FAQ about COVID-19 and MS

We have received many questions from our clients about how COVID-19 might impact the health and wellbeing of people living with MS. Here are the answers to the most frequently asked questions.

What is self-isolation or social distancing? Do I need to do this?

Self-isolation, social distancing and good hygiene practices are the most effective ways to reduce the risk of contracting and spreading coronavirus.

• Social distancing means you should keep a distance of 1.5 metres between you and other people where possible, minimise physical contact, avoid large public gathering and staying at home if you are unwell.
• Self-isolation means you should not go to public places such as school, work, shopping centres, and you should avoid catching up with visitors, so you are only staying in physical contact with people who live with you.
• Good hygiene practices include washing your hands frequently with soap and water, covering your coughs and sneezes with your elbow or a tissue, cleaning and disinfecting surfaces and using alcohol-based hand sanitisers. Everyone is encouraged to do these practices where possible.

I feel anxious or stressed. How can I manage my mental health during this time?
It is important to understand this can be a very anxious and stressful time for a lot of people in the community and these feelings are completely normal. The World Health Organisation has provided some very helpful information on coping with stress curing the coronavirus outbreak which you can find on their website.

Should I be wearing a surgical mask and does Multiple Sclerosis Limited has any to provide?
The Department of Health states that surgical masks are not required if you are well as it has not been proven that widespread use of surgical masks prevents transmission in public. They may be helpful to prevent someone who has coronavirus from spreading it to others. MSL does not supply masks but we currently recommend good hygiene practices, self-isolation and social distancing as the recommended measures to prevent contracting or spreading coronavirus.

Should I continue my DTM therapy for MS?
Many disease modifying therapies (DMTs) for MS work by suppressing or modifying the immune system. Some MS medications might increase the likelihood of developing complications from a COVID-19 infection but this risk needs to be balanced with the risks of stopping treatment. The MS International Federation recommends that:

• People with MS currently taking DMTs continue with their treatment.
• People who develop symptoms of COVID-19 or test positive for the infection discuss their MS therapies with their MS care provider or another health care professional who is familiar with their care.
• Before starting on any new DMT, people with MS discuss with their healthcare professional which therapy is the best choice for their individual disease course and disease activity in light of COVID-19 risk in the region.
• Those who are due to start on a DMT but have not yet done so, should consider selecting a treatment that does not reduce specific immune cells (lymphocytes). Examples include: interferons, glatiramer acetate, or natalizumab. Medications that reduce lymphocytes over longer intervals include alemtuzumab, cladribine, ocrelizumab and rituximab. The following oral DMTs may reduce the ability of the immune system to respond to an infection: fingolimod, dimethyl fumarate, teriflunomide and siponimod. People should carefully consider the risks and benefits of initiating these treatments during the COVID-19 pandemic.
• People with MS who are currently taking alemtuzumab, cladribine, ocrelizumab, rituximab, fingolimod, dimethyl fumarate, teriflunomide or siponimod and are living in a community with a COVID-19 outbreak should isolate as much as possible to reduce their risk of infection.
• Recommendations on delaying second or further doses of alemtuzumab, cladribine, ocrelizumab and rituximab due to the COVID-19 outbreak differ between countries. People who take these medications and are due for the next dose should consult their healthcare professional about the risks and benefits of postponing treatment.

SOURCES
MS International Federation

Australian Government Department of Health

World Health Organisation

Smartraveller