Australian & New Zealand Childrens Haematology/Oncology Group


COVID-19 Guidance and FAQ for children and young people undergoing cancer treatment

Wednesday 18th of March 2020


Coronavirus (COVID-19) is a new strain of coronavirus affecting humans. Some coronaviruses can cause illness similar to the common cold and others can cause more serious diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).  This novel coronavirus is still new and as such we are still learning more about it. 

Symptoms reported in identified cases of COVID-19 novel coronavirus include: 

  • fever 
  • a cough 
  • sore throat 
  • fatigue 
  • shortness of breath

There is no specific treatment for COVID-19 infection. Antibiotics are not effective against viral infections. However, most of the symptoms can be treated with general medical care. There is currently no vaccine for COVID-19 novel coronavirus. 

This is a rapidly evolving situation which is being monitored carefully. This fact sheet provides information based on the current evidence for families of children or young people who are undergoing or have undergone treatment for cancer.  


How is the virus spread? 

The virus is thought to spread mainly from person to person through droplet transmission. These respiratory droplets are produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby (within about 1.5 metres). It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or possibly eyes but this is not thought to be the main way that the virus spreads. This is why washing hands frequently is so important

Is my child at increased risk of more severe infection with COVID-19? 

Information currently available shows that the infection is milder in children than in adults. However, children with a compromised immune system are likely to have a higher risk of more severe infection. Most children receiving chemotherapy do not have life threatening disease when they have other respiratory viruses such as influenza. We hope that this is also the case with COVID-19 but at this stage we do not have enough information to quantify the extent of the risk. Given this uncertainty we believe that it is very important to take extra precautions (outlined below) to protect your child from contracting COVID-19. 

Should my child attend school? 

School closures have been mentioned a lot in the media as a potential means to slow the spread of the virus and minimise the risk that the health care system is going to be overwhelmed.  Currently, the government has not recommended school closures although this may change. This is a separate issue to the question of whether immunocompromised children should avoid school to minimise their risk of infection. Until this point, the infection has not been widespread in the community and our assessment has been that it was safe for children receiving treatment to continue to attend school. Some, but not all, Australian children’s cancer centres are now recommending that children who are receiving therapy or who have had a BMT within the past 12 months should not attend school. This will depend upon local policy and the number of cases in a particular community.
Please refer to your own treating centre for current recommendations regarding school attendance.
It should be noted that the risks related to going to school are no more and in fact, may be less than attending shopping centres, going to the movies or attending gatherings with groups of more than a few people. Therefore, if your child’s treating centre recommends that your child should not attend school, they are in fact recommending that you should institute these other strict social isolation precautions. Removing your child from school without instituting these other isolation precautions will only provide marginal benefit. It should also be noted that it is likely that these precautions will be required for several months.

Should my child’s siblings attend school? 

Once again, refer to your local treating centre’s policy for up to date advice regarding this issue.  Most treatment centres are not recommedning that the entire family self isolate at this point in time as it is not practical for the vast many families. This recommendation may change as the situation evolves. More strict isolation may be mandated by the government if the number of cases escalates rapidly.

What else can we do to avoid infection?

Basic hand and respiratory hygiene measures remain the most important measure for preventing infection.
These include: 
1. Wash your hands with soap and water or alcohol based hand rubs regularly 
2. Cover your nose and mouth with a tissue or flexed elbow when you cough or sneeze and be sure to dispose of the tissues 
3. Avoid contact with anyone who has flu-like symptoms 
4. Try to stay at least 1.5 metres away from people who are coughing or sneezing 
5. If possible avoid close contact with family members with flu-like illnesses 
6. Avoid touching your face 

Should my child wear a mask? 

There is very little evidence that face masks will reduce the risk of infection. Masks need to be worn correctly, changed frequently, removed properly and disposed of safely in order to be effective. Therefore, we are not recommending routine use of face masks. 

Masks can be useful to prevent the spread of the virus if you are infected. If you have symptoms of a respiratory tract infection and it is essential for you to attend hospital, please wear a mask, or ask for one when you arrive.  

Will the supply of my child’s medications be affected by COVID-19?

We are closely monitoring issues related to drug supply and, at present, do not anticipate any problems. Currently, there are no shortages linked to COVID-19.

Should I attend my child’s follow up appointments at the hospital? 

Many hospitals are planning to minimise the number of people required to visit. This will provide increased protection to children who are receiving treatment and the staff required to look after them. Therefore, some hospitals might conduct routine follow up appointments by telephone or videoconference. If you or your child are unwell with flu-like symptoms, please phone ahead for advice as to whether you should attend your appointment. 

Will my child’s chemotherapy treatment be interrupted? 

Every effort will be made to ensure that your child receives their treatment as planned. We are not planning to modify treatment plans at this stage. 

Will there be any other changes to my child’s treatment? 

It is possible that there may be shortages of blood products such as packed red blood cells and platelets. We may need to change our thresholds for transfusion of these products. 

Are there any restrictions on visitors to the hospital? 

Your child’s hospital might place restrictions upon the number of visitors that your child can have while in hospital or attending clinic appointments. 

My child has completed their cancer treatment. Are they at increased risk? 

The vast majority of children with cancer who have completed their planned treatment should have a relatively normal immune system within 2-3 months of completing therapy and are unlikely to be at increased risk of severe infection. We are not advising any special precautions for this patient population.  

Should my child and family have the flu vaccination? 

Flu vaccination is recommended for all family members when it becomes available in April and for your child when recommended by their oncologist. Flu vaccinations will not protect against COVID-19. 

Other related COVID-19 news:

  • COVID-19 updated guidance for children and young people undergoing cancer treatment: Click here
  • A multicentre study of SARS-CoV-2 infection in children with cancer, immunodeficiency or following stem cell transplant: Click here