This webinar held on 30th March, 2020 was an informative session with Dr Sapan C Pandya on how patients who are living with a rheumatological conditions can manage their condition during this current pandemic and lockdown period.
Are people with Rheumatic diseases more vulnerable than others to the COVID infection?
There is no evidence that people who have immunosuppressant diseases will get the corona virus infection more than others. They may be more susceptible for complications once they have contracted the infection. So, if you are on immunosuppressant medications, you will have to be more careful if you get the infection.
Should patients continue to take their immunosuppressant drugs?
The Indian Rheumatology Association (IRA) website has a special section on COVID, which provides guidelines on use of all the medications for Rheumatological diseases including immunosuppressants. The precise specifications on each drug may differ from patient to patient, however the bottom line is that immunosuppressants should not be stopped on your own. It is more important to focus on controlling your existing chronic condition instead of worrying about the corona virus which any normal person is also likely to get. For specific answers about your medication, you must get in touch with your Rheumatologist.
Should patients explore Hydroxychloroquine (HCQ) for prophylaxis?
While the WHO and CDC do not recommend taking the HCQ drug for prophylaxis, the ICMR does. Remember that these are experimental data and there are two undergoing trials still in question. HCQ does play a role in treatment but there is still controversy regarding its use in prevention unless you are a healthcare worker.
How can one prevent and manage flare-ups during this period?
Take your meds regularly. Since you cannot see your Rheumatologist, speak to him/her on the phone or via a video call for advice. Studies show that video calls are as effective as personal visits. If you are unable to get in touch with your Rheumatologist, continue to take your medications and do your investigations as before and send them to the Secretary of The Indian Rheumatology Association (IRA) at secretary@indianrheumatology.org and someone will get back to you promptly.
Try not to stress overly! The best thing to do would be to shut off WhatsApp and social media as the frequency of messages on COVID are bound to increase your stress levels. This is like any other epidemic and so we should be fine if we follow all the hygiene measures like washing hands, using sanitizer, locking down etc.
Advice for patients with Bulbous Pemphigoid?
This is an autoimmune disease not a Rheumatological condition. If you are on Rituximab, which is an immunosuppressant, then follow the same precautions. If you have fever, consult your Dermatologist right away because it is difficult to differentiate between an infection and a flare-up.
Any tips for patients with Psoriatic arthritis who find washing hands painful?
If frequent washing of hands is uncomfortable, then use warm water instead of cold for hand washing. Wash for no longer than 20 seconds. Avoid sanitizers which are alcohol based. Try to not touch your face.
What should patients with Interstitial Lung diseases do?
If you have the slightest doubt you are infected, call your doctor and get yourself tested. People with interstitial lung diseases are likely to get complications if infected and hence must be more careful. Your Rheumatologist at that time may reduce dosage of your immunosuppressant drug. Do not stock up on Oxygen cylinders if you are not already on it.
How can one boost immunity?
- Exercise at home (terrace or balcony) or go for a walk/run in your building if permitted.
- Eat healthy foods.
- Get adequate Vitamin D3 via sunlight.
- There is no evidence that drinking warm water is a preventive measure.
Advice for care of digital ulcers?
If you have digital ulcers, use warm water to wash hands. Avoid excessive air-condition exposure as it causes dryness. Speak to your doctor about medications to treat the ulcers.
