodies cannot be used in hospitalized patients or patients who require oxygen. They can only be used in outpatients with mild to moderate COVID-19 who are at high risk of progression to more severe illness.
Unfortunately, only one of these monoclonal antibodies, sotrovimab, has proven somewhat effective against the omicron variant, and that was in a lab. It’s also in very short supply. The other two were helpful against the delta variant. But there have been so many changes in the spike proteins that they’re not as effective against omicron, so the FDA has now limited their use to only when a patient is likely to have a variant that responds to these treatments.
So, the only monoclonal antibody that we can use right now to treat COVID-19 and prevent hospitalization is sotrovimab. And that’s only when it’s available.
Is there anything available that can prevent cancer patients from contracting COVID-19?
Getting a COVID-19 vaccine is still the best way to prevent infection. But for patients who are too sick to get vaccinated or too immunocompromised to benefit much from vaccination, there may be an alternative.
AstraZeneca manufactures some monoclonal antibodies now called Evusheld, which is a combination of cilgavimab and tixagevimab. It has demonstrated some limited efficacy against omicron, and was granted EUA status by the FDA, so it could be used for “pre-exposure” in some high-risk cancer patients.
It’s available right now, but also in limited quantities, so again, patients must meet very specific criteria to qualify for it.
How can patients obtain these medications?
Many of these drugs are in very short supply right now, and they have very strict eligibility guidelines.
At a bare minimum, for instance, to qualify for Pfizer’s paxlovid, cancer patients must:
- have a confirmed case of COVID-19
- have only a mild to moderate infection
- be at high-risk of being hospitalized
- have had symptoms for no longer than 5 days
- be age 12 or older
- weigh at least 40 kg (88 lbs.)
To possibly qualify for Merck’s molnupiravir, cancer patients must:
- have a confirmed case of COVID-19
- have only a mild to moderate infection
- be at high-risk of being hospitalized
- have had symptoms for no more than 5 days
- be age 18 or older
- not be pregnant or trying to conceive
- have no other drug available
So, while there are options, they might not be available to you specifically, or they may not be available yet — either here at MD Anderson or anywhere else. Only certain pharmacies will have them, and physicians must answer many questions about their patients before they can be released. So, it’s very important to stay flexible if you approach your doctor about one.
Anything else cancer patients should know about possible COVID-19 treatments?
Also, every drug has potential side effects. And since one of these antiviral medications is a combination of two agents (Paxlovid), the chances of them interacting with other drugs you’re taking are higher.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
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
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Blog posts related to MD Anderson's response to COVID-19
If you’ve heard the word “flurona” recently, but aren’t quite sure what it means, you’re not alone. Many people have expressed confusion about this mashup of the words “influenza” and “coronavirus.”
Though it may sound like a brand new disease, flurona isn’t some strange mutant hybrid of these two viruses. It just describes a situation in which someone contracts both the flu and a COVID-19 infection at the same time.
To learn more about flurona, and what cancer patients in particular need to know, we reached out to Chief Infection Control Officer Roy Chemaly, M.D.
How long has flurona been around?
I believe the term itself was coined fairly recently in Israel, but there were a few cases of simultaneous flu/coronavirus infections reported as far back as January or February 2020 in China. That was the height of flu season at the time. So, it occurred very early on in the pandemic.
How many flurona cases have there been to date, and where has it been reported?
Here at MD Anderson, we haven’t seen any patients with it yet. But it’s been reported on virtually every continent now: Europe, Asia, the Americas, even Australia. Based on the published studies I’ve seen, I would say there have been at least 2,000 cases worldwide. But there are likely at least a few more than that. They just haven’t been documented.
Is getting more than one virus at the same time considered unusual?
No. Not at all. It doesn’t happen that often, and it depends on the season and the circulating viruses, of course, but the elderly and very young have been getting two and even three respiratory viral infections simultaneously for years and years.
The most common culprits are:
- rhinoviruses, several of which cause the common cold
- respiratory syncytial virus (RSV)
These viral infections can happen in any combination, or even all at once. So, it’s not really a new phenomenon.
What are the symptoms of flurona? Are they any different from those of the individual diseases?
