The COVID-19 Crisis: Uncharted Waters & the ACR’s Response

Singer Jimmy Dean reportedly once said, “I can’t change the direction of the wind, but I can adjust my sails to always reach my destination.” The COVID-19 pandemic has required us as rheumatologists to adjust our sails multiple times. We have had to rethink many of the ways in which we interact with our worried patients to provide the highest quality care, along with practical and emotional support, and to do it all safely during these extraordinary times.

At the ACR, we have been searching for ways to help our members adjust their sails and assist them in navigating these challenges. I would like to underscore some of the resources that have been developed and are currently available on the ACR website, and highlight the ways in which the ACR has been advocating on behalf of patients and providers.

Early in the COVID-19 crisis, the ACR Executive Committee established two task forces to support our members and the entire rheumatology community. These are the Practice and Advocacy Task Force (Chair: Kelly Weselman, MD, FACR; Executive Committee liaison: Douglas White, MD, PhD) and the Clinical Guidance Task Force (Chair: Ted R. Mikuls, MD; Executive Committee liaisons: Kenneth Saag, MD, MSc, and me). These two groups have worked tirelessly to provide information for members and address ongoing needs posed by the pandemic.

Practice & Advocacy Resources
The ACR advocacy team has done a tremendous amount of work in advocating for the availability and proper use of hydroxychloroquine, a drug that is essential for the treatment of lupus and is also used in other rheumatic diseases. Some early evidence suggested this medication holds potential as a possible treatment for COVID-19. This position has led to drug shortages and decreased drug availability for some of our patients. As rheumatologists and rheumatology professionals, we need to advocate for our patients’ access to the drug while clinical trials establish whether hydroxychloroquine is truly effective to treat COVID-19.

Working in conjunction with the American Academy of Dermatology, the Arthritis Foundation and the Lupus Foundation of America, the ACR has released a statement to the White House Coronavirus Task Force and the nation’s governors highlighting issues critical to hydroxychloroquine access. The ACR has also provided a template that medical providers can use to help advocate for appropriate use of hydroxychloroquine during this time.

The Practice and Advocacy Task Force has provided a great deal of information covering specific guidance on practice management issues, including guiding principles for proper resource allocation of medications that may be in high demand during the COVID-19 crisis. In addition to hydroxychloroquine, these include rheumatic disease drugs with potential applications in COVID-19, such as drugs inhibiting interleukin (IL) 1 and IL-6.