Covid 19 and MS

Are people with MS in the “clinically extremely vulnerable” (CEV) or “high risk” group?

Some people with MS are in the "extremely clinically vulnerable" or "high risk" group because they:

• have significant difficulties with breathing or swallowing (for instance if you need artificial feeding)

• have taken alemtuzumab (Lemtrada) within the last 4 weeks (or longer if specified by a clinician)

• have taken cladribine (Mavenclad), ocrelizumab (Ocrevus) or alemtuzumab (Lemtrada) within the last 6 months AND have two or more other risk factors from this list

• have had HSCT treatment in the last 12 months (speak to your MS team to understand at what point your risks will reduce)

Everyone with MS is technically in the wider group of "clinically vulnerable" people and should follow guidance extra carefully.

At times during the pandemic, UK governments are recommending people self-isolate (shield) if they are considered clinically extremely vulnerable to coronavirus.

What else might put me at higher risk from COVID-19 if I have MS?

This coronavirus is a new virus, so it’s impossible to give a complete list of all the things that might increase risk if you have MS. But here’s a general view from our medical advisers on the main risks you should think about when deciding how to protect yourself from the virus.

Your MS team will be more familiar with your personal circumstances. So if they tell you to take precautions for any other reason it's very important you follow their advice.

Main extra risk factors

The main extra risk factors are if:

• you’re over 70

• you have trouble with things like preparing meals and housework because of frailty

• your frailty or MS symptoms mean you usually need an aid for walking, or you use a wheelchair (score 6.0 or higher on the Expanded Disability Status Scale)

• you have another long-term health condition besides MS, especially obesity, high blood pressure (also called hypertension), or diabetes. See a fuller list of long-term conditions that also apply on the US National Library of Medicine website

• you're pregnant

• you’ve had a course of alemtuzumab (Lemtrada) or cladribine (Mavenclad) in the last 6 months

• you’re taking fingolimod (Gilenya)

• you’ve had a course of ocrelizumab (Ocrevus) or rituximab in the last 12 months

If two or more of these describe your situation, you might want to take more stringent steps to protect yourself. This could include following the guidance in your area for people considered ‘extremely clinically vulnerable’.

How should I do social distancing and self-isolation if I’ve got MS?

Right now everyone still needs to practice social distancing.

And the UK government says people with MS should be “particularly stringent” about following the guidelines. That means

• stay 2 metres (6ft) away from people outside your household (or support bubble)

• wash your hands regularly

• check your government’s advice and rules on face coverings and meeting up with other people.

Everyone with MS is considered ‘clinically vulnerable’, so the governments recommend you’re especially careful about wearing a face covering, social distancing and hand hygiene.

Can I get a contact tracing phone app for COVID-19?

Contact tracing apps for mobile phones are now available in every UK nation. These apps could help control the spread of coronavirus. The contact tracing app for England and Wales will also give you local risk updates and a COVID-19 symptom checker.
They don’t pass on details of your location to the NHS. That information stays on your phone. But they can tell you if you’ve been in contact with someone who’s tested positive for coronavirus. And if you test positive, it can tell people you’ve been close to so they can self-isolate. It doesn’t tell them who you are or where you are.

Can I form a support bubble or ‘extended household’ if I've got MS?

People with MS can be part of a support bubble or ‘extended household’, so it’s easier in lockdown to see close friends or family who don’t live with you. There are different rules for support bubbles in each nation. But generally they mean you can think of yourselves as one household for most coronavirus guidelines. You should check for local restrictions that affect the guidance.

If you live in England, Scotland or Wales and you’re the only adult in your household, you can form a ‘support bubble’ or ‘extended household’ with one other household.

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In all UK nations, you shouldn’t change your bubble once it’s formed.Everyone should take any extra precautions that the households usually take - for example if anyone is clinically vulnerable, or one of the bubble has a lot of contact outside the house.

Although the risk for individual people with MS from COVID-19 varies widely, everyone with MS is technically considered ‘clinically vulnerable’. The UK government says you should keep taking particular care to limit contact with others and should bear this in mind when deciding about forming a bubble.

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Should I wear a face mask if I go out?

Wearing a face covering is not a replacement for proper social distancing and good hygiene. But it might help protect other people if you’re infected with coronavirus – even if you don’t have coronavirus symptoms.
If you have coronavirus symptoms, you and your household (or support bubble) should self-isolate. Wearing a face covering doesn’t change this.
The UK government has a guide to making face-coverings at home. And the Welsh government has a video explaining how to make a 3-layer face covering which they recommend.
It’s important to wash your hands before putting your covering on and taking it off. And we should all avoid touching our faces as much as possible, whether we’re wearing a face covering or not. Coverings should be washed after every use, or thrown away if they’re disposable.
Each UK government has written guidance which says face coverings could be useful if you’re in a small space and social distancing isn’t possible. For example, on public transport or in shops.
In some cases, these are rules people can be fined for breaking. Each nation also has guidance for face coverings in schools.

Can I still get hospital appointments, MS healthcare and social care during coronavirus restrictions?

You should contact your MS team as you normally would. Our medical advisers stress the importance of attending appointments with healthcare professionals, or seeking help if you feel seriously unwell.

We know many MS services have been disrupted during the pandemic and this has resulted in long waiting times for some care. So it might be more difficult to get appointments for routine things like annual reviews. You're likely to be offered an appointment by phone or video call where it's not essential to be seen face to face.

Remember, always contact your team if:

• you have signs of a relapse

• you go to hospital for any reason (even if you’re not admitted)

• you’re considering any changes to how you take your DMT