LUPUS and COVID-19

Immediate Precautions - if you have lupus what you should do right now

Resources - further information

 

IMMEDIATE PRECAUTIONS

1.       If you have been prescribed hydroxychloroquine (Plaquenil) or chloroquine it is imperative that you have 3 months supply on hand. 

To be specific - 3 months supply that is located at your home.  Call your pharmacy right away and get the supply as soon as possible.  If there is any discussion as to why you need 3 months supply you can state that since you are immune compromised you must have enough of this particular medication on hand to avoid flares - as urgently recommended by Dr. Jennifer Reynolds, Director of the Lupus Clinic in BC and rheumatologists. 

Why is this so important and critical?

        There are hydroxychloroquine shortages occurring in the US and this will shortly be the case in Canada, if not already. 

        In lab tests, scientists have found that chloroquine can block the SARS-COV-2 virus that causes COVID-19 from entering cells. Clinicians then tested the chloroquine treatment in patients and found that among 100 COVID-19 patients, those given chloroquine recovered faster and had less severe symptoms than those who did not receive the drug.

        While this is not an approved treatment here for COVID-19, it is possible some physicians may start prescribing it.   Dr. Reynold’s concern is that there may be a lack of hydroxychloroquine availability for patients with lupus if there is more widespread use for COVID-19 patients.

2.       Take your medications.  Be diligent - don’t skip doses

·         You need to do everything you can to avoid a flare/needing hospital care.

 

3.       Your hands!  Wash your Hands, and watch what you do with your hands.

        Wash with soap for a minimum of 20 seconds - 30 seconds is better.  Make sure you do all parts of your hands including between your fingers

        Keep your hands away from your nose and mouth

        Do not shake hands

        Do not share food, drinks, and utensils, and do not eat from buffets

 

4.       Self-Isolate

        Avoid hospital visits and doctor visits unless absolutely necessary.  Most patient consulting is now virtual (by phone or by internet).  If you do not have in person virtual access to a doctor see the resource section below

        While leaving your home in not recommended, if it is absolutely necessary that you leave your home Keep Social Distance - that means stay 6 feet or 2 metres away from other people.

        Stay at home.  If at all possible don’t have visitors at your home, don’t go visit others.

5.       Stop using ibuprofen - see section below “Concerns about Taking Anti-Inflammatory Medications

 

 

RESOURCES

 

HealthLink BC and 8-1-1 HealthLink

8-1-1 is a free-of-charge provincial health information and advice phone line available in British Columbia. The 8-1-1 phone line is operated by HealthLink BC, which is part of the Ministry of Health.  Online at https://www.healthlinkbc.ca/

COVID Symptom Self-Assessment

If you are feeling unwell, you can check your symptoms online. This resource is available 24 hours a day.

The Province of British Columbia provided a COVID-19 Provincial Support information page. You will find information on preparing, containing and breaking the chain of COVID-19 transmission.

If you have questions you can call HealthLink BC at 8-1-1 toll-free in B.C., or for the deaf and hard of hearing, call 7-1-1. Translation services are available in more than 130 languages.

 

Virtual Consult

Contact the office of your physician and specialists to schedule a virtual appointment using technologies such as ZOOM, Skype, FaceTime, SMS Text Messaging, Email. 

Babylon by Telus

TELUS’ virtual healthcare solutions allow you to securely monitor your health and that of your families. Through Babylon by TELUS Health, you have access to a free, customised COVID-19 online symptom checker, and patients in B.C., Alberta and Ontario can schedule a one-on-one video consultation with a licensed doctor at no cost from your smartphone and in the comfort and safety of your own home. Note: BC Lupus has no direct experience with the Telus Babylon and this link is shown only as a possible resource

The Canadian government

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

 

The BC Centre for Disease Control

http://www.bccdc.ca/health-info/diseases-conditions/covid-19

 

Arthritis Research Canada responding to the COVID-19

 

March 16, 2020 (Vancouver, BC) – In light of the recent developments with the COVID-19 outbreak and the changing recommendations from the governments of BC and Canada, Arthritis Research Canada is carefully monitoring the information and implementing a number of protocols to ensure our volunteers, research participants, students, and staff are informed and protected according to the latest reports.

