Answering 18 COVID-19 Questions: Part 1

People with multiple sclerosis are the reason the National MS Society is here, and we know this time of uncertainty can be unsettling. We are working closely with our partners around the globe to bring you the latest, most accurate information possible to keep you and your families safe as we move through the COVID-19 pandemic together.
 
Here are some of the recent questions asked on our Ask an Expert call.
 

MS and COVID-19

What is known about people with MS who have gotten COVID-19, including what their COVID-19 disease course has been like, mortality rates etc.?
There are only anecdotal data right now, meaning individual reports of people with MS who have gotten COVID-19. There are registries that are just getting started in the United Kingdom, Italy and Australia. The United States also has a registry that is under development now.

Does level of MS progression and disability have any impact on the severity of COVID-19?
Significantly compromised mobility—meaning spending most of the day seated or in bed—may make you at higher risk for more a more serious COVID infection. Sometimes when mobility is compromised, overall lung capacity may be reduced, potentially making a more serious lung infection from COVID-19 possible.

If I get COVID-19, could it cause a relapse?
It is known that infections in general may provoke new symptoms or new MRI activity. As COVID-19 is an infection, it is possible that an MS relapse could occur. Sometimes a fever can provoke a temporary worsening of old symptoms and the symptoms settle down when the body temperature returns to normal. If you are concerned about your symptoms, please contact your MS provider.

Can relapses be treated with steroids or acthar gel during the COVID-19 pandemic?
Steroids or ACTHAR gel are safe to administer for MS relapses.

Should I delay my medical appointments, like MRIs?
If your MRI is considered routine screening or routine follow-up, you may be able to postpone. Check with your MS provider to be sure. If you are experiencing new symptoms of your MS, you may need to have an MRI. In this case, contact the radiology office to learn of any infection prevention procedures they have in place.

Are any problems foreseen with delivery of time DMTs?
Contact your specialty pharmacy or pharmacy benefit manager to identify any delivery disruptions. If disruptions do occur, contact your PBM for instruction on using an alternate pharmacy

What should I do about getting my MS infusion?
Contact you MS provider for advice on continuing or postponing your infusion. If you have an infusion scheduled, please contact the infusion center ahead of your appointment for any special instructions related to COVID-19. If your infusion center has closed, please contact the drug manufacturer patient assistance program to identify an alternate infusion center.

Staying Safe

What precautions for minimizing risk of infection spread should be in place for people who receive help in their homes by paid caregivers?
Paid caregivers should follow the standard precautions outlined by the Centers for Disease Control and Prevention. Contact your caregiver ahead of time to ensure he/she is not experiencing COVID-19 symptoms to allow time to make alternative arrangements if needed.

Do people with MS experiencing COVID-19 symptoms get screening priority?
Not necessarily. If you are experiencing any symptoms of COVID-19, please contact your primary care provider for guidance right away. Each health organization and office has procedures in place.

What help can the Society provide for people who need medical supplies that are either out of stock or have increased prices that are not affordable?
The Society has help and resources available. Contact an MS Navigator to discuss your specific needs.
 
Should healthy people wear masks in public? 
Research from China and U.S. Hospitals suggests that small viral particles may stay in the air for a period of time after someone with the virus is coughing, sneezing or even breathing or talking in that particular area. The length of time viral particles stay in an area seems to be based upon things such as the amount of virus and the circulation of air in that location. It is unlikely that this occurs during social distancing outdoors as there is adequate air circulation.   
 
The CDC is now recommending  people cover their faces when in public. Face coverings do not include medical masks, like N95 respirators or surgical masks. Instead, people are encouraged to wear homemade cloth masks like bandanas and scarves.

Food and Nutrition

Should I be taking a vitamin D supplement since I’m not going outside?
Vitamin D supplements should be based upon your Vitamin D level. If you are unsure how much you should take, please contact your MS provider for advice.

Is it safe to eat fresh fruits and vegetables?
The fruit and vegetables themselves are fine. Wash any produce thoroughly before eating.

With all the food delivery options, can someone spread the virus when preparing food?
It is unlikely that the infection will be spread in this way.

Besides washing hands, what else can you do after food shopping to prevent spread of the virus?
Place grocery bags on the floor to unpack and wash produce. Most other items are not handled as much as produce (like boxes, bottles, cans, etc.) and are unlikely to be contaminated. If you are concerned, particularly bottles or cans, these can be washed off as well.

Working and COVID-19

Should healthcare workers who have MS be working?
There is no increased risk of you getting COVID-19 because you have MS. If you are concerned about your risk of getting COVID-19 because of the DMT you take, please contact your MS provider for advice.

What PPE and precautions should healthcare workers who have MS use?
There are no special PPE instructions for people with MS. They should follow the same precautions as other healthcare workers. If you are concerned about your risk due to your DMT, please contact your MS provider for advice.

What are my rights if my employer is not being flexible with work from home options?
There are many protections that could be available to you. Contact an MS Navigator to discuss your individual rights and options.

Editor’s Note: Read part 2 and part 3 of answering your questions about COVID-19. Listen to more Ask an MS Expert webinars or visit the Society’s Coronavirus Resources Pagefor more information.