COVID Town Hall Meeting for Rheumatology Save

On Thursday, April 2nd, RheumNow hosted its' first Town Hall Meeting for Rheumatologist, with this 90 minute discussion devoted to the COVID-19 crisis as it affects Rheumatologists. 

The panel of six reknowned experts in rheumatology, practice, science, trials, telemedicine and infectious diseases included:

• Cassie Calabrese, DO (Cleveland Clinic)
• Jack Cush, MD (UT Southwestern)
• Artie Kavanaugh, MD (Univ of California - San Diego)
• Alan Matsumoto, MD (Arthritis & Rheumatism Associates)
• Alvin Wells, MD (Rheumatology and Immunotherapy Center)
• Kevin Winthrop, MD (Oregon Health Science University

The panelists answered over 40 questions on COVID matters with questions from each other and from over 800 rheumatologists who viewed the 84 minute session.  You can view this session (in its entirety) below.

You can listen to the whole podcast (1:24) here;  or in parts:

Part I

Part II

Part III

Below is a timeline of the questions addressed by the panel: 

Part  I  Panel Questions  

0:00   Introduction

1:22   How has the COVID-19 pandemic affected you?

4:09   What’s the most common question you’re getting and what is your response?

8:06 What adjustments have you made in your practice or how has your practice changed?

13:13 Things we are not doing anymore…

13:40   Questions amongst panelists

13:33 A Kavanaugh (to K Winthrop) What’s the evidence favoring the evidence hydroxychloroquine (French Study)

16:40 J Cush (to C Calabrese) Is azithromycin an effective COVID therapy?

17:45 C Calabrese (to K Winthrop)  What about “Universal Masking”?

20:24 A Matsumoto (to ID docs CC, KW) When can patients (or healthcare workers) resume infliximab infusions after being symptomatic?

24:23 A Wells (to AK) what to do with trainees during this “shutdown”?

25:55 A Wells (to CC) What about the new 15 min test vs the ‘real time' (PCR) test?

26:22 J Cush on the Global Rheumatology Alliance -      rheum-covid.org

27:25 Are Rheumatic patients “at-risk” for COVID-19 infection or worse outcomes?

Part II – Audience Questions

33:32 What about the timing of hydroxychloroquine use and for how long?

34:50 Should patients on bDMARDs or tsDMARDs (because of presumed risk) not go to work and should we write letters for such people?

37:05 Bush Administration disaster preparedness guidelines and supporting patients

39:06 What infusions should we not do? Denosumab?  Zolendronic acid?

41:09 What to do about tocilizumab infusions being COVID diverted? What are the alternatives?

44:09 Should you start your lupus or RA patient on hydroxychloroquine or a new biologic in this era?

46:58 A patient has a resolved COVID-19 infection, would you start a biologic if needed?

47:21 Is anyone worried about the cardiotoxicity of hydroxychloroquine or chloroquine?

48:42 Would you the doctor, self-medicate, or prophylax, with HCQ if you have new onset suspicious symptoms?

50:04 Should rheumatologists do inpatient consults during the COVID?

51:30 If tests were universally available, would you test all your rheumatology patients for COVID-19?

Part III - Audience Questions 

54:14 How comfortable are you with telephone or televideo visits with your patients?

57:24 A Covid (+) patient was treated at home, how long after the infection till you resume the biologic?

1:00:00  PsA Case, post TKR, off adalimumab, now flaring skin and joints and has low grade fever, cough and aches; is it safe to restart the TNF inhibitor in the COVID-19 era or what would you do?

1:03:58 Is hydroxychloroquine protective; Should we screen before IV infusions?

1:04:29 What dose of prednisone is immunosuppressive?

1:05:50 Is it Hydroxychloroquine may not be helpful in HIV and chikungunya?

1:07:03 What are your policies on seeing new patient consults in clinic?

1:09:10 What will  happen to ongoing clinical trials in rheumatology?

1:11:41 Are you having a hard time getting HCQ for your patients?

1:12:04 Should we look at COVID-19 viral loads?

1:13:12 Who wears masks in your clinic – doctors; staff; patients?

1:16:22 During the PPE shortage, can masks be reused?

1:18:33 How good/valid are patient self-joint exams?

1:20:30 How are you handling patient requests for letters to be excused from work?

1:23:45 Adjorn;

Look for Tuesday Night Rheumatology – Grand Rounds starting 4/7/20 8PM EST (5PM PST)