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Infections March 2020

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Infections March 2020




Coronavirus COVID-19

Can affect anyone, but people with pre-existing health problems and older people are thought to be at greater risk of developing severe symptoms.
If you have a long-term health condition you may be feeling anxious, here's what experts are advising.

Our Rheumatologist member Dr. Daniel Lewis from The Lewis Institute, Melbourne, advises:

’The consensus is that individuals with rheumatic conditions on immunosuppression are no more prone to catching the virus but may have an adverse outcome if infected.’’


The standard recommendations available everywhere are;

  • Wash hands with soap for 20 seconds often especially before eating
  • Don’t touch your face or eyes with unwashed hands as this is the entry point for the virus
  • Don’t shake hands – use the elbow bump as a greeting
  • Disinfect your phone often with alcohol swab or hand sanitiser
  • Stay home if have a temperature
  • If you are coughing or sneezing wear a mask if you are with other people

Dr. Lewis saidmy general advice is that whenever possible stay-at-home and avoid mixing in confined public places. This advice may change in the coming days and weeks. General lifestyle principles remain as important as ever.  The risk of infection is significantly less if individuals have adequate sleep and exercise regularly. Now is not the time to take shortcuts with health enhancing behaviours. General nutrition principles include a diet high in vegetables and fruits and low in alcohol and sugar.’’

“Stress, both physical and emotional increases the risk of infection and of an adverse outcome if an infection occurs. Now is the time to enhance your stress management strategies.”
“If you are unwell” Dr. Lewis advises “You must stay at home. Call your GP or rheumatologist to seek advice regarding continuing or temporarily discontinuing immunosuppressant medications. This is especially prudent if your prednisolone does is greater than 7.5 mg daily.”

“At the time of writing there are dedicated “fever clinics” being set up around the country with specific testing and management advice relevant to an individual’s circumstances’’

“Just as with the bushfires, individuals at risk had their own personal fire plan. Individuals with immunosuppression require an “Infection Management Plan” which can be as simple as thinking about all the things and supports you will need if you develop an infection and need assistance.” said Dr. Lewis.

Member Forum

Our patients Susan Hughes and Jill Berenson are sharing additional safety protection measures they are following to avoid infection in Dragon Claw’s forum.

Please Note: You must be logged in as a member to access the Member Forum

There are two ways to get to the Subject dealing with Coronavirus protection

You can click on Access the Forum


Go to top menu My forums, select Viral Infections & You Safety and then select the Subject Coronavirus protection)

Once you are at the correct Subject you can ask your questions or share your ideas – all patients and carers are welcome!

Additional Information

The following is sensible advice Dragon Claw found from the World Health organisation, The BBC online and The Huffington Post.

  • It appears that people who are older, those with weakened immune systems and people who have underlying chronic conditions including asthma, diabetes or heart disease are more at risk of severe effects
  • Most people recover from coronavirus quickly after a few days' rest. For some people, it can be more severe and, in rare cases, life-threatening.

What if I have a different chronic health issue?

Those with underlying medical issues like high blood pressure, lung complaints and weakened or compromised immune systems are more likely to develop serious illness as a result of the disease.

What about my medication?

It is important that even if you are unwell, you continue to take your prescribed medication. If you need to collect prescriptions while unwell, ask a friend or family member to collect them for you.
Prof Peter Openshaw, from Imperial College London, says people should plan to have at least four weeks' supply of medicine.
It might also be a good idea to have some extra food provisions in - but there is no need to panic-buy.

How can I stay safe?

The main practical thing at the moment is to carry on taking sensible steps to reduce your risk of picking up infections. The virus is thought to be spread by coughs and via contaminated surfaces, such as handrails and door handles in public places.



Do I need to avoid public places?

Most people can continue to go to work, school and other public places.

You only need to self-isolate and stay away from other people if you are advised to by a medical professional.

Should I use a face mask?

