Lisette Caesar, 49, is fighting colon cancer and she’s at the tail end of a seven-month slate of chemotherapy. That means she is in pain most days. And the treatment weakens her immune system. 

So, especially in the age of coronavirus, social distancing is not optional. Public health officials say the risk of getting seriously ill from coronavirus increases for people with health issues like heart disease, lung disease, diabetes, and compromised immune systems. 

Caesar had to turn down tickets to attend a Knicks game last week (though that option is now moot), even though she loves basketball. And she just canceled plans to see a play this week. 

“I'm not doing any kind of large outings right now because you just don't know, you know, who has what at this point.” 

Even with friends, she keeps more of a distance than she did just weeks ago.

“Definitely no hugging or kissing anymore,” Caesar said. No fist bumps, either. 

Otherwise, the health precautions most healthy people are ramping up are ones that Caesar is used to. She is a frequent handwasher and enforcer of handwashing for those that come visit her home in Brooklyn. She cleans the floors and surfaces of her apartment with vigor. She asks visitors to take off their shoes or offers them shoe covers. Masks are in a basket by the front door for visitors who feel they might be coming down with something — but most friends know only to come by if they are feeling healthy.

Having faced colon cancer for going on a year now, nothing about coronavirus is making her uneasy at the moment.

“I know that there's a lot of people anxious, but because I guess I've been living with this for so long, I'm not anxious about it,” she said. “As cautious as I am, I can't control if I do catch a cold or catch something. We can do preventative things, but, you know, life is unpredictable.” 

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Still, for some with underlying health issues, there is some fear of the unknown with coronavirus. Cardinale Smith, an oncologist and chief quality officer for cancer for the Mount Sinai Health System, said she is frequently getting two types of questions from patients. 

First, she said patients ask, “‘How significant is this? You know, can I move on with the rest of my life because I feel like all I'm hearing is about coronavirus.’” 

And then there are patients who are deeply concerned about how dangerous the virus could be for them. 

“Like not really knowing how one can best protect themselves, but also really not knowing what that real risk is to you as an individual,” said Smith, is a source of stress.

Smith also explained that it was especially important for patients with serious health issues to stay connected to others and still feel a sense of community. Mount Sinai has canceled in-person support groups, but patients can continue them through video or audio conferencing. 

Now is also a good time, Smith said, for healthy neighbors to support those who are especially vulnerable to becoming seriously ill from coronavirus.

“If you're able to go pick up their favorite meal or food from the grocery store and just drop it off at their door for them,” Smith suggested. “If you have a car and your neighbor doesn't, and they need to get to an appointment, I think offering to drive—those kinds of community building things are really key.”

Caesar has strong support. She is the principal of Mosaic Preparatory Academy, a public school in East Harlem and one she helped found. She is on leave this year for cancer treatment, but gets regular calls and cards from students and their parents, Caesar said. She misses her students dearly, and started a YouTube channel, “Reading With Dr. Liz” from home.

Principals in the school district have sent her meals and alkaline water, which helps flush out the toxins from the chemo.  

And Caesar always preferred an online Facebook group for people with colon cancer to an in-person support group, so that aspect of community support remains unchanged for her. 

One difference: Caesar now has to wait days instead of hours for her grocery orders, since more and more people are flocking to these delivery services, too. 

Caesar’s last chemo treatment is scheduled for this Monday. Her cancer was diagnosed at Stage 2, fairly early, which she hopes means that seven months of treatment will be enough. 

“It’s been a very, very hard journey. I've had days where I just want to give up,” she said thinking of the pain of treatment.

“I've had family call me and literally curse me, say ‘get out your own funk.’ They remind me of my purpose in terms of the work I do in education, so that I continue to fight to get back to that,” Caesar said.

She plans to speak at her school’s fifth grade graduation in June, as long as things calm down on the coronavirus front.