Get help Covid-19 (coronavirus) Covid-19 (coronavirus) To help stop the spread of Covid-19 (coronavirus) everyone has been asked to stay at home. You should only go out for a few reasons, such as shopping for food. But some people may need to do more than this. You may need to restrict your movements further or self-isolate. You do these things to stop other people from getting coronavirus. Arthritis Ireland is aware that treatments for inflammatory arthritis, in particular, may put patients at a higher risk of getting an infection and that these patients may be feeling particularly vulnerable and anxious. Latest updates On 27 March, the Government issued strict guidelines for people to stay at home. The only times you can leave your home are: to travel to or from work if you are providing an essential service to shop for food to collect medical prescriptions and medical supplies and attend medical appointments to carry out vital services like caring (including family carers) for brief individual exercise - within 2 kilometres of your house. (You can bring children but must keep 2 metres away from others for social distancing) for farming If and when you leave your home follow physical/social distancing guidelines, by keeping 2m distance from other people. People who are immunosuppressed (for example, through taking treatment for inflammatory arthritis) are included in the list of at-risk groups published by the HSE. These are more at risk of serious illness if they catch coronavirus. However, it is not thought that these groups have a higher risk of catching coronavirus. Those who are over 70 or in extremely medically vulnerable groups are asked to take extra care by cocooning. This includes people on immunosuppression therapies sufficient to significantly increase risk of infection. If you are unsure whether or not you fall into one of the categories of extremely medically vulnerable people listed, you should discuss your concerns with your GP or hospital clinician. Avoid contact with anyone who is unwell or has any symptoms of coronavirus Stay at home at all times and avoid any face-to-face contact for 2 weeks from 27 March Ask neighbours, family or friends to help you with shopping and any medicine that you need Do not attend any gatherings, including gatherings with family and friends anywhere Do not go out shopping and if you are having food or medicines delivered they should be left outside your door Click here to download a notice for your front door Keep in touch with family and friends using a phone or computer If you need to contact your GP or other services use the phone Visits from people who provide essential support with your daily needs should continue. These include healthcare, personal support and social care. On 2 April, the Irish Society for Rhuematology published advice around cocooning to guide rheumatology patients who are on immunosuppressants and steroids (see above). Most patients will have a mild illness and recover, but if we all take the correct actions we will protect those who will develop severe illness if infected The mortality is 1-2% and high risk groups for severe disease have been identified as age over 70, chronic heart and lung disease, diabetes and active cancer. There is currently no scientific evidence to support claims that non-steroidal anti-inflammatory drugs (NSAIDs) could worsen Covid-19. People should follow advice from a doctor or pharmacist if using any NSAID. Read the statement from the European Medicines Agency here. The data from studies of the outbreak in Wuhan have so far not identified immuno-suppressive treatments prescribed in rheumatology patients as a risk factor for higher mortality, but it is a reasonable cause for concern and the data on the disease is being monitored. The Covid-19 epidemic may last several months, so if you stop your medicine you will be likely to have a flare during this period and restart or have to take more intensive treatment with steroids. We do not recommend stopping your rheumatology medication and do not stop steroids suddenly or you may become very unwell. At present there is no known benefit to stopping your immunosuppressive medication, however if you have stable disease you should discuss with your rheumatologist whether the dose of the immunosuppressive medication can be safely reduced during this pandemic. If you are on immunosuppressives sufficient to significantly increase risk of infection and have other high risk factors for Covid-19 or have had a history of recurrent or opportunistic infections while on immunosuppressive therapy you are high risk and should follow cocooning guidelines to protect yourself. If you have symptoms of a viral infection - cough, shortness of breath, breathing difficulties, fever (high temperature) – continue steroids, but hold your other immunosuppressives and seek advice with your GP or rheumatologist or consult the HSE website – do not stop steroids suddenly without medical advice. Do not alter your medications without specific instructions to do so by your rheumatology team, who have