The British Lung Foundation says: "We do not recommend using a face mask to protect yourself as there isn't enough evidence to show how effective they are. Also, for people living with a lung condition wearing a face mask can make breathing more difficult."

Maintain social distancing

Maintain at least 1 metre (3 feet) distance between yourself and anyone who is coughing or sneezing.


When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.

Avoid touching eyes, nose and mouth


Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.

Practice respiratory hygiene

Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.


Droplets spread virus. By following good respiratory hygiene you protect the people around you from viruses such as cold, flu and COVID-19.

If you have fever, cough and difficulty breathing, seek medical care early.

Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.


National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.

What should I do if I feel ill?

The symptoms of COVID-19 are:

  • a cough
  • a high temperature
  • shortness of breath

These symptoms do not necessarily mean you have the illness.

You might want to take the Australian symptom checker available on the healthdirect site:

         Healthdirect Symptom Checker





The 2018/9 fiscal year Annual General Meeting (AGM) will take place on Tuesday 24th March 2020 at 8pm (AEST).  It will be conducted as an online meeting in the digital spirit of Dragon.  If you wish to participate then please reply with your contact details to:

                         This email address is being protected from spambots. You need JavaScript enabled to view it.t

and place the following in the Subject line:

                                  2018/19 AGM Attendance




Glucosamine in the treatment of osteoarthritis

The following jount statement was kindly provided by Arthritis Australia  & the Australian Rheumatology Association


Australian Rheumatology Association and Arthritis Australia Statement regarding the use of glucosamine for the treatment of Osteoarthritis Recent media reports have raised concern over the use of glucosamine in the treatment of osteoarthritis.

These reports appear to be based on two unrelated recent events:

  1. A change in recommendation by the American College of Rheumatology (ACR) [1] In October 2019 the ACR updated their guidelines for the management of osteoarthritis from a longstanding conditional recommendation against the use of glucosamine for osteoarthritis (on the basis that it probably does not help), to a strong recommendation against the use of glucosamine for osteoarthritis (on the basis that it convincingly does not help). They did not cite new safety concerns.
  2. A recent paper highlighting the known risks associated with glucosamine, particularly in people with shellfish allergy [2] This paper reviewed 366 glucosamine related adverse drug reactions reported to the Therapeutic Goods Administration between 2000-2011, including 43 classified as severe, possibly related to the known risks of glucosamine in those with shellfish allergy. This highlights a valid concern but the number of adverse events needs to be considered in the context of the many hundreds of thousands of people who took glucosamine during that period. This suggests that severe adverse reactions are very uncommon.

Many other osteoarthritis treatment guidelines make conditional recommendations against the use of glucosamine on the basis that it probably does not help, including The Royal Australian College of General Practitioners guideline for the management knee and hip OA [3].

Arthritis Australia and Australian Rheumatology Association comment:

This information highlights growing evidence that glucosamine does not help people with osteoarthritis and is a reminder that people with shellfish allergy should not take glucosamine (which is commonly derived from shellfish). It does not identify any new safety concerns and should not cause undue alarm in people already taking glucosamine.

Comment from The Royal College of General Practitioners (RACGP):

Dr Harry Nespolon, President of the RACGP stated “The RACGP does not recommend the use of glucosamine as a way of preventing osteoarthritis. If you have concerns about using glucosamine or treatment for osteoarthritis I recommend you have a chat with your local GP about the options available to you.”



Media Contacts:
Australian Rheumatology Association – T: 02 9252 2356 | E: This email address is being protected from spambots. You need JavaScript enabled to view it.
Arthritis Australia – T: 02 9518 4441 | E: This email address is being protected from spambots. You need JavaScript enabled to view it.
The Royal College of General Practitioners – T: 03 8699 0939 | E: This email address is being protected from spambots. You need JavaScript enabled to view it.