No. People with flurona can exhibit any combination of the symptoms that normally accompany each virus, including the ones that overlap, such as:
- body aches
- runny nose
- sore throat
- sinus congestion
So, there’s no specific set of symptoms that really points to someone having flurona.
How have people who’ve developed flurona fared? Were their symptoms or death rates any worse than those of people who only had one viral infection at a time?
We were really worried about that early on, which is why we campaigned so hard in 2020 and 2021 about getting vaccinated against both to prevent a “twindemic.”
If getting one upper respiratory virus was bad, we reasoned, then getting two must be worse. But when we put what limited data was available together, we found that there was really not much impact on mortality with two viruses among the general population. So, that was a welcome surprise.
And while some patients did have more severe symptoms, others had only mild ones. The same went for variables like the need for advanced care (e.g. a respirator), and how long it took people to recover. It really was a mixed bag.
What are the implications for cancer patients and the immunocompromised if they get both COVID-19 and the flu — or even two other viruses — at once?
There’s no data for that yet, so it’s really hard to say. We always worry about patients and survivors whose immune systems are suppressed, whether it’s due to steroids or cancer treatments. If someone is sick enough to be under our care, we never really know how they’re going to react if they get an infection on top of it.
The good news is that there’s not really much flu virus circulating right now. One reason is that people have been pretty good about wearing masks and social distancing. And if these behaviors can prevent exposure to one virus, then they can prevent exposure to others, too. But both COVID-19 and flu vaccinations have also played a part in reducing the number of simultaneous infections.
What can cancer patients and survivors do to protect themselves from the so-called flurona?
We have good treatments and prevention methods available for the flu. And we have some treatments and prevention methods available for the coronavirus. But vaccinations may not work as well in people who are immunocompromised. And the one monoclonal antibody we have that may work against the omicron variant is in very short supply.
So, I would say continue taking the same preventive measures you already have been:
- wear a mask
- practice physical distancing
- avoid large gatherings
- get vaccinated against both the flu and the coronavirus, and get additional doses or booster shots as soon as you can to better prevent COVID-19, as directed by your care team.
It’s always better to focus on prevention rather than to depend on “cures” — or effective treatments — to save the day.
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.
The number of breakthrough COVID-19 infections continues to climb, both in the United States and around the world. Many are now due to the omicron variant, as opposed to the delta variant, which still accounted for more than 90% of all documented COVID-19 infections in the U.S. as recently as mid-December.
So, what does this mean, from a practical standpoint? Is it okay to send your kids back to school after the holiday break? What should you do if you test positive for the virus now? Should you still get a vaccine booster shot, if you become infected with omicron before you can obtain one?
We checked in with Chief Infection Control Officer Roy Chemaly, M.D. for answers. Here’s what he had to say.
Are breakthrough infections more common with omicron than they were with previous strains?
Yes, I think so. We’re definitely seeing more breakthrough infections with omicron than delta, simply because the efficacy of the vaccines is lower against it.
Why is that? Does it mean the vaccines aren’t working?
No. Every variant is going to be at least slightly different from the ones that came before it. That’s just the nature of evolution. But omicron, in particular, has a lot of mutations that make it more transmissible and able to evade the passive immunity acquired from vaccination. So, the vaccines are not going to be as effective against it as they were against delta or other previous variants.
Is there still any value in getting vaccinated or getting a booster shot now?
Absolutely. Even with something like the flu, the goal is to reduce the overall number of infections, as well as the severity of the infections that still occur.
The existing, FDA-approved COVID-19 vaccines are still very effective at preventing serious illness. And that’s the most important thing. Because the milder your symptoms are, the less likely it is that you’re going to need hospitalization, or die from the underlying infection.
With a booster shot, your chances of getting COVID-19 are much lower than if you’re only fully vaccinated. That’s why it’s also very important for everyone who is eligible to get a booster.
Is omicron causing milder symptoms in people than previous variants did?
Anecdotally, I would say yes. In general, the symptoms people are presenting with appear to be less severe with omicron than with delta.
What are the primary symptoms of people infected with omicron? Do they differ from previous variants?