 

We are encouraging everyone to follow the advice being provided so that we may help prevent the spread of the virus across our communities and country. While we are concerned for all people, we are particularly so for those with auto-immune diseases and/or those who are immunosuppressed.

 

The following links provide the latest information from

The Canadian government:

https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html

 

The BC Centre for Disease Control:

http://www.bccdc.ca/health-info/diseases-conditions/covid-19

 

Additionally, as an organization dedicated to preventing arthritis and improving the quality of life of those affected by arthritis through research, we offer the following information and recommendations:

 

1) Are there concerns about taking anti-inflammatory medications?

 

In light of observations that patients taking ibuprofen may have more severe respiratory illness when affected by COVID-19, the WHO recommends to avoid using ibuprofen to treat symptoms of COVID-19, and use acetaminophen instead to treat symptoms of fever or headaches. Taking this a step further, we recommend that patients using anti-inflammatory medications for their arthritis consider stopping them, even when asymptomatic for COVID-19, so that the medication is out of their system if they contract the illness. We recommend trying acetaminophen on a regular schedule up to the maximum recommended dose to control arthritis pain (e.g. up to two Tylenol for arthritis three times a day), and consider using NSAIDs only if there are no other options for pain control.

https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms

·         Examples of anti-inflammatory medications, also called NSAIDs, include ibuprofen (Advil), naproxen (Alleve), diclofenac (Voltaren), indomethacin (Indocid), celecoxib (celebrex), meloxicam (Mobicox). If you are unsure if your medication is an NSAID, contact your pharmacist.

 

2) What is known about the rate and severity of infection in patients with rheumatologic disease, especially those patients taking prednisone, DMARDs, biologics, or other immunosuppressive agents?

 

·         Currently, there is no specific data on SARS-CoV-2 (the name of the virus responsible for COVID-19 disease) in patients with rheumatologic disease or immunosuppression. However, the medications listed do suppress the immune system and therefore increase the risk of having a more severe infection if patients come in contact with the virus. Therefore, people on these medications are considered at high risk and should take extra precautions to avoid contact and should seek medical attention if they have any symptoms, following the local directives for testing and accessing health care if symptomatic.

 

3) Should patients who are taking prednisone, DMARDs, biologics, or other drugs for their rheumatic diseases stop them?

 

·         It is not recommended for people to stop their DMARD medications if they have no symptoms of COVID-19, as uncontrolled inflammation can be harmful for the body’s response to the virus. Stopping prednisone abruptly is also dangerous to one’s health, as the body’s own production of cortisol is suppressed.

·         People should follow the usual practice of interrupting therapy during episodes of infection (i.e. if symptomatic or positive for COVID-19). Patients should talk to their rheumatologist or prescribing doctor prior to discontinuing any of their medications, or if they are uncertain what to do, e.g. if a close contact is positive for COVID-19. This is a complex decision based on assessment of other diseases and of the specific situation.

 

4) Are any pharmacologic measures (prophylactic or therapeutic) recommended?

 

5) What can patients do to protect themselves against contracting this disease?

 

6) What else can patients and their providers do?

 

We hope that you will join Arthritis Research Canada in following the advisories communicated by the BC Medical Health Office, BC Centre for Disease Control and Ministry of Health, and the Canadian government.

Your health and welfare is very important to us and as we all deal with the COVID-19 situation that is currently unravelling before us, please know you are in our thoughts as we actively adapt to this pandemic.

 

Stay well.

 

 

ABOUT ARTHRITIS RESEARCH CANADA:

Arthritis Research Canada is the largest clinical arthritis research institution in North America. Our mission is to transform the lives of people living with arthritis through research and engagement. Led by world-renowned rheumatologist, Dr. John Esdaile, Arthritis Research Canada’s scientific team of over 100 are creating a future where people living with arthritis are empowered to triumph over pain and disability. Within British Columbia, Alberta and Quebec, Arthritis Research Canada is leading research aimed at arthritis prevention, early diagnosis, new and better treatment, and improved quality of life.

 

Marketing & Communications
Arthritis Research Canada
604-207-4002 or mc@arthritisresearch.ca