(relaxed upbeat music)
- We're here today to talk about coronavirus,
or in this particular case, COVID-19.
We're gonna answer some frequently asked questions
that we've been getting from our patients.
The CDC came out with guidelines for people at higher risk
of getting very sick from the COVID-19.
Should we consider people with rheumatic diseases
to be at high risk?
- So, there are several reasons
why we might consider patients with rheumatic disease
to be at higher risk.
Probably the most common reason is that many of our patients
take immune suppressing medications.
These medications could be in the form of biologic,
injectable, or infusion medications,
but also oral medications that people take,
that suppress their immune system,
such as methotrexate, CellCept, or prednisone,
all of these medicines work
by suppressing the immune system,
so that does place a patient at higher risk potentially
from having complications of COVID-19 infection.
Another reason that people could be at higher risk
is they could have complications of their disease
that might involve their heart or lung,
that would also place them at higher risk.
So given those concerns,
what precautions should our patients be taking?
- One thing is to stock up on supplies.
This would prevent you from having to go out frequently
into the public, to get supplies.
So if you could stock up on your supplies,
and even your medications,
to have about a one month extra supply
of medications if possible.
You're going to take your everyday precautions,
which includes good hand hygiene,
of course, if you cough or sneeze,
to cough into your elbow,
to try to avoid touching your face,
and some of these other regular standard precautions.
So you don't wanna go someplace where there are going to be
large crowds, you really wanna limit close contact
with other people, you wanna be cautious with your travel.
Please avoid traveling on a cruise,
and if you have any nonessential air travel,
you may wanna consider canceling that as well.
Should I stop my immunosuppressants,
to help decrease my risk?
- I think at this point,
in an asymptomatic patient,
we do not want patients as a general rule
stopping their immune suppressing medications.
There are several reasons for that, the first reason is
is that stopping the medications could precipitate
a flare up of disease, and for some of our patients
these flare ups could be serious.
And in some cases, may actually require
going on more immune suppressing medicines
than you were to begin with if there to be
a significant flare of the disease.
We also know that patients who have flare of their disease
might be actually also at higher risk for infection
or infection complications if their disease is active.
So for those reasons, we really don't recommend
that asymptomatic patients stop
their immune suppressing medications.
Symptomatic patients are a different story,
and we would like patients
who develop respiratory infection symptoms,
particularly if there's been a concern for exposure,
to in conjunction with their provider,
likely stop their immune suppressing medications.
Another reason patients should not stop
their immune suppressing medicines,
if they don't have any symptoms of respiratory infection,
would be that we don't really know the timing at this point
in terms of how long that period of time might be,
since we don't know how this virus is gonna behave.
And if patients are off their medications
for a period of time, that increases the risk
that they might have a flare,
and may reduce the efficacy of their medications
once they go back on them.
- [Vicky] What should I do if I develop symptoms
of a respiratory illness,
and I suspect I may have been exposed to COVID-19?
- So, if a patient develops respiratory symptoms
that are severe, meaning a patient has severe
shortness of breath, or chest pain
that requires emergent evaluation,
we still suggest that patients call 911,
and get those symptoms immediately addressed.
It is probably helpful that you would tell the paramedics
if there has been an exposure,
or a concern of exposure to COVID-19,
and tell the same thing to a 911 operator.
If you have mild symptoms, we ask that you call
your physician, and discuss those symptoms,
and whether you would stop
your immune suppressing medications,
if you can stay at home, what you would need to do at home
to take care of yourself, and what symptoms
you should watch out for to seek
additional medical attention.