Most of the infections we’re seeing now are in people who are symptomatic rather than asymptomatic, meaning that infected people are showing symptoms more often than not. Their symptoms are generally flu-like and similar to those of previous variants. But in many cases, the headache, fever and coughing are milder.
The loss of taste and smell may also be much less prevalent with omicron than it was with delta. But again, this is all strictly anecdotal, not based on formal study.
What should someone do if they develop a breakthrough infection now?
If you’re asymptomatic, stay home for 5 days, then wear a mask for 5 days, per the Centers for Disease Control’s new quarantine guidelines.
If it’s a mild infection, quarantine yourself for 5 days. If your symptoms are resolving or you’re asymptomatic and/or back to your normal baseline after that, you can leave your house, but wear a mask for another 5 days. It is always recommended to wear a mask in the community and at any gathering.
If it’s a severe infection, monitor yourself carefully. And if you’re getting progressively worse instead of better, seek help. This is particularly true if you start experiencing shortness of breath, a severe cough, breathing problems, or other concerning symptoms of COVID-19.
If you’re an MD Anderson patient, I’d also suggest checking with your doctor for guidance that’s specific to you. We can use the FDA-approved anti-viral drug veklury (Remdesivir) or steroids in cancer patients who are sick enough to be hospitalized, whether it’s due to pneumonia, low oxygen levels, or some other issue.
But the two anti-viral drugs recently granted emergency use authorization by the Food and Drug Administration for use against COVID-19 are not available yet. And most available monoclonal antibodies don’t work against omicron, except for one kind called sotrovimab, which is very hard to get right now.
If someone develops a breakthrough infection after being fully vaccinated, but before receiving the booster shot, should they still try to get one?
Yes. My recommendation is to get a booster shot, even if you’ve already been infected. You’ll have to wait until you get better, of course, and be out of quarantine and not symptomatic. But I still recommend getting a booster as soon as you’re eligible, because natural immunity is not going to be as effective as what you’ll have if you get boosted.
Are there any special measures cancer patients or immunocompromised people should be taking to protect themselves right now?
Other than getting boosted or an additional dose, no. Talk to your doctor to be sure, of course, but generally speaking, cancer patients and other immunocompromised people should be taking the same public health measures right now that we’ve all been following to some degree for the past two years:
What guidance do you have for parents about sending their kids back to school after the holidays?
First, if your children are eligible, get them vaccinated. If they are 16 or older, get them boosted as soon as they are eligible. I would also have them keep wearing masks at school, especially during the first month of 2022, because we really don’t know how this pandemic is going to evolve. Will there be a sharp decline in cases or will this variant linger for months?
Based on what’s happening in South Africa, it may not linger very long. It may get better more quickly than it did with delta. But that’s impossible to predict, so I would still take all precautions until we know more.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
To help reduce the spread of the novel coronavirus (COVID-19) and make it easier for patients to see a doctor without leaving home, MD Anderson and many other health care providers are offering virtual visits for many patients.
Existing MD Anderson patients who have a clinic follow-up visit or a consult visit with a new MD Anderson provider may be eligible for a video visit, depending on where they live. Each state has different regulations regarding video visits and the practice of medicine by out-of-state clinicians. Talk to your care team to learn what may be available and best for you.
“Virtual visits offer a convenient way for our cancer patients to continue receiving the outstanding care they have always experienced from their MD Anderson care team, with the added benefit of not having to leave their homes,” says Neema Navai, M.D.
If you’ve never had a virtual visit before, here’s what you should know to get the most out of your virtual visit.
Plan ahead ensure a productive conversation
“Virtual visits offer tremendous convenience since they can be done from anywhere with the click of a button,” says Navai. “But they do require a little bit of planning ahead to ensure you and your provider have a productive visit.”
Whether your appointment is virtual or in person, it can be hard to remember everything you want to discuss with your health care provider.
So, before your appointment, write down your questions, as well as new symptoms and concerns. This will help ensure you don’t forget anything important that you want to discuss during your visit.
Before your virtual visit with your MD Anderson provider, it’s also important to complete the eUpdate process to update your information in MyChart. You can verify your personal details, medications and insurance information up to 7 days before your virtual visit. We recommend doing this 2-3 days before your appointment so these details can be shared with your clinical team in advance. A member of your care team will call you before your appointment to review your list of medications and ensure you’re ready for your video visit.
