TR: What have been your patients’ concerns about the effects of immunosuppressant medications during this pandemic?
Dr. Phillips: My patients have been all over the spectrum. Early in the pandemic, we messaged patients they shouldn’t stop treatment, and we wanted to talk to them about their concerns. As COVID-19 has progressed, we’ve gotten data from the COVID-19 Global Rheumatology Alliance about rheumatic patients who have contracted COVID-19. The data have been reassuring suggesting prednisone above 10 mg is a risk factor for complications, but the other drugs we use seem to not have increased complication risks. Speaking for myself, that data have given me a reasonable comfort level.
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TR: What are you telling your patients about a possible COVID-19 vaccine, and are you using the ACR vaccine guideline/COVID-19-related guidance?
Dr. Phillips: We are in the process of rolling out that literature in our office. My messaging is following closely what is in the document. I’m focusing on vaccines being generally safe.
The conversation I have been having with my patients is that they—and myself—should be prepared to get the vaccine at some point. For the vast majority of people, the risk to benefit [profile] is going to [favor] taking the vaccine. It’s hard to give firm guidance when we don’t know which vaccine(s) will be available.
TR: What is next for your practice?
Dr. Phillips: The biggest point for me is I don’t think we can begin talking about recovery from COVID-19 right now. The first battle is over, but the next one is yet to come. I’m anxious about how winter is going to go. I am hopeful that those of us who got through the initial storm—physically and financially—are equally successful in weathering the second storm.
We have learned to be much more flexible. Over the next few months, we can’t assume anything about what the environment will look like. We have to be super flexible. We can’t assume things are fine and will continue to go that way, so that our bank accounts will stay full, and we will stay healthy. We can no longer take any of these things for granted.
Kurt Ullman is a freelance writer based in Indiana.