your medical records. If you develop symptoms of any infection, including Covid-19, in consultation with your rheumatology team immunosuppressive therapy should be paused for the duration of the infection until you feel well. Arthritis Ireland advises those living with inflammatory arthritis and taking immune-suppressing medications to follow a number of steps: Knowing the symptoms Ensuring regular and thorough handwashing with soap and warm water or use of alcohol-based handwashes If you are in an extremely medically vulnerable group, follow cocooning guidelines Avoid touching your face, especially eyes and mouth Cough or sneeze only into an elbow or tissue paper and tissue paper should be discarded safely. Being as healthy as possible – hydration, nutrition, rest, exercise, managing stress Read the advice on the HSE website Testing If you are in a priority group (e.g. are immunosuppressed) and have fever and a cough, or fever and shortness of breath, phone your GP to be assessed for a test. Similarly, if you are in a priority group and have been in contact with someone you know or think has Covid-19 and you have any of these symptoms – cough, congestion, runny nose, sore throat, body aches, tiredness – phone your GP. Further information about testing can be found here. Attendance at an emergency department or GP clinic is not recommended, as this would increase the likelihood of coming into contact with other infections, and also raise the possibility of passing on any infection to others. How to protect yourself and others from coronavirus Follow this advice as strictly as possible and encourage others to follow this advice too. Do Wash your hands properly and often Cover your mouth and nose with a tissue or your sleeve when you cough and sneeze. Put used tissues into a bin and wash your hands. Clean and disinfect frequently touched objects and surfaces. Avoid close contact with people - keep a distance of 2 metres (6.5 feet) between you and others. Avoid crowded places, especially indoors. Follow the travel advice from the Department of Foreign Affairs Stay at home. Don't Do not touch your eyes, nose or mouth if your hands are not clean. Do not share objects that touch your mouth – for example, bottles, cups. Do not shake hands. Symptoms of Covid-19 (coronavirus) It can take up to 14 days for symptoms of Covid-19 (coronavirus) to show. Symptoms of the virus include: a cough shortness of breath breathing difficulties fever (high temperature) Further information on symptoms of Covid-19 (coronavirus) is available from the HSE. Hygiene and prevention Hand washing The HSE has also issued the following essential advice on when precisely to wash your hands: After coughing or sneezing After toilet use Before eating Before and after preparing food If you are in contact with a sick person, especially those with respiratory symptoms If your hands are dirty If you have handled animals or animal waste Step-by-step guide on how to properly wash your hands and avoid infection: Wet your hands with warm water and apply soap Rub your hands together until the soap forms a lather Rub the top of your hands, between your fingers and under your fingernails Do this for about 15 seconds Rinse your hands under running water Dry your hands with a clean towel or paper towel Face masks Don’t use a face mask if you feel well and do not have symptoms – there’s no evidence that using masks is of any benefit if you are not sick. Use a face mask if you: have or may have coronavirus are in close contact with someone who has or may have coronavirus are a healthcare worker in close contact with people who have or may have coronavirus Travel advice The Department of Foreign Affairs and Trade (DFA) advises against all non-essential travel overseas until further notice. This includes Great Britain, but not Northern Ireland. You will need to self-quarantine for 14 days if you’re returning to Ireland, except Northern Ireland Ports and airports There are no entry restrictions to Ireland at present. To date, entry screening at ports and airports is not recommended by the World Health Organisation (WHO) or the European Centre for Disease Control (ECDC). Effective public health protocols in place at ports and airports include: airline crews have been briefed by the HSE in recent weeks in the event of a suspected case, contact tracing forms will be distributed to all passengers and completed forms will be passed to HSE lead personnel at the incident site prior to disembarking, passengers will be advised to contact their GPs should they develop symptoms within the following 14 days the airline is instructed to decontaminate the aircraft in accordance with WHO aviation hygiene standards Contact our national helpline 1890 252 846/01 661 8188 (Mon-Fri 10am-4pm) or email [email protected] for any queries relating to the Covid-19 (coronavirus) or living with arthritis. Coronavirus posters Front door poster [updated 28.3.20] Public information booklet [updated 25.3.20] Covid-19 poster [updated 13.3.20] Hand hygiene poster [updated 13.3.20] Updated 2 April 2020