These are challenging times. We are dealing with a serious pandemic due to an infection with Coronavirus (COVID19). This is likely to have a significant effect on our daily life for the next 4-6 months. We wanted to remind you that just because you have an underlying autoimmune disease and are on a conventional DMARD (methotrexate or leflunomide) and/or a biologic, it does not mean that you are at a higher risk for developing this infection. Therefore, we do not recommend that you stop your medication currently. However, if you were to develop COVID-19 or any other infection, you should stop your conventional DMARD (methotrexate or leflunomide) as well as your biologic until you have recovered. You should also notify us as well as your primary care provider.
The most common presenting symptom of COVID-19 is a dry cough since this infection primarily involves the lungs. This may be associated with shortness of breath which can progress if the infection becomes more severe. Fever (temperature of greater than 100.4) is present initially in about 40% of individuals but almost all have a fever at some time during this illness. Many individuals also complain of fatigue; some may also have diffuse muscle pain while others have headaches or diarrhea and nausea. A runny nose, sinus congestion, earache, skin rash or enlarged lymph nodes are not seen with this infection. For many individuals, this will be a very mild infection that passes within several days. Some individuals who have underlying lung disease such as emphysema or COPD, diabetes, heart disease and are over the age of 70 appear to be at a higher risk for more severe infection. Severe infections have also been seen less frequently in young healthy individuals for reasons we don’t yet understand.
To try to slow the spread of this disease we strongly recommend that you self-quarantine if you develop the symptoms noted above. If testing becomes readily available, you should take advantage of this opportunity to determine whether you definitely have the infection. If other family members or friends have been exposed, we would also strongly recommend that they also self-quarantine for 14 days to make sure they do not have the infection and spread it to others. For people who do become infected, we still do not know how long they should convalesce and isolate themselves from others. For more information about COVID-19 and methods to limit infection and how-to self-quarantine, I would encourage you to visit the CDC web site which is updated regularly at https://www.cdc.gov/
Should you have a clinic visit at AOCC, please know that we have taken additional precautions to enhance your safety. These measures include screening patients who might be at higher risk for carrying the infection before entry into the clinic, restricting nonessential visitor access as well as carefully cleaning/disinfecting exam rooms between patient visits and cleaning/disinfecting the waiting rooms, bathrooms, and other common areas frequently during the day. We are also exploring the possibility of remote visits through telemedicine/telehealth and hope to have more information about this within the next several weeks. Please know that we are dedicated to keeping you informed and helping you through these trying times.