What does COVID-19 mean for me?

Yesterday was Day 15 and an appointment with Dr. Atallah.

My labs are holding ok:
White blood cells: 2.3 (from 2.4 on Monday)
Absolute neutrophils: 1.3 (same as Monday)
Hemoglobin: 10.4 (down from 10.7)
Platelets: 25K (down from 33K, and because they're so close to 20K, I need to go in for labs tomorrow)

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I have started and re-started a post on SARS-CoV-2/COVID-19 so many times, but before I could post, information and recommendations and seemingly everything that's known has changed!

I won't re-write everything that someone else has already written, although I'll share a few general thoughts (current as of today) and a few great (IMO) links for further reading.

Why is this such a big deal when the flu, suicide, TB, gun violence, etc. all kill more people annually?

• Unlike the flu or a cold, this is a novel coronavirus which means that it is new, and therefore no one has antibodies against it (except the 69,623 people worldwide who have had it since December 2019 and recovered as of today). So when one person is sick, pretty much everyone around them has the potential to be infected. Did you hear about the super spreader in New York infecting at least 28 others?
• Read: COVID-19 is not the flu
• We are still not sure how long before a person becomes symptomatic that they are contagious. There are cases that have appeared without known contact with a symptomatic person.
• Read: CDC's How COVID-19 Spreads
• While it is true that the majority of cases will be minor, it does NOT make sense for anyone to try to get sick (think Chickenpox parties). Besides the fact that not all cases are minor, the longer it takes for the general population to be infected, the more time there is for hospitals to treat and release (not be overwhelmed), for faster tests to be developed, for a vaccine to be developed and produced, and overall to save more lives.
• Read: Flatten The Curve
• Although the cancellations of sporting events, concerts, requirements to work from home, conversion of school to online formats, and everything else is a complete pain for pretty much everyone right now, I'm asking you to trust in public health. Hey--we're used to only being acknowledged when we don't do our job right!
• Fun read/printout: Work At Home Bingo Card

Now on to how the COVID-19 pandemic may impact me personally (since this is, after all, my blog about cancer):

I started off, in January, convinced that "the novel coronavirus" was like many other coronaviruses and that influenza was still a much bigger concern. That's definitely not the case now. In the last week or so, I've spent a lot of time thinking (selfishly) how it might impact me, and more specifically my transplant.

1. I have a weakened immune system. Catching COVID-19 could well prove fatal. I am more likely to catch it if it keeps spreading because people selfishly think it's not a big deal and continue to go out in large groups in public and spread it.
2. My donor is international. What if travel is not allowed between the country they live in and the US? Would I even be able to get the stem cells?
3. My donor is young--early 20's. What if they (or their parents) decide that, in these uncertain times, it is too risky to donate stem cells?
4. There will likely be a surge of patients requiring hospitalization. What if hospitals are overrun with COVID-19 patients and there isn't even a room available for me for the transplant?
5. Medical providers will likely be stretched by patient care, their own possible illness, being needed to take care of children who are no longer in school or daycare. What if my medical team cannot care for me while I'm in the hospital?
6. The US gets medical supplies from many other countries, and already many things are becoming scarce. What if I'm in the hospital, but supplies are no longer available, including PPE (important when working with someone immunocompromised) or IV fluids?
7. I was told that the sooner I get to transplant (after achieving remission), the better. What if my treatment gets pushed back due to all the other priorities, and in that time I fall out of remission and am no longer eligible for a transplant?

At my doctor appointment yesterday I was reassured of some of my fears, but unfortunately not all of them.

I do have to be extra careful to not get sick. But more importantly, my donor is in Europe. I learned yesterday that my transplant has been pushed back by a week. I hope this is the only delay. Unfortunately, pushing it back means that I will require another round of Vidaza. I am trying really hard not to feel sorry for myself.

Round four of Vidaza will be March 26-April 1 (I'll add entries to the google driving spreadsheet when I have exact times).
I'll have a bone marrow biopsy sometime in April.
If nothing else changes, I will be admitted to the hospital for pre-transplant chemo on April 23.
My transplant day will be April 29.

I did learn that they will not start the pre-transplant chemo until they have the stem cells "in the refrigerator" at the hospital, so that at least means that I won't end up with no bone marrow and none coming! I just hope that this schedule is not put off any further. And I need my body to be awesome about keeping me in remission. I am hopeful.

I've been trying really hard to find a silver lining in this delay. I did find one. Last year I signed up for a really cool project, 30 Days of Biking. Essentially you commit to bike every day in April--indoors, outdoors; long, short; fast, slow. I didn't think I'd be able to participate this year, but I'm going to try to ride either 22 Days of Biking or 23 Days of Biking (depending on admission time). I invite any of you to join me in this project--and I will ask for volunteers to ride the remaining days in April FOR me. Kind of like surrogate bikers. Or maybe Handmaid bikers! Will you be a Handmaid biker for me?
If you want to sign up to bike all 30 days yourself, go to: https://30daysofbiking.com

OK, one last thing. I just want to say that since I went to grad school and earned a PhD in Public Health by researching hematopoietic stem cells, I will be SO UNBELIEVABLY PISSED if a pandemic kills me while I'm weakened by my own defective hematopoietic stem cells. I am not a fan of irony. It's time for Buffy the Vampire Slayer to attack COVID-19.