As we represent the physicians and advanced practice providers (physician assistants and nurse practitioners) that care for patients with rheumatologic disease in North Carolina, we feel it is necessary to make a statement about the Coronavirus (COVID-19) pandemic.  Please refer to the links at the end of this document for more information on COVID-19.

First of all, all patients with rheumatologic disease should follow the same common-sense prophylactic measures as the general population to include

• Avoid close contact with people who are sick.
• Avoid large gatherings if able.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Cover your cough – cough into a tissue or elbow/sleeve of shirt.
• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand sanitizer when not near soap and water (at least 60% alcohol).
• Clean and disinfect areas you and others touch often.

CDC does not recommend healthy people wear facemasks for protection (reserve for those with known or suspected infections).

Patients older than 60, including those with other chronic illnesses, are at increased risk of poor outcomes if infected with COVID-19 and should follow more strict precautions to include:

• Stay at home as much as possible if you live in an area where there’s an outbreak.
• Avoid travel.
• In public, avoid crowds and poorly ventilated buildings.
• Keep several feet of distance from people.
• If you need to isolate, keep in touch with family and friends.
• Contact your primary care doctor if you feel that you may be infected or show symptoms of cough, fever and/or shortness of breath.

As of now, the vast majority of rheumatology patients should remain on their arthritis medications.  The only exception would be if they are told by their individual rheumatologist to stop or hold a medication.  The current feeling is that having well controlled inflammatory disease is the best defense.  There is no reason to stockpile medications.  A normal 30 to 90 day supply on hand is adequate at this time.  Also, there is no reason to stockpile supplies (this applies to clinics and hospitals as well).  Such stockpiling contributes to shortages and general panic.

https://www.rheumatology.org/announcements

https://arthritis.org/about-us/news-and-updates/coronavirus-and-arthritis-what-you-need-to-know

https://www.cnn.com/interactive/2020/03/health/coronavirus-tipsheets/older-adults/ronavirus.asp

http://www.patientcareonline.com/news/coronavirus-answers-common-patient-questions

https://www.hss.edu/conditions_rheumatic-disease-and-COVID-19-coronavirus.asp

https://creakyjoints.org/living-with-arthritis/coronavirus-facts-for-chronic-illness-patients/