 AustralianRheumatologyAssociation                         ArthritisAustralia


OMERACT Survey Request


OMERACT stands for Outcome Measures in Rheumatology and represents a community of patients, health professionals and researchers. OMERACT is an organisation that encourages Pharmaceutical companies to test new drugs properly and patient input is vital in this process.

We have been asked by OMERACT to see if any of our Members would be interested in undertaking a short, but very important, survey they have developed.

This survey will help support the work they are doing and we feel it’s important to support these initiatives, as your contribution will help map the future of measurement in trials of shared decision-making interventions in rheumatology.
If you want to be part of this process, you can participate in a short online survey:

In this survey, they will ask you to…

1.     Watch 2 short videos on OMERACT and shared decision-making
2.     Answer a set of questions
3.     Let them know if you wish to be involved in the next steps
If you want more information – read on, and if you don’t, please skip to the survey link. 

Description of the project

OMERACT work together with partners to improve the conduct of clinical trials by developing core sets of outcome domains. A core set of outcome domains is a short list of the most important outcomes (results or endpoints) that should be measured in every clinical trial.
The OMERACT working group for shared decision making has developed a draft core set of outcome domains for evaluating interventions, which can facilitate shared decision making in rheumatology.
They are now seeking the support of patients, health professionals and researchers who are willing to help them review this draft core set.

If you are interested in the topic of shared decision-making, you can be involved in the prioritisation and endorsement of the core outcome domains.


Because the methodology of OMERACT and the potential outcome domains for shared decision making interventions are not widely known, they would like to ask you to watch two 5-minute white board videos.

They explain what OMERACT is and what the shared decision making process looks like (video 1), and which outcomes are important when evaluating SDM interventions (video 2).
They hope that after watching the video, you will be willing to complete a short online survey to help them improve the clarity and relevance of the draft core set of outcome domains for shared decision making interventions in rheumatology. This should take about 10 to 15 minutes.
The Research Ethics Board at the Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Canada, has approved this study.

Your information will be anonymised and treated confidentially.

Click here to the participate in the survey
Please feel free to forward this invitation to individuals who might be interested in participating.
Thank you kindly for considering this survey request.

Please let OMERACT know if you have any questions at: This email address is being protected from spambots. You need JavaScript enabled to view it.



Dragon Claw is run by volunteers.  None get paid so we use all funds for projects and our overheads are very low.  Membership is free.  We’d love you to become a monthly donor, which helps ensure a predictable steady stream of support. Notify us of your proposed donation HERE and we’ll prepare a tax-deductible receipt.

Volunteers Needed

Dragon  Claw  Charity  Ltd  is  a  fully  registered  Australian  charity and  operates  in  the health  promotion  space.    We  focus  exclusively on  rheumatoid  arthritis  and  lupus.    Due  to  rapid  growth  and increasing   opportunity   we   are   seeking   two   people   to   fill   the positions  of  Executive,  joining  the  founding  three.    The  executive team  manages the organization with the support of a formal Board and  a  number  of  advisory  groups.    If  you  are  interested  to  make  a difference,  can  focus, deliver  on  agreed  outcomes  and  have  the ability  to  donate about 10  hours  per  week,  then  please  consider Dragon Claw.  These two positions are entirely volunteer as are all positions.  Please visit our Website and if we pique your interest then send a one page application to This email address is being protected from spambots. You need JavaScript enabled to view it..


DragonClaw provides information, community and support.

Why the name?

Rheumatoid Disease (RD) can be felt like an unpleasant animal moving around the body biting and scratching.

Occasionally,the dragon rears up and breathes fire,which is felt as a flare, hence the name.

Our Patron

Dr. Mukesh Haikerwal AO former National President of the Australian Medical Association. He is currently a board member of Beyond Blue, Cancer Victoria and Brain Injury Australia. In addition, he is a professor at the School of Medicine, Flinders University, Adelaide. Encouraging self-care and care co-ordination to reduce isolation and stress.



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