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COVID-19 advice sheet for Immunocompromised patients from ADHB (March 2020)

Please note this advice from ADHB and may differ in different regional hospitals. Contact your local renal unit or GP Pracitce if you are unsure.

What is COVID-19?

COVID-19 (COronaVIrus Disease 19) is a new illness that can affect your lungs and airways. It’s caused by a virus called coronavirus. The current outbreak of COVID-19 started in China, but cases have now been reported in many countries worldwide including a few cases New Zealand.  The cases in NZ have occurred in people who have travelled to countries with significant COVID-19 outbreaks, or who live in the same house as those who have travelled.

 What are the symptoms of COVID-19?

The symptoms of COVID-19 are-

Most people experience mild to moderate symptoms. The symptoms are similar to other viral illnesses that are much more common, such as cold and flu.

How does COVID-19 spread?

COVID-19, like the flu, can be spread from person to person. When a person who is infected coughs, sneezes or talks, they may spread droplets containing the virus a short distance, which quickly settle on surrounding surfaces.  People may become infected directly by droplets contacting their eyes, nose or mouth, or by touching contaminated surfaces then touching their eyes, nose or mouth without washing their hands.

Am I at more risk for infection in view of my immunocompromised state?

People who are older (particularly over 70) and those with underlying health conditions, such as chronic lung disease, cardiovascular disease, diabetes, chronic kidney disease, and cancer appear to be at higher risk for major complications.

All patients with any type of kidney disease should take the recommended precautions to protect from infection.

People with kidney disease should be aware that, just like with the flu, they are at a higher risk of severe symptoms and complications from coronavirus. Coronavirus, just like any viral infection, can affect your kidney function especially if you become very unwell, dehydrated or get another infection on top, and there is a risk of developing acute kidney injury (AKI).

Please ensure you have enough supply of medications. While there is no need to stockpile medications, please ensure you have at least a fortnight's supply.

Should I still come to clinic appointments?

At this stage, there is no need to cancel clinic appointments unless you are unwell with symptoms such as fever, cough, sore throat, runny nose or shortness of breath.  If you are unwell on the day of your clinic please call to cancel and do not attend. Some appointments may be changed to be via telephone rather than in person.

We are screening patients as they come into clinic and those who are unwell are being seen separately and advised to wear a mask.

If possible, come to clinic appointments by yourself- or just bring one family member.

Do I need to stockpile my medications?

No, at this stage we are not anticipating shortages of prescription medications so there is no need to get a larger supply than usual.

What can I do to protect myself and others against COVID-19?

Will masks help prevent me getting infected?

At this stage, there is no need to wear a mask when in public. However, if your healthcare provider advises you to wear a mask when in public areas because you have a particularly vulnerable immune system, follow that advice. 

Should I still go to work or school?

At this stage, close household contact with cases is the main risk. Certain types of employment (e.g. customs, healthcare, work requiring extensive overseas travel) may also be increased risk if community spread becomes more sustained. You need to discuss this with your employer and your specialist.

Consider alternatives to spending time with large groups of people close together (e.g. movies, concerts, religious and other meetings). You don’t need to be a hermit, just avoid situations where you will be in close contact (less than a metre) with others.

What should I do if I develop possible symptoms of COVID-19 or think that I might be infected?

If you have concerns about COVID-19 exposure  because you have travelled or had contact with a case, or have mild cold/flu symptoms, stay home and call Healthline on 0800 358 5453.

If more significant symptoms occur, such as fever, cough, or difficulty breathing, contact your GP and inform them of your symptoms.  Phone your GP before attending to avoid exposing staff and other patients to possible infection. 

If you experience a medical emergency call 111 for an ambulance and tell the operator if you are worried it might be related to COVID-19.

Should I change the doses of my immunosuppression because of concerns about COVID-19?

Usual doses of medications should be continued because the harm associated with dose reduction without specialist consultation is significant. 

What are the current travel recommendations for immunocompromised travelers?

Currently immunocompromised travellers should avoid overseas travel.  Up to date travel recommendations can be found at the Safe Travel website (www.safetravel.govt.nz) and the Ministry of Health lists countries and areas of concern (https://www.health.govt.nz/). 

If essential travel cannot be avoided for example, when there is family illness or bereavement, precautions should be taken to reduce your risk of infection. Ensure you have adequate travel insurance – many insurers will no longer cover costs related to COVID-19. If symptoms occur, such as fever, cough, or difficulty breathing, travellers are advised to contact local health care providers, preferably by phone.

Depending on spread, people may be quarantined or asked to self-isolate for 14 days on their return. We advise checking for up to date information prior to departure.