Ovarian cancer and COVID-19 (coronavirus): advice for patients in Wales

At the start of the pandemic in March 2020, medical experts identified the people who needed to follow shielding guidance to stay safe as their medical condition or treatment gave them a high risk of serious illness from coronavirus.  

You will be on the Shielding Patient List and will have been asked to follow guidance for people in this group if you have been diagnosed with ovarian cancer and you are currently having: 

• chemotherapy, or have had chemotherapy in the last 3 months
• treatment where they are taking a PARP inhibitor (olaparib, niraparib, and rucaparib)
• immunotherapy or any treatment that affects their immune system

You will receive a letter from the Chief Medical Officer for Wales if you are on the Shielding Patient List.

Shielding advice was paused in Wales on 1st April 2021 and is not being reintroduced. The Chief Medical Officer (CMO) for Wales sent a letter that month to confirm the latest information and advice. The CMO wrote again in December 2021 to provide advice in response to the Omicron variant. You can read a copy of the letter here.

At the moment, all adults on the Shielding Patient List (SPL) must still follow the same rules and general precautions as the rest of the population in Wales, but are also advised to take extra precautions to keep themselves safe from Covid-19. 

The basic steps you can take to protest yourself are:

• Keep contacts to a minimum
• Keep indoor spaces well ventilated – such as keeping windows open if you can
• Wash your hands regularly with soap and water for 20 seconds, or use hand sanitiser if hand washing facilities are not available
• Stay two metres or three steps away from people you do not live with
• Avoid touching your face and wear a face covering where required
• Clean surfaces regularly and avoid touching surfaces others have touched

People on the Shielding Patient List should follow the current alert level's guidance on socialising inside and outside their home. You should also continue to consider the risks of close contact with others as the chance of catching or passing on Covid-19 is generally higher in crowded spaces and enclosed indoor spaces. 

There are extra precautions you may wish to take when meeting others you do not live with to lower your risk of catching Covid. For example, you could:

• Meet outside if possible
• Make sure the space is well ventilated if you meet inside - open windows and doors or take other action to let in plenty of fresh air
• Wash your hands regularly and avoid touching your face
• Take a lateral flow test before meeting other people and ask those you are meeting to do the same

Having your Covid-19 vaccine is one of the most important things you can do to protect yourself against Covid-19. Some people on the Shielding Patient List have been advised against having the vaccine by their own doctor. If you have received personal advice, you should follow the advice of your own doctor.

Read the latest guidance for clinically extremely vulnerable people on the Government's website.

The advice to those who are clinically extremely vulnerable, previously ‘shielding’, has been kept under constant review. In all of the advice to you, the government have tried to find the right balance between the risks of coronavirus and the harm that asking you to continue to follow shielding measures can cause. Staying at home for long periods of time can harm your mental and physical health. 

Whilst there has been an increase in the numbers of cases in Wales, this has not resulted in the same rise in people becoming very sick and needing to go to hospital or dying as was seen in the first and second wave. This is largely due to the vaccination programme. As the risk of becoming very ill is lower, the Chief Medical Officer for Wales is continuing to advise everyone on the Shielding Patient List that is it not necessary to follow shielding measures right now. 

The Shielding Patient List is being maintained so that the Chief Medical Officer for Wales can write again to people in this group with any updates or if the advice on shielding changes.

Yes. The Shielding Patients List is updated regularly so you will have been added if there are medical reasons which mean you are now considered clinically extremely vulnerable from Covid-19.

You can read about the support and information available to you on Gov.Wales. 

Here's a summary of the support and resources available to you:

Support with daily living

You can go to the shops yourself, however if you do not feel comfortable doing so you should ask friends, relatives, neighbours or volunteers to go shopping for you. 

Priority slots for supermarket deliveries continue to be available in Wales. The major food retailers now have much more capacity for deliveries so there is less need to have separate arrangements. 

If you need support and you do not have anyone to help you, you can speak with your local council. If you need help with collecting medicines and have no one to help you, please contact your pharmacy directly.

There is also a service available if you, or someone you know, is affected by coronavirus (Covid-19) and needs additional support. This will help you to find information for a wide range of matters, from paying bills to finding somewhere to live.

If you need support from a volunteer or voluntary organisations your local County Voluntary Council will be able to put you in touch with organisations that might be able to help.

If advice changes for your area, the Welsh Government will communicate with the public via local radio and television, and you will also receive a letter if you are advised to follow shielding measures again. 

Support with your bills

If you do not have enough money to pay your bills, it is important to seek help as soon as possible. Call Citizen’s Advice free on 03444 77 20 20 or visit the Citizens Advice website. 

If you need help from the welfare system, you can also visit the Government website or call the Universal Credit Helpline on 0800 328 5644 (0800 328 1744 for Welsh language). 

You can also apply online for the Welsh Government’s Discretionary Assistance Fund payment here or by calling free on 0800 859 5924. 

Supporting you through work 

You should continue to work from home if possible, however you can return to work if your workplace is Covid secure. When planning a return to work, it is advisable to talk with your employer as early as possible about how employees are being kept safe. Your employer should help you to transition back to work safely and must take all reasonable measures to minimise exposure to coronavirus.

