Coronavirus: How to Prevent and Prepare

The World Health Organization (WHO) has declared the new coronavirus outbreak a pandemic, reflecting how globally widespread it has become. The number of new cases of COVID-19, the illness caused by the virus (named SARS-CoV-2), seems to have stabilized in China, yet infections are on the rise elsewhere.

And people with arthritis are watching very closely. While infection rates are still relatively small in most areas of the United States, cases in hotspots, like New York and Washington states, and most recently Boston, are on the rise. Still, it is hard to know how much how much we should worry  – a lot depends on where you live. It may be a sign of the times that the National Basketball Association (NBA) suspended its season; major cultural events, like  Coachella and South By Southwest (SXSW), are being cancelled or postponed; and a growing number of universities and local school districts have suspended in-person classes. But it is almost business-as-usual in other, less affected parts of the country.

One thing, however, is clear: While no one with arthritis needs to panic, we should not take this casually either. The CDC has defined high-risk groups as those over 60 and those with chronic health conditions such as lung and heart problems, and diabetes. Many people with arthritis, particularly those with osteoarthritis, are over 60, and there are also millions of people with dysregulated immune systems due to autoimmune and inflammatory types of arthritis. Moreover, treatment for those diseases, like rheumatoid arthritis, psoriatic arthritis and lupus, consists of immunosuppressants.

As several of the top experts in infectious diseases and epidemiology have said, prepare for the situation to get worse before it gets better. For people with arthritis, being prepared means doing – and not doing – many of the same things as the general public. However, there are some unique considerations to be aware of.

Your goals should be to do your best to cut your personal risk of infection, reduce transmission rates and be ready if it comes to your area.

Local health departments and the Centers for Disease Control and Prevention (CDC) have good basic advice on how to reduce your risk of contracting the virus.

According to the CDC, protect yourself by:

• Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place or after blowing your nose, coughing or sneezing. Any kind of soap will do. See the proper technique.
• If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
• Avoid touching your eyes, nose and mouth with unwashed hands. The virus enters the body through those mucous membranes.
• Avoid close contact with people in general, because it is believed people can spread the infection before they show symptoms, and particularly avoid those who are sick.
• Avoid large gatherings, air travel and cruises, especially if you are in a high-risk group. Experts have said that slowing the spread of the disease may be more feasible than stopping it; we need to “flatten the curve,” on graphs that show rates of infection rising sharply in a short time. 

The CDC and others  have good basic advice on how prepare your household for a local outbreak of COVID-19. They suggest many of the same measures you’d take for any emergency, like a snowstorm or hurricane.

• Keep a two-week to 30-day supply of canned, frozen and dried foods, including frozen fruits and vegetables, shelf-stable milk and nonperishables, such as canned tuna, rice, beans and nuts. Many fresh foods keep well for a couple of weeks, including eggs, carrots, squash, apples and oranges. You don’t need to hoard (which will create shortages); just pick up a few extra items on each grocery run.
• Don’t forget pet food.
• Make sure you have household supplies, like laundry detergent, toilet paper, dishwashing detergent and diapers if your children need them.
• Keep a 30-day supply of prescription medications; many insurance companies are relaxing their refill schedules in light of the situation. Additionally, many retail pharmacies will now deliver medications.
• Additional items to have on hand in case you get sick: acetaminophen (Tylenol) or an NSAID like naproxen (Aleve) or ibuprofen (Advil), cough medicine, tissues, throat-soothing tea, cough drops, Gatorade (or Pedialyte for children) and chicken soup. Don’t forget vitamins, fish oil and other supplements, if you take them.
• Make sure you have enough effective cleaning supplies to keep high-touch surfaces clean. Know the difference between cleaning and disinfecting – an important distinction, especially if you have someone in your household who is sick.
• Make contingency plans for your kids in case schools close. Some school systems have already suspended classes. Have indoor activities ready for your kids and make a backup plan for childcare if you will still need to work, whether from home or on site. Health officials say grandparents may not be a good option because older adults are most likely to catch and have severe complications from the virus.
• As for masks, they are not recommended by the surgeon general, the CDC, or infectious disease experts if you’re healthy; they won’t prevent you from catching the virus. If you’re already sick, wearing a surgical-type mask may reduce the risk of spreading the disease to others by blocking some of the virus-laden droplets from coughing and sneezing. N-95 masks, which are thicker, fit better, and block out smaller viruses, are in short supply and should be reserved for health care workers and people tending to someone sick at home.

A few more important things:

• Stay informed. The situation changes daily (sometimes hourly). The websites of the CDC, the World Health Organization (WHO)  and your local health department are reliable sources.
• Be careful not to spread information that might be misleading. Misinformation can spread quickly and cause unnecessary worry.
• Take care of others and be kind. Although social distancing is a good way to prevent disease spread, check on older neighbors and relatives and help out when you can.  We are all in this together.