General ARA Covid Guidance

General ARA Guidance on COVID-19, Omicron Variant, and available treatments

Updated 7/18/22

1. ARA is not infusing any monoclonal antibody treatment and will be unable to do this.
2. ARA is not doing COVID testing for active infections.
3. ARA does not have access to any treatment/preventative pill or infusion for COVID. 
   1. Milder symptoms can be managed at home and many people can recover without direct medical care.  Stay well-hydrated and rested.  Please check in with your primary care provider first if there are any immediate concerns regarding the severity of your illness.
   1. There are medications that can be prescribed to treat COVID.  Local pharmacies have a limited supply of COVID oral antiviral treatments, such as Paxlovid or Lagevrio, reserved for patients at high risk of progression to severe COVID. Please contact your primary care provider first to see if you are eligible.
4. Monoclonal antibodies are in very short supply across the state, and ARA does not have any information about which locations still have supplies. The supply access changes daily, and ARA physicians are not given updates about locations with supplies. 
5. The monoclonal antibodies currently being offered in our local hospital centers have limited to no effectiveness against the Omicron variant.
6. The Omicron variant generally causes milder disease than the Delta variant.
7. Commercially available testing for COVID does not differentiate between the Omicron variant and Delta variant, but Omicron is causing most new cases in the region.
8. ARA will only provide outpatient referrals for monoclonal antibodies to patients who have a positive COVID-19 test within the last 10 days and are on one of the following medications: Cellcept (mycophenolate or myfortic), Rituximab, or Orencia, or are currently on >20 mg of prednisone prescribed by their ARA doctor. Even if the physician provides a referral, you may not be able to get monoclonal antibodies within the recommended 10-day time frame after infection, as we have no ability to move our patients up on the waitlist for these medications.
9. All patients who think they should qualify for monoclonal antibodies, but are not on Cellcept, Myfortic, Rituximab, or Orencia should contact their primary care provider regarding monoclonal antibody infusion referrals. 
10. If you are a patient and do not have a primary care provider to contact, and you are moderately ill, or having shortness of breath, uncontrolled fevers, or chest pain,  you should go to the ER for evaluation.
11. If you have a positive COVID test, ARA recommends you hold your immune suppressive medications while you are experiencing active illness. The only exception to this recommendation is Plaquenil as it is not immunosuppressive and prednisone as it should not be abruptly stopped.
12. If you are unable to get tested but have close contact who has tested positive for COVID or is experiencing symptoms, we suggest you isolate yourself and self-monitor. It is okay to hold off on taking immune suppressive medications for 48 hours while self-monitoring for symptoms, but if you are on prednisone, you should not stop that medication. 
13. If you feel mild to moderately ill, your doctor recommends you isolate, hydrate as you would with any flu-like illness.
14. If you had COVID and are >10 days out from a positive test and are no longer symptomatic, you can keep your inpatient infusion or office visit. We do not require proof of negative test to come into the office.
15. Updated information will be available on the website once it becomes available. We do not recommend you call for updates as we are experiencing a very high call volume.