That’s because people with MS who use many of the available disease-modifying therapies (DMTs) approved for reducing MS relapses and slowing MS progression are high on the risk scale if they are living in proximity to the novel coronavirus, COVID-19, or to other viral outbreaks. It’s one of the reasons we are always advised to get the annual flu shot.
The WHO’s Protective Plan of Action for Everyone
Let’s start with the basics. The World Health Organization recommends the following for everyone in an effort to reduce risk of infection with COVID-19:
Wash your hands frequently with soap and water or use alcohol-based hand sanitizer that contains at least 60 percent alcohol.When coughing and sneezing, cover your mouth and nose with a flexed elbow or tissue. Discard the tissue in the trash.Keep at least 1 meter (about 3 feet) of distance between yourself and others, particularly those who are coughing and sneezing.Avoid touching your eyes, nose, and mouth with your hands.Practice food safety by using different chopping boards for raw meat and cooked foods, and wash your hands between handling them.
Most important to the whole prevention process is, of course, washing our hands. Many of us think we wash our hands well enough. Here, however, is a video from WHO that instructs us all to spend 60 seconds properly washing to prevent spread of illness. Extra Precautions for Those Living With MS The MS International Federation (MSIF) has come out with some good guidelines for people with MS. The most important would be: “If you are taking a DMT and are either exposed to COVID-19 or are confirmed to have the COVID-19 infection, please contact your neurologist or other medical professional.” The neurologist Barry Singer, MD, in his MS Living Well blog, has also offered some advice for evaluating your personal risk and taking actions to protect yourself. He notes in his blog post that “people with MS with higher levels of disability, such as with moderate to severe weakness in arms and legs, may be more vulnerable to coronavirus complications.”
Which DMTs Raise the Risk of COVID-19 Complications?
On the subject of DMT, it’s important to know the difference between immunomodulating and immunosuppressing drugs and which, if any, you are on. According to the well-known MS specialist Gavin Giovannoni, MBBS, PhD, “Unless you are on interferon-beta [Avonex, Rebif, Betaseron, Extavia], glatiramer acetate [Copaxone, Glatopa], or teriflunomide [Aubagio], the so-called immunomodulatory therapies, your immune systems are likely to be compromised and hence you are at risk of getting more severe COVID-19 infection or secondary complications of an infection.” This in no way suggests that because of COVID-19 the vast majority of people in the world with MS should stop our DMT. In the heavily impacted areas of northern Italy, however, Dr. Giovannoni reports that neurologists have stopped dosing their MS patients with Ocrevus (ocrelizumab), Lemtrada (alemtuzumab), and Mavenclad (cladribine) until the epidemic has passed.
Your Personal Risk Depends Largely on Your Location
At this point, for people living with MS outside of highly impacted areas (those areas can be monitored via the Johns Hopkins interactive dashboard of cases), the risk of acquiring the infection seem quite low. If, however, you live in one of the areas more affected by an outbreak, it is important to step up your vigilance and, perhaps, develop a contingency plan for your family in case the virus moves closer to your everyday life. We are at a higher risk of contracting the virus if we are near an infected person, and may be more impacted if we contract COVID-19. Be aware, be cautious, be vigilant, be informed, but don’t be panicked. Wishing you and your family the best of health. Cheers, Trevis
