When the emergence of COVID-19 was announced, my family and I were quite concerned about my health because I have psoriasis and psoriatic arthritis (PsA), both of which are immune-mediated diseases. In addition, I take at least two medications for psoriasis and PsA, which help to alleviate symptoms of both conditions by suppressing my immune system.
When I was working (I retired a year before the pandemic came to America), I would regularly become infected with colds that circulated around the office. Because of my vulnerability to viral infections, I would take a flu vaccine as soon as they became available each year. I learned that patients taking immune-suppressive drugs could only take injections of dead vaccines, not live ones. This was not a problem with typical, annual flu vaccines, but it was a problem with the shingles vaccines until recently. Unfortunately, I developed shingles during the period when the only available vaccine was a live vaccine. The newly developed Shingrix vaccine is a dead vaccine and is recommended for patients with psoriasis or PsA among other chronic conditions.
In the early months of 2020, I was advised to discontinue taking my IL-17 biologic drug because it was uncertain as to whether that medication would cause me to be more vulnerable to the highly transmissible COVID-19 virus. My wife and I chose to self-isolate to the maximum extent practicable – no movies, theaters, museums, indoor restaurants, and only limited shopping. We limited our personal interactions to members of our immediate family, all of whom were taking similar precautions. We chose to wear masks whenever we went outdoors, whenever a workman came to our home, and when we went indoors to shop. We were particularly careful so as not to infect our baby grandson.
We were extraordinarily relieved when the vaccines were approved by the FDA, and after closely monitoring the state and local websites as to vaccine availability, we were able to receive our first injections in the parking lot of a local sports arena. Several weeks later, we drove to the same county-run location for our second shot. We have since had three booster shots.
During the pandemic, I was diagnosed with an unrelated condition that required surgery and hospitalization. The hospital was extraordinarily careful to conform to COVID-19 protocols.
About 14 months after I suspended injections of the IL-17 drug, I was told that I could restart that medication. Fortunately, there was no recurrence of my psoriasis during that 14-month period. I believe that was a typical experience for other psoriasis patients taking certain biologic medications.
Notwithstanding the fact that we have been vaccinated, we continue to wear masks when workmen come to our home, when we go indoors for shopping for food or otherwise, and we only eat at restaurants that have outdoor dining options. Fortunately for us, we live in Southern California, so outdoor dining is comfortable almost all the time. If it is too cold, we opt for restaurants that have heating devices at the outdoor tables.
During the pandemic, I have continued to be an active member of a few health care organizations as a volunteer. Fortunately, all of them have been conducting regular meetings via videoconference. While this is clearly a more time-efficient and cost-saving practice, I must admit that some things are lost in the translation – sidebar conversations, socializing before and after the meetings, and the vitality of in-person meetings for connectivity. While videoconferencing allows the conversations to continue, some of the dynamics are lost.
As of the date this blog is being published, all of our precautions have been successful. During this period of self-isolation, I have been grateful, especially to my wife and my immediate family, but also for close and supportive extended family and friends, crossword puzzles, delivery services, streaming, videoconferencing, and recommendations for reading. COVID remains a fact of life, but people should try their hardest to not allow it to defeat the quality of their life.
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