After the discovery of the first patients in December 2019, COVID-19 has spread rapidly across the globe. In its wake, more cases and fatalities continue to appear in an international crisis that is unprecedented in the modern era, an emerging pathogen that so far has no cure. While we race to find the solution to this pandemic, we, the local and international community, will need to rally together to stop the spread and the impact of COVID-19.
Our office will also need to change its policy temporarily. The members of our subspecialty in British Columbia have been in discussions on the impact of COVID-19 on our patient population and communities, and nationally, the national Clinical Immunology and Allergy societies in North America have also published a joint contingency plan as a guide. The BCCDC and Canada have been very active in providing updates and suggestions as the outbreak has been developing. These sources will be the guide for us as physicians to help in the future care of our patients for the foreseeable future.
Until the pandemic is over, all symptomatic patients will be asked not to come in to limit the spread of infection; if there is a suspicion of COVID-19, call 811 for the Nurses’ Line for assessment and further instructions. Here is an online self-assessment tool to help review your symptoms.
For those in our community self-isolating after contact with a possible patient with COVID-19 or have returned from international travel, here are some tips for self-isolation. Please practice social distancing; this will help to minimize the spread of the infection.
For the safety of all in our community, I will be limiting all face-to-face patient meetings to only emergent/urgent cases. All other upcoming scheduled new referral and follow-up appointments will be kept but will become online and virtual. We will be sending out a link through email for your virtual meeting shortly. All testing (skin testing, patch testing, pulmonary function testing, food and drug testing, venom testing) will be completed after the pandemic is over, and social distancing is no longer a necessity.
When we return next week, we will be increasing the frequency of cleaning of our office throughout the day to help reduce the chance of spread through surface and item contact. Handwashing soap will be readily available, and handwashing will be encouraged for at least 20 seconds for all those who come into the clinic.
All patients on prescription medications should continue with their medications. Patients on immunoglobulin replacement (intravenous (IV) or subcutaneous (SC)), C1 esterase inhibitor (IV or SC), or biologic agents should continue with treatment. These will not change with COVID-19. Those patients on intravenous treatment in hospital might consider transitioning to home SCIG or SC-C1INH therapy; this could be arranged if patients were wishing to limit their need to go to hospital for their intravenous treatments. Patients on oral immunotherapy will continue with their treatment schedule.
Almost all immunotherapy injections will be put on hold or stopped. In some instances, the time between maintenance doses for patients receiving will be extended to reduce the number of visits. There will be only one injection an hour to limit the number of patients in the office and to minimize group sizes while we observe social distancing. Large groups in the office will not be allowed.
All food and drug challenges will be cancelled and rescheduled, and OIT patients will stay on their current dosages at home. Eating in the office will be forbidden.
For those in our community at most significant risk, the immunodeficiency patients, the exacerbating asthmatic, and any other extraordinary patient requiring help, please call our office to see what we can arrange if you are feeling unwell. For patients receiving immunotherapy injections, please call in and we will discuss what can be done with your injections considering these trying circumstances.
If we can stop the spread in our community, hopefully, life will return to a new normal state as soon as possible. We will take the lessons learned from this pandemic and move forward, realizing this community we have is global, and that we are a small world, after all. Thank you for your time reading this.
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