I’ve been off work the last week with another chest infection, its infuriating, frustrating and detrimental to my career but unfortunately it’s part of daily life when on biologics treatment – but it’s better than the alternative. Arthritis is destructive; it’s your body attacking itself due to your immune system being overactive and essentially, like a drunk bloke in a pub on a Saturday night, it picks a fight.
The reality of biologics treatment
Biologic therapies are groundbreaking and without them, millions of peoples lives would be worse off (despite my complaints given recent events!). However, they come with a huge drawback. They work by dampening down your immune system (to stop the body’s defences attacking itself) but that makes those of us on them vulnerable to infection, particularly those that target the respiratory system and ear, nose and throat (ENT). To give you some context, since 1st November 2019 alone, I personally have had the following, in this order:
- Chest infection (Nov – 2 weeks off work)
- Tonsillitis (Nov – 1 week off work)
- Sinus infection (Nov – at same time as tonsillitis)
- Chest infection again (Dec – 3 weeks off work)
- Chest infection (Jan – 1 week off work and counting)
It’s a nightmare and what’s particularly hard to explain to your employer is why biologics are such a good thing – especially, as in my case, they have never seen you on crutches or in a wheelchair in your employment because of the amazing work biologics do.
No biologics user can claim ignorance to the risk of infection, in the UK, we are are assigned a dedicated biologics nursing team, given alert cards to carry in our wallets warning of our treatment and risk of infection, have a nurse come to our home the first time you take it, have to have regular blood tests (minimum every 3 months), chest x-rays and screening for things like Tuberculosis before we can start treatment and yearly chest x-rays after that, you must have the flu jab each year – the list goes on.
If you somehow missed the point that you will get ill whilst your immune system is suppressed then you either were not listening or do not respect the seriousness of your situation.
A quick look at the Humira website even has a safety warning pop up that you have to acknowledge before it will go away that makes the risks all too clear:
What is the Coronavirus?
So when the World Health Organisation (WHO) declared the latest virus outbreak in Wuhan, China as an emergency, it’s a worrying time for those of us vulnerable to infection or with compromised immune systems.
This video from the WHO gives a brief overview as to what coronaviruses are:
Although, in reality, the risks are small given you’d have to be in direct contact with someone who was exposed to the virus in the Wuhan region of China from the end of the year, confirmed cases of infection are now popping up across the world. It only takes one sick person to not report it or be quarantined for potentially tens, hundreds or more to be exposed to the virus who have never travelled to the region of the initial outbreak.
According to the WHO Situation Report from 1st February 2020 (which can be found here), the current situation and risk level is as follows:
So clearly, the threat is real and you can see why they are concerned and taking the precautions that they are, particularly with those that have travelled from the area.
How you can protect yourself
The guidance is simple and follows the same basic rules that are issued every flu season in schools and places of work – yet it’s amazing how many people don’t follow them. For example, how many times do you see somebody leave a public bathroom without washing their hands and then you have to grab the door handle afterwards!? Every time I have this experience (it’s a regular occurance with british men in my experience, unfortunately), I feel like slapping my biologics alert card on their forehead!
The WHO have offered the following advice for the public to protect themselves:
WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices:
Frequently clean hands by using alcohol-based hand rub or soap and water;
When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
Avoid close contact with anyone who has fever and cough;
If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
When visiting live markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.
So stay vigilant and next time you think about skipping washing your hands after going to the toilet, sneezing and then shaking someone’s hand or trying to soldier on through your job whilst leaving tissues all over the desk and infecting the rest of the office with your coughing – spare a thought for those of us with compromised immune systems; the vulnerable, elderly, young, cancer sufferers – and that for some of us, it’s a unwanted choice for the greater good to put ourselves in this state of health – as it sure as hell beats the alternative with untreated, unrelenting arthritis.
Humira.com (2020). IMPORTANT SAFETY INFORMATION ABOUT HUMIRA® (adalimumab). [Online] Available at: https://www.humira.com/ [Accessed 02 February 2020].
World Health Organization (2020). Coronavirus. [Online] Available at: https://www.who.int/health-topics/coronavirus [Accessed 02 February 2020].
World Health Organization (2020). Novel Coronavirus (2019-nCoV) advice for the public. [Online] Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public [Accessed 02 February 2020].
World Health Organization (2020). Novel Coronavirus(2019-nCoV) Situation report No.12. [Online] Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200201-sitrep-12-ncov.pdf?sfvrsn=273c5d35_2 [Accessed 02 February 2020].