NASS has suspended all branch activity until further notice due to the current COVID19 outbreak. Please follow the link from our homepage for more information.

COVID19: Assessing your risk

We have put together a guide which we hope will help you to decide the measures you should be taking to protect yourself. This is the best advice we have at the moment based on guidance from the British Society for Rheumatology but it is subject to change as we are dealing with a very new virus. You should be assessing your own personal circumstances and seeking medical advice, bearing in mind that your usual sources of medical advice – such as your local rheumatology clinic – might be closed or very busy. You can find information on the NHS website, or call 111 if your query is urgent. In an emergency always call 999.

Note that everyone must stay at home and only go outside for food, health reasons or essential work. This lasts until at least Monday 13 April. See the government advice website for more information.

It is the medications you take for your axial SpA (AS) which lower your immune system more than the condition itself but there are other factors which may contribute to this including other conditions, age and kyphosis.

Low risk

  • If you are taking no medication
  • If you are taking non-steroidal anti-inflammatory medication
  • If you are taking sulfasalazine
  • If you were taking steroids such as prednisolone but have now stopped

Recommendations

  • Stay at home unless essential and practice social distancing when outside staying at least 2 metres (6 feet) apart, and wash your hands on returning home
  • If you or a member of your household develop symptoms of COVID19 then you should self-isolate, visit NHS 111 and stop taking your anti-inflammatory medication

Moderate risk

  • If you take a biologic drug (anti TNF and IL 17A) and/or methotrexate and DO NOT fall into any of the following categories:
    • Over 70
    • Heart attack (myocardial infarction)
    • Chronic heart failure
    • Hypertension
    • Chronic lung disease
    • Peripheral vascular disease (blocked arteries in your limbs)
    • Stroke (cerebrovascular accident) or TIA (transient ischaemic attack)
    • Dementia
    • Autoimmune connective tissue diseases such as vasculitis and lupus
    • Peptic ulcer disease
    • Chronic liver disease (not short-lived abnormalities of blood test)
    • Diabetes Mellitus
    • Chronic kidney disease (on or being considered for dialysis, post-kidney transplant)
    • Cancer
    • AIDS (not just HIV positive)

Recommendations

  • Strict social distancing – do not leave your home as a precaution
  • Continue to take your medication as prescribed
  • If you develop symptoms of COVID19 you should stop taking your biologic drug or methotrexate immediately
  • If someone in your household develops symptoms delay your next injection, and keep yourself indoors as much as possible. Going back onto your biologic will depend on whether you develop symptoms or remain asymptomatic but with no active symptoms in the household.
  • You can continue to take sulfasalazine

High risk

  • If you take biologic drugs or methotrexate AND fall into any of the following categories:
    • Over 70
    • Heart attack (myocardial infarction)
    • Chronic heart failure
    • Hypertension
    • Chronic lung disease
    • Peripheral vascular disease (blocked arteries in your limbs)
    • Stroke (cerebrovascular accident) or TIA (transient ischaemic attack)
    • Dementia
    • Autoimmune connective tissue diseases such as vasculitis and lupus
    • Peptic ulcer disease
    • Chronic liver disease (not short-lived abnormalities of blood test)
    • Diabetes Mellitus
    • Chronic kidney disease (on or being considered for dialysis, post-kidney transplant)
    • Cancer
    • AIDS (not just HIV positive)
    • Pregnancy
  • If you have been taking steroid medication such as prednisolone for more than 4 weeks
  • If you have kyphosis (curvature of the spine) which affects your lung capacity

Recommendations

  • Self-isolate and shield yourself as per government advice
  • If you or anyone in your household develops symptoms of COVID19 DO NOT stop taking your steroid medication and instead contact a health professional to discuss
  • If you or anyone in your household develops symptoms of COVID19 stop taking your biologic drug or DMARD immediately and consult a health professional

Support for those in self isolation: https://www.gov.uk/coronavirus-extremely-vulnerable

Last updated 26 March 2020