Until further notice, Ward 52, the Rheumatology ward,  has been relocated to HDU to create extra capacity required during the pandemic.

During this time, Rheumatology patients who need admission will be admitted to one of the Medical wards at the Western General Hospital.

The Rheumatology Outpatients Department has now returned to Outpatient Departments A and B on the first floor of the Outpatient Building of the Western General Hospital. The telephone number for reception is 0131 537 1324. Rheumatology Outpatient services continue as before in St John’s Hospital and East Lothian Community Hospital. 

NHS Lothian Rheumatology advice for patients during the  COVID-19 pandemic

We have provided answers to some frequently asked questions below. This will be updated as necessary if new information becomes available.

Should I continue my immunosuppressive medication?

Yes. If you are feeling well, you should continue your immunosuppressive medication as normal. There isn’t any evidence to suggest that it would increase your likelihood of getting COVID-19. The reason for continuing treatment is that having poorly controlled arthritis is also a risk factor for infections.

What should I do if I have symptoms of an infection, like fever or cough, while taking immunosuppressive medication?

You should stop your immunosuppressive medications until you feel better and/or have completed a course of antibiotics if these were required. The immunosuppressives can be re-started once you are better unless advised otherwise by your GP/hospital doctor.

If you are taking prednisolone (steroids) for arthritis or another condition, it is very important that you do not stop them abruptly. Please continue taking the steroids.

If you have a fever, cough or loss of taste or smell, please arrange to get a Coronavirus test as per the Government’s guidelines.

Should I stop taking my immunosuppressive medication if a member of my household develops COVID-19?

If a member of your household develops symptoms of COVID-19, they should self-isolate and arrange a test. We do not recommend that you stop taking your immunosuppressive medication unless you develop symptoms of COVID-19.

Do I need to practice “Shielding” because I take immunosuppressives?

Most patients who take immunosuppressives will probably not need to practise shielding. Current shielding guidelines are less strict than during the March ’20 lockdown. You do not have to stay inside, and you can go out to exercise, but you should stay at home as much as possible. You should work from home, and if this is not possible you should not attend work. You should try to avoid going to the supermarket or pharmacy and ask friends or relatives to do this for you. However, if no-one can help then you are able to go to these places yourself. Current guidelines about shielding can be found below:

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

Who should practise Shielding?

Shielding is only advised if you are in the following categories:

• Taking oral or intravenous cyclophosphamide in the last 6 months.

• Taking Prednisolone at a daily dose of 20mg or greater for more than 4 weeks.

• Taking Prednisolone in a dose of more than 5mg per day for more than 4 weeks AND any one of the immunosuppressive drugs listed in Box 1 below

• Have any of the following co-morbidities (age over 70, high blood pressure, diabetes, heart disease, any lung disease, kidney impairment) AND are taking two or more of the immunosuppressive drugs listed in Table 1 below.

Would my Rheumatic condition, or its treatment, stop me from getting a COVID-19 vaccine?

No. We advise that all patients receive the COVID-19 vaccine.

Should the treatment for my Rheumatic condition be paused or changed to receive the vaccine?

There is no evidence that treatment for Rheumatic diseases should be paused or changed in order to receive the vaccine. It should, however, be noted that the vaccine may not be as effective when taken near treatment with Rituximab.

Will I be prioritised to receive the COVID-19 vaccine?

If you are in the ‘shielding’ category, as described above, then you will be in priority group 4 to receive the vaccine. If you are not in the ‘shielding’ category, but take a regular medicine for a Rheumatic disease, then you will be in the ‘high risk’ category. The high risk category is priority group 6.

When will I get my vaccine?

The situation with vaccination is rapidly changing, so we can only give an approximation of when the vaccine will be offered to different groups. This approximation is based on the Scottish Government’s Vaccine Deployment Plan. The Scottish Government currently plans to begin vaccinating priority group 4 by mid-February. The aim is to begin vaccinating priority group 6 by mid-March. You will receive a letter from the NHS inviting you for vaccination. More information about the vaccine rollout can be found here:

https://www.gov.scot/publications/coronavirus-covid-19-vaccine-deployment-plan-2021/

Where will I get my vaccine?

Many of the vaccinations will be delivered by local GP practices. However, you may be invited to attend one of the mass vaccination centres.

For more information on the COVID-19 vaccine, please visit:

https://www.versusarthritis.org/covid-19-updates/vaccines-for-covid-19-your-questions-answered/

What will happen to my rheumatology outpatient clinic appointment?

Rheumatology follow up appointments will continue but will be largely telephone consultations. Where necessary we will arrange a face-to-face consultation.

What about the blood tests I usually have because of the treatment I am on?

These will continue to be taken as normal either by your GP or the hospital, depending on what treatment you are on.