Like many medical professionals across the world, we have been getting lots of questions about how COVID-19 might impact your care. We wanted to reach out to you to let you know some of the steps we’ve taken and also answer some common questions for those with rheumatologic conditions. Here is a helpful video on the overall approach to Rheumatology as it related to COVID-19:
1. Should I stop my medications?
The short answer is no.
The American College of Rheumatology guidelines continue to recommend that you continue your rheumatological medications. The goal is to keep your inflammatory disease in remission, and in doing so, keep you healthy.
However, if you do get infected with COVID-19, stop all your arthritis medications except for NSAIDs and the hydroxychloroquine, and call your provider.
We are extremely happy to see no increased rate of infection in our rheumatology patients compared to the general population. Patient data published so far showed that baseline use of biologics (injections or infusions) is not associated with worse COVID-19 outcome.
Our knowledge about this virus is evolving, so our recommendations may change week to week.
We will try to keep you posted the more we know about the COVID-19 infection, and about its impact on our rheumatology patients considering the medications you use.
This video is also a good overview of how Rheumatologists are thinking about medication safety and COVID-19:
2. Do I stop my NSAID?
You can continue taking your NSAID the way prescribed.
The initial reservation against the use of NSAIDs in light of the COVID-19 has been unfounded. So please go ahead and continue to use your NSAID as prescribed by your provider.
3. Should I use Hydroxychloroquine to prevent or to treat COVID 19?
Recent clinical studies using Hydroxychloroquine in the treatment of COVID-19 did NOT reveal encouraging results. Based on these studies, Hydroxychloroquine is no longer used as treatment nor as prophylaxis (preventative).
However, Hydroxychloroquine is extremely valuable medication for the use of RA, SLE and many other rheumatological conditions.
So if you take Hydroxychloroquine, continue to use as prescribed. Keep in mind there is not strong evidence that hydroxychloroquine is going to protect you against contracting the virus.
4. When should I resume my rheumatological medications after testing positive for COVID?
If you got infected with the virus, please stop all rheumatological medications except for the Hydroxychloroquine and the NSAIDs and consult with your rheumatology provider.
5. Should I be around other people?
Social distancing is strongly advised. The CDC recommends a 6 foot distance between people outside of immediate family, if possible.
Wear a face covering in all stores, medical offices, and other enclosed areas.
Avoid gatherings of more than 10 people.
Going out for walks around the block and seeing the sun is recommended if you are able to practice social distancing.
6. Should I come in for my infusion?
If you do not have symptoms of COVID-19, continue all your rheumatology medications, including infusions; for full details, see Question 1.
When you enter the OrthoNebraska campus we are doing everything to limit your exposure to other people. All patients are being screened for any possible contact with the virus and/or symptoms of the virus. Details on screenings can be found here.
We are asking infusion patients to enter the infusion area directly, to limit their contact with any other people. If you need someone to be with during the infusion, please limit this to one person. In the infusion suite, we clean each infusion area, at the start of the day, and after every patient encounter. We all wear masks. We wipe down every chair and every piece of equipment.
We have been monitoring all updates from the CDC regarding concerns about COVID-19. We will adjust our practices accordingly.
7. Should I come to my appointment?
We are offering virtual and in office visits. For the safety of our patients and to minimize the exposure risk, we prefer virtual visits over in office visits for all our follow up patients. However, virtual visits are not always appropriate for some, especially those who need joint injections or the disease is not stable enough to be seen virtually, so please consult with your provider if you think you need to be seen in office over virtual.
If you come in to be seen, please note we have started the following policies on the OrthoNebraska campus for your safety:
- All patients are being screened at the parking lot entrance for any possible contact with the virus and/or symptoms of the virus.
- Each room is cleaned after each patient. Chairs and tables along with sinks and light switches are cleaned. Paper is changed on the examination table. All staff are wearing masks for your protection.
- We will work hard to keep the clinic moving and prevent you from having to sit in the main waiting area. To that end, we will be trying to keep office visit running on-time. Please prioritize your questions.
Please allow an additional 24-48 hours to answer non-urgent questions and an additional week for paperwork.
Our patient portal is a convenient and efficient way to ask any other questions you might have that might not require a visit. Email invitations to the portal are extended shortly after your first appointment. If you would like a new invitation, please call (402) 609-2100 and our team would be happy to send you a new one.