Coronavirus and those with a weakened immune system like MS

Coronavirus and those with a weakened immune system like MS

So my mom called yesterday and discussed the coronavirus with me and my weakened immune system. I can’t lie I was expecting this conversation with her and was pretty amazed she’s lasted this long. I also have to admit it’s been in my head. To make things worse, my infusion is coming up. I decided to write to my MS specialist. This is what she wrote me back:

Hi Jamie,
I hear you. Right now there are only a few cases and the risk is very low. But, it seems like the coronavirus is serious for those who get it. Maybe skip physical therapy for a few weeks? Or at least obsessively wash your hands afterwards and don’t touch your face when you are there. The issue with mahjong is that you will be touching things that a lot of others will also be touching as well. The other issue is you probably enjoy it and I don’t want you to stop! Ugh.

I would use common sense. If the outbreak gets closer to you, maybe you really shouldn’t go to public places. Most importantly, If people are actively sick, don’t go around them. Carry purell with you at all times. Below is the FAQ that we made for our patients. 

Coronavirus Disease 2019 (COVID-19) 
We are all concerned about Coronavirus Disease 2019 (COVID-19) and cannot predict what will happen regarding risks of infection in our area over the next few weeks. This is a developing situation that we will all be monitoring. We hope you will find these answers to frequently asked questions helpful. 

Am I at increased risk for becoming infected with COVID-19 or at a higher risk for complications because of my MS? 

Because COVID-19 is a new virus, we do not have specific data to guide us as to whether those with MS might be at increased risk for infection or for complications of infection. We have no reason to believe having MS alone would increase the risks, however, the use of disease-modifying therapies that suppress the immune system could hypothetically confer a slightly increased risk, similar to what we sometimes see with other viral infections. 

Should I stop taking my MS medication because it suppresses my immune system? 

Every health recommendation we make is based on a consideration of potential benefits and potential risks. At this time the risk of not having your MS adequately treated is greater than the risk of possible coronavirus infection. Stopping your MS treatment could potentially lead to permanent neurologic damage that your treatment would have prevented. This is a very big risk. On the other hand, the theoretical increased risk of a worse outcome from coronavirus infection related to being on MS medication is thought to be small at this time. 

Should I keep my upcoming appointment at Mount Sinai with my doctor? (I left this in for reference to anyone’s doctor’s appointment not just the one’s at my practice. )

As of now, we do not think visiting an outpatient building at Mount Sinai increases your risk of COVID-19 exposure and it is very important to keep up to date on your MS care. However, if you are uncomfortable coming in for your routine visit, please ask our staff about options for a telehealth visit instead (not every patient is eligible for this, but please inquire). 

How can I reduce my risk of becoming infected? 

We recommend similar measures to those regarding other viral exposures such as influenza. Most viruses enter the body through the eyes, nose and mouth and are introduced by viral particles on your hands when you touch your face. Measures to reduce the likelihood of infection include: 
1. Avoid touching communal hard surfaces when possible 
2. Wipe shared surfaces (such as shared desks or keyboards) with sanitizing wipes before use 
3. Wash hands frequently with soap and water (scrub for at least 20 seconds, including web space between fingers, fingernails, wrists), or use an alcohol-based hand sanitizer when soap and water are not available, particularly after touching shared surfaces  
4. Avoid touching your face (especially eyes, nose, and mouth) 
5. Avoid close contact with people who are ill (maintain distance of at least 3 feet from anyone who is coughing or sneezing) 
6. Prioritize getting adequate sleep and eating a healthy diet 

Is it safe for me to travel? 

This is an evolving situation. You should check the CDC website for up to date information regarding travel. It is not recommended to travel to areas that are demonstrated to have COVID-19 outbreaks. Other travel appears to be safe at this time, particularly if you follow the above guidelines to reduce your risk of infection.  

Should I work from home instead of going into work? 

If your employer permits this and you are able to perform your regular duties from home and you prefer this, it is a reasonable strategy for the coming weeks.  

What should I do if I become sick? 

If you develop symptoms such as fever, cough, and runny nose, at this time it is more likely that you have a common cold or influenza than COVID-19. You should take precautions to avoid infecting others such as staying home, using tissues and depositing them directly into the trash, coughing/sneezing into a tissue or your elbow rather than your hands, avoiding touching your face, and washing hands frequently. 

You do not need to seek medical care for minor symptoms and it is best to stay home. Should you experience any respiratory distress (difficulty breathing) or severe symptoms, you should call your primary medical doctor for advice on the logistics of arranging an evaluation or coming in to the ED. On arrival to any healthcare setting you should immediately notify personnel of an infection and expect to wear a mask and be placed in isolation pending testing. 

Where can I get more information?
The World Health Organization (WHO)
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
The Center for Disease Control (CDC)
https://www.cdc.gov/coronavirus/2019-ncov/index.html
The National MS Society:
https://www.nationalmssociety.org/About-the-Society/News/What-You-Need-to-Know-about-Coronavirus

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