We have all had to change the way we work as a result of the Covid19 pandemic and this includes rheumatologists.
At Alert Level 2, both rooms (Greenlane and Glenfield) are now fully open for face-face consultations. You will need to to confirm you are well and answer a range of screeing questions prior to entering the premises. You may need to wait in your car until we call you in for your consultation (this depends on wether there is space in our waiting room or not - as we are limiting numbers to ensure appropriate physical distancing measures are followed). All patients will have to have their hands sanitised and wear a surgical mask on entry into our waiting room. You will also not be able to bring family or a support person into the clinic rooms (including waiting room) unless there is a specific reason that this is required and will need to be pre-arranged with the admin staff.
If you prefer, we are still doing some consultations as telephone or video consults if this is sufficient for your needs. Southern Cross Healthcare, NIB, ACC, and several other insurance companies will temporarily cover phone and video consultations under their policies to account for the current situation.
Corona Virus Disease 19 is a new coronavirus that causes lung and airway infections. It is sometimes called SARS-CoV-2.
Typical symptoms include fever, sore throat, cough, tightness of
the chest and shortness of breath. The current evidence is that most cases appear to be mild. The symptoms are similar to other viral illnesses such as the common cold and flu.
It is not clear if the risks of COVID-19 are increased for patients with immune-mediated rheumatic diseases or the medications they are on. The information to-date does not suggest that there is a significantly higher risk for patients on mild immune suppression.
Early international data indicates that immunosuppression does not increase your risks of getting COVID- 19 or geting complications if you do get Covid19 infection.
People over the age of 70 and with chronic health conditions such as diabetes, heart conditions and respiratory illness are at higher risk of complications such as intensive care admission or even death.
This following list of medications that you may be on can suppress the immune system. If you are just on one medication from this list, then your risk of Covid is not thought to be increased. However if you are on 2 or more of these medications then we worry that your risk may be increased - but so far there is not clear evidence to support that. The British Society of Rheumatology have pragmatically recommended extra precautions if you are on 2 or more of the following medications :
- Adalimumab (Humira)
- Etanercept (Enbrel)
- Prednisone >7.5mg/day
- Secukinumab (Cosentyx)
The following medications do NOT suppress the immune system and do not count in the 2 or more medications that may increase your risk:
The level of precaution needed is dependent on the current risk of Covid19 spread in the community. If at any point there is a surge of new cases in New Zealand, you should take extra isolation measures such as not leaving your home and minimise all non-essential contact with other members of your household if any of the following apply to you:
- Are greater than 70 years old
- You have diabetes
- You have hypertension
- Known to have heart disease
- Known to have lung disease
- On 2 or more of the immune suppressant medications listed in section 4.
If you do happen to contract Covid19 infection, then please contact Dr Suppiah as to whether you need to temporarily stop any of your medications. The evidence on what we should do is constantly evolving as we learn more about Covid19 infection. Prednisone should NOT be stopped suddenly.