Sober and qualified advice on treatment in the event of Covid-19 infection.

[Dasein]

I decided to start a new thread on Covid-19 specifically to ask for suitably qualified professional advice for us all in the event that we believe we may have suspicious symptoms. We don’t know how stable or chaotic the medical setting will be at the time so it would be helpful to be able to knowledgeably influence our treatment.

Obviously if in UK we should call 111 and make a point of telling them of our underlying conditions and the drugs we are taking making sure that all subsequent medical contacts are aware. We should not pitch up at A&E or our GP surgery.

Should those of us who are taking Prednisolone try to get additional doses of Pred to mitigate adrenalin deficiency or should we try to argue against this so as not to further weaken our immune systems?

Is it perhaps a mixed blessing that we are immune suppressed? For instance might our slower response to infection actually reduce the life-threatening impact of aggressive immune system response to lung infection?

Just how compromised are our immune systems likely to be by our intake of Pred? I for example started on 30mg daily for a week when I started last May and have tapered steadily to currently 6mg per day. I suspect there are a lot of us with similar patterns of treatment. Just how at risk are we vs the general public from this bug?

Is there anyone who either can provide us with aa few words of this kind of general guidance (PmrPro?) or who can persuade a colleague to provide a short guide?

[SheffieldJane]

Did you read the guidance from Vasculitis UK that PMRPro kindly posted earlier. I think that should suffice for now. The same precautions you would take for a flu outbreak.

[Dasein in reply to SheffieldJane]

Yes I did thanks. It really is amazing the wise support PMRpro gives the group. My post was on a different subject however, being specifically related to Prednisolone and its bearing on Covid-19 and its treatment.

[PMRpro Ambassador]

Have you not read the other posts on the same topic which all contain links to official and, therefore, qualified, advice on how to act currently?

No-one on the site is qualifed in the way you want as we are all patients, albeit with various levels of experience in the field. The authors of the links already supplied are and it seems pointless duplicating such advice.

In particular cases we may need to speak to our own healthcare providers but I imagine this is likely to happen in the case of us being suspicious of having an infection. At the present time the logical and sensible approach is to take all the advice available in terms of avoiding large gatherings and close contacts with anyone - something many of us do as a matter of course during the winter anyway to reduce the risk of ordinary flu. Frequent handwashing, avoidance of children and others with infections of any sort and choosing how we shop seem obvious things to do - choosing quieter times in supermarkets or shopping online for example. But panic is out of place at present.

These are links that provide the sort of information you require:

healthunlocked.com/pmrgcauk...

who.int/emergencies/disease...

who.int/emergencies/disease...

If anyone has any similar official links please add them in the replies.

[Dasein in reply to PMRpro]

Thank you PMPro collecting them and for sharing them . These all offer useful advice in particular for reducing risk of infection in the first place and yes I had read them and modified my behaviour as a result. My questions are more specific to Prednisolone and the risk that Covid-19 infection poses for those of us who are still on steroid therapy. Health systems will likely be under considerable pressure so it seemed appropriate that we should be as informed as possible in advance.

Stay well.

Best wishes.

[PMRpro Ambassador in reply to Dasein]

I seriously doubt anyone knows - except it has already been advised that high dose steroid not be used specifically for Covid-19 as it is likely to result in prolonged time in ICU - it did in SARS and MERS. Pred in patients requiring it for a specific need like us is a different matter. Keep calm and carry on ...

[Hidden]

There is an overview of pred and other steroid use in tbe earlier phases. Also what public health England are saying...

contagionlive.com/news/is-t...

publichealthmatters.blog.go...