Social distancing to avoid SARS-Cov-2 infection in cancer and non-cancer patients.

Background: Social distancing has been recommended by the CDC to avoid exposure to SARS-CoV-2. Cancer patients on or after active therapy appear to be more prone to COVID being symptomatic and life threatening. When evaluating cancer patients' risk of acquiring COVID it is essential to know the behavior of cancer patients that will affect their risk of exposure. However, it is not known to what degree social distancing is practiced by cancer patients compared to non-cancer patients and what factors lead to the decision to distance oneself. Methods: After a pilot phase using patients MyChart messaging, links to the electronic questionnaires were texted to patients using Twillio. Responses were stored on REDCap. Six questions about their social distancing behavior and mask wearing were posed and responses were compared between cancer and non-cancer patients. Demographics, comorbidities and a questionnaire about anxiety (GAD-7 scale for Generalized Anxiety Disorder) were recorded. To assess differences between cancer and non-cancer groups Bonferroni-corrected chi-square tests and proportions confidence intervals were used. Results: The pilot survey was sent in mid-2020 and the full survey followed in January 2021 during a high community COVID incidence. 387 cancer patients (32.4% responded and 503 noncancer (22.9% responded) patients completed the survey. Questions about leaving their house, driving, shopping, friends and family indicated that patients with cancer are more cautious (p 60 years, 69 % vs 45%) and less likely to work (52% vs 31%) or less likely to be white collar workers (21% vs 38%). There was no difference of the anxiety score in both groups (not at all anxious, 54%). Conclusions: Cancer patients' responses revealed a distancing behavior that would likely lower the risk exposure to SARS-CoV-2. It is unclear, which of the demographic differences would account for this behavior, although remarkably anxiety was not a clear motivating factor. The high acceptance of masks is encouraging. Early publications during the pandemic and patient education suggesting a higher COVID risk for cancer patients may have reduced risk prone behavior. Considering COVID's impact on the vulnerable cancer population and uncertainty in immunosuppressed patients about clearing the virus or adequately responding to a vaccine, further studies about health behavior and health promotion during the pandemic are needed.