A Pretoria-based rheumatologist recently emailed letters to her patients, providing them with tips and guidelines to help manage their health during the coronavirus pandemic. She also shared helpful links to various credible sources to shed more light on the situation.
Rheumatologist’s tips and guidelines for patients
Dear Patient
Unfortunately I can’t answer every Corona/COVID19 enquiry personally at this stage. Please read through the info below and contact the rooms on (012) 440 -0816 during office hours if you still have questions. This info was compiled on 17 March 2020. Please note that the advice might change as the pandemic progresses.
Corona/COVID19 Advice
Immune suppressive drugs are useful to prevent a worsening of your auto-immune arthritis. When you stop these drugs, you may experience a flare-up that can be difficult to bring under control again later on. With regard to the effect of these drugs on a possible Coronavirus infection, we do not yet know enough to offer formal advice. We therefore advise you not to stop or reduce your medication at this time, unless advised by a doctor to stop for other medical reasons. This pandemic can potentially last for a few months and stopping your medication unnecessarily might cause great difficulty later on to bring it back under control.
If you have symptoms such as fever, shortness of breath or persistent cough, you may need to be tested for coronavirus. Please contact your GP or myself.
Depending on the results, if you are positive for COVID-19 you should stop your biologic therapy, methotrexate or leflunomide, as you would for any active infection; the treatment may be resumed after the infection has cleared. You will probably be able to continue with your cortisone (steroids), but please check this first with your GP or myself. Remember that for most people the COVID-19 infection is much like a bad cold and people recover fully. Only a really small number (3-4 people out of every 100) of people infected with the virus will die. I suggest that you also stop anti-inflammatory medicines if you are diagnosed with COVID-19, as it looks as if anti-inflammatories might perhaps slow down your recovery. You may safely take paracetamol (Panado, Painamol) for the treatment of fever and pains until you have recovered. Combination pain killers like Tramacet and Stilpnae are OK too.
In the event that you have a routine appointment booked it would be wise phone the rooms beforehand to ask if it is essential to come in or if it can be performed by telephone. However, if your arthritis is not well controlled you will have to come in for an examination.
Please also take the following normal precautions advised for the whole population
- Wash your hands very regularly for at least 20 seconds using soap and water. Dry hands thoroughly afterwards. Alternatively you can use an alcohol based hand sanitizer.
- Try to avoid touching your face.
- Coughing or sneezing should be into an elbow or tissue paper and the latter should be discarded safely.
- Use disposable tissues.
- Wear a mask when you are ill; if there are no symptoms it is not necessary to wear a mask. The mask cannot completely prevent virus transmission, but it is a good reminder of not touching your face and serves to warn others that you may not be well.
- Practice sensible social distancing (1- 1 ½ m) especially from people who appear to be ill, e.g. coughing or sneezing.
- We should greet each other without shaking hands, and avoid hugs.
- Try to avoid busy public transport and large groups of people.
- Do not embark on unnecessary travel
Useful links
Telephonic hot-line 0860 240 024 (ONLY FOR CORONA enquiries)
https://www.eular.org/eular_guidance_for_patients_covid19_outbreak.cfm
Home made masks: https://www.indiatoday.in/trending-news/story/coronavirus-anand-mahindra-shares-easy-hack-to-make-face-mask-at-home-seen-yet-1654691-2020-03-12
https://www.mediclinic.co.za/en/corporate/corona-virus.html.
Official information on number of cases worldwide: https://www.worldometers.info/coronavirus/
Stay healthy,
Regards
Dr Christa Visser
