INFORMATION ABOUT COVID- 19 for those with AUTOIMMUNE DISEASE and other chronic illnesses

The spread of the coronavirus, now called COVID-19, is causing alarm worldwide.
The World Health Organization has declared a global health emergency, and many countries have a rise in confirmed cases.
In the US, the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary if the coronavirus spreads within communities.

As Wuhan has seen the highest number of infections their numbers have been analyzed showing:

• people over 60 are more at risk.
• people with other chronic illnesses are more at risk.

Those with other chronic illnesses do worse: There have been approximately 5,000 cases where individuals have reported a known co-morbid medical condition, such as high blood pressure, diabetes, heart disease, chronic lung disease, or cancer. The average mortality rate in these groups is in the 5-10% range, whereas of the 15,000 individuals who reported no other medical conditions, the mortality rate to date has been less than 1%. FORBES

While less than 1 percent of people who were otherwise healthy died from the disease, the fatality rate for people with cardiovascular disease was 10.5 percent. That figure was 7.3 percent for diabetes patients and around 6 percent for those with chronic respiratory disease, hypertension, or cancer.  THE SCIENTIST

It is hard to know the facts in these early days of the conronavirus about the long term prognosis for people with autoimmune disease. My concerns are that many people with autoimmune disease take immunosuppressant medications to manage their symptoms and these can make them more vulnerable to infection generally. Also our bodies are working so hard already, are they going to fight off the coronavirus?

THE SYMPTOMS

Common corona virus symptoms include:

• fever 
• dry cough
• fatigue

Some people also get:

• sore throat
• congested nose
• nausea and gastrointestinal symptoms
• shortness of breath
• flu like aches and pains

THE MAIN PROBLEM WITH THE CORONAVIRUS is that you are contagious when you do not have symptoms. These symptoms generally appear three to four days after exposure but can be up to 27 days later!

GENERAL PRECAUTIONS

According to the WHO, coronaviruses may survive on surfaces for just a few hours or several days, although many factors will influence this, including surface material and weather.

That’s why personal preventive steps like frequently washing hands with soap and water or an alcohol-based hand sanitizer, and wiping down often-touched surfaces with disinfectants or a household cleaning spray, are a good idea. HARVARD HEALTH 

WHAT WE CAN DO IF WE HAVE AN AUTOIMMUNE DISEASE:

"If you’re sick or you are immune-compromised, avoid places with large numbers of people." UCHealth.

In Australia we have been told by the Health Minister to stop shaking hands when we great people. In France they have been told to stop kissing on the cheek. This is because this disease is so transmissible. The only way to avoid it is to not have any contact with anybody!

Keep up to date on your local health warnings and advice. The main advice at the moment seems to be to wash our hands often, for 20 seconds or more, with soap and water.

CDC provides recommendations on postponing or cancelling travel to certain countries only, at this stage. These travel notices are based on assessment of the potential health risks involved with traveling to a certain area. Their list of travel notices is available here.

Smart Traveller, by the Australian government, provides travel updates on countries and recommendations.

The Institute of Public Health in Norway, says "To prevent infection, people should keep at least one metre away from people with respiratory symptoms and those who are ill should avoid coughing or sneezing directly onto others."
TREATMENT

• Avoid infection by not traveling to epidemic areas. 
• Infected people should use mouthwash. 
• Frequent and thorough hand washing and good general hygiene are recommended. 
• Preventive measures are especially important for people with weakened immune systems. 
• Immunosuppressants should be considered discontinued among those infected until the infection is over. A vaccine against covid-19 has not yet been developed (as of March 2020). Antibiotics (against bacteria) do not work against viruses. Anti-viral drugs especially for coronavirus are not available (as of March 2020). 
• In cases where covid-19 causes pneumonia, hospital treatment will often be necessary. Oxygen supplementation and breathing aid, including the use of a respirator may be necessary.
• People who use immunosuppressive drugs and have no symptoms of infection should continue with their usual treatment during an epidemic. 
• If signs of infection with fever and other influenza symptoms should occur, a 1-2 week treatment break with the immunosuppressive therapy may be appropriate. However, it assumes that one is not completely dependent on the treatment. Prednisolone and other cortisone preparations should not be terminated abruptly.  Physician and specialist in rheumatic diseases PhD Øyvind Palm 

WHAT I WILL BE DOING:

I personally have 3 autoimmune diseases and other health issues.

I will be avoiding all non essential travel and have sadly postponed an overseas holiday to Asia.

I will be avoiding all large events and gathering places such as universities, the library and the shopping mall.

If I was still working I would be asking to work from home due to my compromised immune system.

I am trying to be my healthiest self by eating well and exercising. I have already added magnesium and Vitamin D supplements to my diet and will now add a daily multivitamin as well and garlic tablets. It can't hurt and it may help fight off infection.

Eating garlic appears to offer the best of both worlds, dampening the over-reactive face of the immune system by suppressing inflammation while boosting protective immunity, for example natural killer cell activity, which our body uses to purge cells that have been stricken by viruses or cancer. In World War II garlic was evidently dubbed ‘Russian Penicillin’ because, after running out of antibiotics, that’s what the Soviet government turned to. Dr Michael Greger at Nutrition Facts

I have asked my doctor for extra scripts of my medications so I can have an adequate supply.

I have put in place a plan with my family regarding what we will be doing if more cases come to our area.

We have checked our medicine chest to make sure all painkillers etc are in supply and not out of date.

We are checking our pantry and making sure we have all our normal food supplies and a few extra so that we do not have to go to the shops as often. Our list includes extra toilet paper, canned food and dry goods such as rice and pasta.

For food, you can just buy two or three weeks’ worth of shelf-stable food that you would eat anyway, and be done; this could include canned food like beans and vegetables, pasta, rice, cereals or oats, oils/fats, nuts and dried fruits. It’s really not that hard because we’re talking two-three weeks, so whatever you get is fine. Zeynep Tufekci is an associate professor at the University of North Carolina School of Information and Library Science, her coronavirus article is at Scientific American.  

I will be updating this page with suggestions as I research them.

I have no medical background but use reliable sources when providing you information and when doing research. Best wishes from Lee Good.

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