Download the apps you need in advance
Before your appointment, download the apps you need on the device you plan to use and make sure you can access them correctly.
MD Anderson patients are encouraged to use the MyChart mobile app on a smartphone or tablet for the best video visit experience. You can download the free MyChart mobile app from the App Store or Google Play. You will also need to download the ZOOM Cloud Meetings app to the same device. Newer smartphone and tablets will be able to download the ZOOM Cloud Meetings app; see a list of operating systems that support the ZOOM Cloud Meetings app.
You must use the MyChart mobile app to join a video visit on your smartphone or tablet. You cannot go to our MyChart website from your smartphone or tablet and start your video visit.
While you can use a computer to access your MyChart account at MyChart.mdanderson.org, you may have more technical problems than if you use the MyChart app on a smartphone or tablet. Use our MyChart Video Visit Instructions or call 1-877-632-6789 if you need assistance. You also can watch a video with MyChart Video Visit instructions.
Set the stage for your virtual visit
Just as you’d do for a video call with colleagues, find a quiet, well-lit space for your virtual visit. Be sure to check the background noise and any visuals that may appear around you while you’re on screen.
Test where to direct your gaze on your webcam setup. Look into the camera so your doctor can have a more engaged conversation with you.
Use headphones, if possible
Plan to use headphones or a headset, if you have them. This will make it easier to hear your provider and may improve the sound quality.
If you’re including a household member in your virtual visit or don’t have headphones or a headset, check for background noise and move to a quieter space, if necessary, to eliminate distractions during your virtual visit.
Do a tech check
Before your visit, make sure your device is charged and that you have a strong internet signal or WiFi connection. A higher speed internet connection will help to increase the overall quality of the video and audio during your virtual visit.
It’s also important to confirm that your audio, video and headphones are working at least an hour before your virtual visit. They should work if you’ve recently used your device for other video chats.
“As with any new technology, you may encounter technical issues, but to ensure we can provide a timely and high quality experience, it’s a good idea to test everything before your visit,” says Navai. “You’ll have a better, more focused conversation with your provider if you don’t have to worry about technical difficulties.”
Your virtual visit will last as long as an in-person appointment
Your virtual visit will run a lot like an in-person visit and last about as long. Your provider will ask you questions, covering topics such as new symptoms, side effects and other concerns you may be having, as well as next steps for your treatment or follow-up care.
Use this time to ask questions and share concerns with your provider, just as you would in person.
You can include family members in your virtual visit
Just as you might have brought family members to appointments before visitor restrictions were put into place to prevent the spread of COVID-19, you can include family members in your virtual visit. A family member or loved one can provide a second set of ears, take notes and ask questions you might not think of.
If your family member if participating from your home, have them in the same room as you and make sure they can appear on the screen, too, if possible. If you try to include them from another device in the same home, there may be a distracting echo.
Want to include a loved one in your virtual visit from another location? If you're an MD Anderson patient, you can add them through the ZOOM app by following these instructions.
Plan to pay the same co-pay that you would for an in-person visit
You will be charged the same co-pay for your virtual visit as you would for an in-person appointment. But you will not be asked to pay during your virtual visit. Instead, the balance will be listed in your eUpdate after your visit. Your insurance company determines the cost of this co-pay. If you have questions about charges, payments and balances, send a message in MyChart or call 1-800-527-2318.
Know what to do if the connection is lost
Sometimes things don’t go exactly as planned. Here’s what to do if you lose your connection during your video visit:
- If you can still see your video, keep the video connection active and don’t close the video window. Your provider may be able to rejoin soon.
- If you lose your connection, restart the video visit following these steps. You may be placed in the virtual waiting room until your provider is able to restart the video visit.
- If the video visit can’t be restarted, your provider will call you to complete the visit or provide more instructions. Your provider will call you at the phone number you listed in your eUpdate, so be sure to keep that phone close by.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
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Due to our response to COVID-19, all blood donations at MD Anderson
Blood Donor Center locations are being held by appointment only.