1.Should patients cease their medication as a precaution?

Some rheumatology patients, particularly those on steroids and biologics, will be immunosuppressed and should therefore be considered ‘high risk’.

All patients should however continue to take their medication unless directed otherwise by their rheumatology team.

If you are planning to start or switch to a new medication this may now need to be reviewed.

Please remember patients on long term glucocorticoids (steroids, prednisolone) should not stop these abruptly.

If you are showing any symptoms and you think you might have coronavirus, or you’ve been in close contact with someone who has it:

• stay at home and avoid close contact with other people
• do not go to a GP surgery, pharmacy or hospital
• dial the NHS 111 coronavirus service to find out what to do next

2.Should patients who become infected with the virus cease their medication?

If patients develop symptoms of any infection, established practice should be followed and immunosuppressive therapy paused for the duration of the infection and until they feel well, in consultation with their rheumatology team.

The expectation is for those on glucocorticoids (steroids, prednisolone) where treatment should not be stopped abruptly, and advice should be sought from their treating team.

3.What precautions should patients be advised to take?

Patients concerned about the risk of infection should be advised to take precautions as outlined byPHE. In addition, patients should ensure that their vaccinations, such as flu and pneumococcal, are up to date to reduce the risk of secondary infections.

4.Should patients who are intending to travel abroad change their plans?

Patients should be directed to the country-specific advice published by PHE which can be accessed here.