You should complete a Risk Assessment with your employer to help consider your personal risk factors for Coronavirus (COVID-19). This tool helps you consider your personal risk factors for COVID-19 and suggests how to stay safe. If you have concerns about your health and safety at work the first conversation you have should be with your employer. You can raise any ongoing issues with any union safety representatives, or ultimately with the organisation responsible for enforcement in your workplace, either the Health and Safety Executive, here, or your local authority. 

If you feel that you have been treated unfairly by your employer, or somebody who gives you a service, then the Equality Advisory and Support Service (EASS) offers a free advice service which you can access by calling 0808 800 0082, by text phone on 0808 800 0084 or by visiting their website.

Supporting your wellbeing 

Further information on looking after both your physical and mental health and wellbeing is available on the Public Health Wales website. For those with specific health conditions or requirements click on the 'Charity and Support Organisation Directory’. 

Education Programmes for Patients (EEP) Cymru provides a fantastic range virtual health and well-being courses for people living with a health conditions for free across Wales. EEP Cymru offer a six-week course 'Thriving & Surviving: Dealing with life after cancer'. Click here for a full list of courses and to sign up for a virtual wellbeing course. 

SilverCloud is an online course which offers support for anxiety, depression and much more, all based on Cognitive Behavioural Therapy (CBT). 

CALL Mental Health Listening Line provides a confidential mental health listening and emotional support line which is open 24/7. CALL can also signpost to support in local communities and a range of online information. Call 0800132737, text “help” to 81066 or visit their website. 

Mind Active Monitoring provides six weeks guided self-help for, anxiety, depression, self-esteem, and more. To get started, talk to your GP, any other health professional, or sign up directly here. 

ACTivate Your Life is a four session taught course that aims to teach people about stress and suffering caused by emotional issues, like worry, or chronic pain. To start go to the Public Health Wales website. 

The Young Person’s Mental Health Toolkit links young people, aged 11 to 25, to websites, apps, helplines, and more to build resilience. You can access the toolkit here.

Support for ovarian cancer patients 

We are continuing to inform and update anyone with an ovarian cancer diagnosis in this time. You can sign up to receive our monthly patient newsletter for tips on navigating the lockdown, as well as updates on the Government guidance at the bottom of the page. If there’s anything in particular you’d like to see from us, tell us on info@ovarian.org.uk. 

Ovacome's support line is now open extended hours, and you can call them for free on 0800 008 7054.

If, at any point, you think you have developed symptoms of coronavirus, such as a new, continuous cough and/or high temperature (above 37.8 °C), you should :

• Book a test immediately

• Seek clinical advice using the using the NHS 111 Wales COVID online service. If you do not have access to the internet, call NHS 111. Make sure you mention that you are an ovarian cancer patient who has been considered to be at risk. Do this as soon as you get symptoms
• In an emergency, call 999 if you are seriously ill. Do not visit the GP, pharmacy, urgent care centre, or a hospital.

To help the NHS provide you with the best care if you need to go to hospital as a result of catching coronavirus, please prepare a single hospital bag. This should include your emergency contact, a list of the medications you take (including dose and frequency), any information on your planned care appointments and things you would need for an overnight stay (snacks, pyjamas, toothbrush, your medication etc). If you have an advanced care plan, please include that.

The following advice is from the British Gynaecological Cancer Society.

Some existing cancer patients have open access to their gynae-oncology service, normally via the Clinical Nurse Specialist (CNS). If you have already had a gynaecological cancer diagnosis and have symptoms concerning for recurrence (such as persistent bloating and stomach pain), please get in touch with your CNS via their usual contact details. Please be aware that many staff have been re-deployed to look after acutely unwell patients, so there may be a delay, or a CNS from another cancer team may be covering the gynaecological cancer team.  Please be understanding with us if this is the case. We will try our very hardest to look after you and get back to you as quickly as we can.

Sometimes you may be referred to another hospital in your area, if your normal hospital is very busy. We have been working together to help get you seen and treated as soon as we can. We are all one big NHS team, now more so than ever. Please bear with us and be understanding, if this is the case.

Carers or support workers who support you with your everyday needs can continue to visit you, unless they have signs of coronavirus.

All carers or support workers must wash their hands with soap and water for 20 seconds when they enter your home and often while they are in your home. 

Your hospital or clinic will contact you if any changes need to be made to your care or treatment. Please phone your hospital or clinic if you have any questions about your appointment. 

Some hospital appointments may need to be cancelled, postponed or changed to be over the phone or the internet. You can read a helpful guide put together by Ovacome about how to prepare for these appointments here. This is part of the plans to help the NHS to respond to the coronavirus outbreak. You will still be able to contact your hospital care team if you have an urgent issue.

If you do not feel ready or able to collect your own prescriptions you can:

1. Ask someone to pick up your prescription from your local pharmacy to help (this is the best option).
2. If you do not have anyone who can help, telephone your pharmacy and ask them to deliver your prescription. Let them know you are in a high-risk group.

You may also need to arrange any special medication prescribed to you by your hospital care team to be collected or delivered to you.

You can find the latest guidance for patients living in Wales here.

You can find out more in our Covid-19 vaccine FAQs. You can also read more here:

• NHS Covid-19 vaccine page
• GOV.UK COVID-19 vaccination page
• Joint Committee on Vaccination and Immunisation