These are certainly unprecedented times in the world. As COVID-19 continues to sweep through the US,
American employers are turning their attention to how they can manage its impact to their people. But
how do employers know who is at a higher risk for contracting this disease and becoming seriously ill?
What does it mean to be immunosuppressed or immunocompromised?
People who are immunosuppressed or immunocompromised, whether because of an underlying
medical condition or because they are taking immunosuppressive medications, have a reduced ability to
fight off infections and a higher risk of becoming seriously ill from bacteria, viruses and other pathogens.
Our immune systems are a remarkably complex organization of multiple cell types and numerous
chemicals that play different roles in fighting different types of infections. Therefore, depending on why
someone is immunocompromised and the underlying cell types and chemicals that are affected, certain
infections might pose more or less risk to different individuals.
What does it mean to be immunocompromised or immunosuppressed in a COVID-19 world?
People living with autoimmune diseases, especially those taking immunosuppressive medications, are at
more risk of becoming ill from certain infectious diseases than the general population. But is that true
for COVID-19? Unfortunately, we simply do not yet know. There is not enough reliable data to tell
medical experts whether the case rate and severity of infection with SARS-CoV-2 (the virus that causes
COVID-19) is affected by the drugs commonly taken by autoimmune patients (including prednisone,
DMARDS, biologics and targeted synthetic molecules). That being said, with what is known about the
heightened risk of severe illness and complications patients on immunosuppressive drugs face if they
contract influenza (another RNA-virus respiratory disease), it makes sense for this group to strictly
follow, even exceed, the CDC-published guidelines to minimize their chances of SARS-CoV-2 infection.
For a complete list of these guidelines, click here.
Importantly, while one of the most common symptoms of COVID-19 is fever, patients taking
immunosuppressive medications may not develop fevers, even if infected. So, it is important that your
members with autoimmune disease pay close attention to other symptoms of COVID-19 (the most
common being cough, fatigue, body aches and shortness of breath). Remember, many other infections
can cause symptoms that mimic COVID-19 so the best thing to do is to call your doctor if you are not
feeling well. Do not present yourself to an acute care clinic or emergency department without calling
first.
Should patients taking immunosuppressive drugs reduce or stop them because of COVID-19?
No patients should change any of their medications without speaking to their doctors. This includes
immunosuppressive and other medications taken for autoimmune disease. Medical providers will
determine the best course of action on a case-by-case basis and will largely follow their current practice
for altering therapy during episodes of active infection. Patients who have scheduled infusions or
injections should call their providers to discuss whether they need to be rescheduled.
What can employers do to help their employees stay healthy and informed during this difficult time?
- Allow all employees who are able to work remotely do so. This may require efforts to implement remote capabilities, shift some responsibilities, and offer flexible hours. Your members with autoimmune disease need to strictly follow social distancing and self-isolation policies to reduce their exposure to the virus. If they must work in person, help them avoid public contact with other people whenever possible and offer masks or face shields.
- Minimize uncertainty. Extreme stress is one of the most detrimental things to peoples’ health, including their ability to fight infections. Set up a hotline and website to provide answers to employees’ specific questions about how COVID-19 will impact their healthcare, pay, position in the company, etc.
- Work with your employees’ healthcare plans to ensure e-visits are available and make employees aware of how to access these services easily. Autoimmune patients often have frequent medical visits - ensure that they retain access to their medical team through this period.
- Offer wellness programs that enhance employees’ nutrition and physical fitness or offer a targeted autoimmune disease program. Mymee provides personalized guidance to help users identify the underlying root causes of their disease and eliminate triggers that contribute to flares, all while potentially reducing their reliance on expensive medications.
Do you know how many high-risk, immunosuppressed members are in your population? Do you have a way to reach out to them directly and offer your support? Autoimmune disease is already topping the lists of healthcare spending and with the implications of a disease like COVID-19, it makes sense to focus on this vulnerable population today. If you'd like free access to Mymee's proprietary data request, which allows you to see the true story of autoimmune disease in your population, please complete the form here.
