Covid-19

19 March 2020

 

Memo: Information for Islet Transplant Patients during Pandemic 

 

Due to the recent COVID-19 pandemic we are making immediate changes to ensure the safety of our patients and our staff. The following changes are in effect:

 

1.     There are to be no new islet transplants for the time being (the T-depleting therapies need to be avoided for now, and islet transplants are unlikely to be effective without this)

2.     Patients will not come directly to clinic unless absolutely necessary – clinics will be virtual, by phone or by video conference using secure connections where possible (see appendix 1). MyAHSConnect is a secure tool which was launched recently, and we encourage you to sign up:

a.     Sign up for an Alberta Digital ID https://account.alberta.ca/signup

b.     Then you can sign in to myAHSConnect https://myahsconnect.albertahealthservices.ca/MyChartPRD/Authentication/Login? This will let you

                                               i.     communicate securely with the islet program

                                              ii.     see your own lab results

                                            iii.     upload photos (eg of a rash)

                                            iv.     upload blood glucose results (eg photo of records 

There are some additional things that you can do to help us care for you:

c.     Ensure we have an up to date email address for you (send us an email to isletprogram@islet.ca

d.     If you have a smartphone (iPhone, Android) let us know your cellphone number (in the same email) We may send you an invitation to a zoom meeting (videoconference) this way you can join easily from a smartphone, tablet, laptop or desktop

3.     We are reviewing the need for routine testing –non-essential tests will be deferred, eg abdominal ultrasound, ensure tests, we may ask you to extend the intervals between your regular lab work (eg wait 2 months instead of every month) if values have been stable.

4.     Transplant patients will have priority access for necessary lab work where possible – if local labs are closed or are restricting access

 

We know you will have lots of questions. Some answers to Frequently Asked Question are provided here. 

 

FAQs

A.     Should I go for my Routine Lab work? – yes, you should go if possible

a.     But, could I delay my routine lab work or other tests? – this may be possible, especially if you are more than 1 year since your last transplant. If your blood work is due in the next 2 weeks, check with your co-ordinator. Don’t call us if you are not due for blood work soon (see #3 above)

b.     My local lab is closed – you may need to call around to see if there is an alternative lab until we hear more about lab restrictions

B.     Do I need to take precautions? – YES, precautions are advised for everyone, particularly social distancing https://www.alberta.ca/prevent-the-spread.aspx

C.     Should I self-isolate? – Only if you are sick or meet self-isolation criteria. For up to date information see www.ahs.ca/covidparticularly the tab “Information for Albertans” 

D.    How do I self-isolate? - https://www.alberta.ca/self-isolation.aspx

E.     Can I go to work? – Yes, if you are well - but you should try to work remotely from home if and where possible

F.     Can I have a sick note / letter? – sick notes will not be provided at this time, and as per government direction are not required at this time. 

We appreciate that you may be facing financial challenges and the following links may be helpful:

a.     https://www.alberta.ca/covid-19-supports-for-albertans.aspx

b.     https://www.canada.ca/en/services/benefits/ei.html

G.    What should I do if I get sick? – during any illness, your blood sugars can rise (even if you are not eating)

a.     Check your blood sugars at least twice per day

b.     Keep hydrated with fluids that don’t have too much sugar in them (unless your blood glucose is low)

c.     If your blood glucose levels are above 10 mmol/L more than half of the time, start some insulin (eg, lantus 6 units at breakfast and dinner, OR Tresiba OR Toujeo: 8 units once per day at breakfast)

d.     If your blood sugars are above 16 mmol/L (unless you have a good reason) you probably should take a correction dose of short acting insulin (Humalog, Novorapid OR FiAsp) 3-4 units which can be repeated in 2 hours if the blood glucose has increased by more than 2mmol/L

e.     Additional information for SICK DAYS for diabetes are here: https://www.albertahealthservices.ca/info/Page15977.aspx

H.    What if I think I have got COVID-19? 

a.     stay home – do not go to an ER or clinic

b.     take the COVID-19 self-assessment test

c.     call Health Link 811 for testing and instructions

I.      How can I get my medications? – Rexall may be able to arrange delivery of anti-rejection drugs. A friend or relative may be able to help pick up other routine prescriptions for you

J.      Is there anything else I should get to be prepared? – Make sure you have the following

a.     blood glucose test strips

b.     a blood glucose meter that works (battery is still working)

c.     short acting insulin in a working pen (or pre-filled pen) or at least some syringes and a vial of insulin

d.     Supply of your regular medications

K.     Should I stop my anti-rejection drugs? – We do not advise you to discontinue anti-rejection drugs at this time. There is no evidence that the routine transplant medications are harmful or put you at higher risk, unless you have an active infection. Please note:

a.     If you lose your islet transplant by stopping the antirejection drugs you may become sensitized and it could mean that you may not be eligible for a future transplant. 

b.     If you are admitted to hospital with an active infection appropriate adjustments may be made to your antirejection medications (dose reduction or short interruptions) to accelerate recovery but with close observation so we can get the patient health as quickly as possible while also taking care of the islets. 

Comments