|NOTE: This post was updated on the 9/04/2020, to reflect the requirements of Alert Level 4 and emerging data.
This information and advice has been put together by the Australian and New Zealand Association of Neurologists for patients with Multiple Sclerosis.
Since December 2019 following cases emerging in and around Wuhan, China most regions of the world have now experienced cases of a novel respiratory illness caused by a new coronavirus which has been identified as SARS-CoV-2 (COVID-19).
The mortality of this infection amongst cases displaying symptoms and confirmed to have the virus is in the order of 1-7%, mainly in older persons with other health problems.
National and International measures to reduce the risk of transmission of the virus have been implemented in most jurisdictions. It is likely that these measures will slow the rate of transmission, but at this point it is unclear if further spread can be prevented and it is unclear how long the present outbreak will last.
At present there is no known effective treatment for COVID-19 and there is no vaccine. Older persons and those with pre-existing medical conditions (respiratory disease, heart disease, diabetes, cancer) have a higher risk of complications from COVID-19 infection. Men may also be at a slightly increased risk.
People with multiple sclerosis do not seem to be at increased risk, based and on data discussed in a world-wide phone conference on April 1, 2020 (E Waubant, M Sormani, International Federation of Women in MS). Approximately 200 people with multiple sclerosis have had symptomatic coronavirus infections, and few have died. They were largely older and with significant disability. Note this is very early data, collected during a crisis in many of the hospitals.
In New Zealand, we are currently at alert level 4. The number of people infected and the present risk of being infected with COVID-19 remains low. The latest data indicate that the number of new cases is declining. This suggests that the present transmission prevention efforts may be working.
This is the result of two main factors. The first is that the population of New Zealand has largely followed the recommendations of social distancing and personal protection. The second is the outstanding work undertaken by our Public Health teams who have successful traced the source of a large number of cases and implemented testing, quarantine and self-isolation as necessary. This has been an amazing achievement and goes largely unnoticed. However, we need to remain vigilant as the situation may still change. We will continue to monitor this and change our advice accordingly.
In order to minimise the risk of being infected by COVID-19, you should follow the standard precautions advised by the Ministry of Health New Zealand (see Ministry of Health advice). This is the best source of advice on how to keep yourself safe and will be updated daily.
If you develop symptoms of COVID-19 infection (see Ministry of Health advice on symptoms) or have a confirmed diagnosis of COVID-19 infection you should:
If you are concerned that you are developing symptoms of COVID-19 you can:
If you have visited a high-risk area, have symptoms of COVID-19 infection, or have had close contact with someone who has been diagnosed with COVID-19 please do not attend your outpatient appointment, infusion or MRI. Please contact your specialist clinic, MRI department, infusion centre or MS Nurse who will make alternative arrangements.
Current travel advice is available on the New Zealand Safe Travel website. However, all travel has now been banned.
It is recommended that all persons with MS have the flu vaccination when it becomes available in April.
At present we have no evidence of an increased risk of COVID-19 infection or its complications in people with MS or related conditions, or in those on treatment. However, as indicated below there are potential, theoretical risks with some medications and it would be sensible for healthcare workers on any of these therapies to avoid work environments that would bring them into direct contact with people either known to be or likely to be infected with COVID-19. If you require any documentation to this effect, please contact your neurologist who will be happy to assist.
The main piece of advice from the Neurologists is do not stop treatment. At the present time it seems that the risk of MS relapses/rebound outweigh the risk of COVID-19 disease severity so patients should not stop treatment without discussion with their neurologist.
If you are concerned, sick or contract COVID-19 it is important to advise your Neurologist so they can be involved in your treatment plan.
The NZ and Australian Neurologists are working with the MS Data Alliance to develop a registry of people with Multiple Sclerosis who do contract COVID-19. If you do receive a positive test, ask your neurologist to add you to the registry or contact MSNZ (using our contact form or phone 0800 67 54 63) and we will ensure this happens. It is through these records that Neurologists and researchers will be able to understand more comprehensively if there are any greater impacts of COVID-19 on people with Multiple Sclerosis or not.
If you are travelling from overseas and require assistance or access to MS treatments please contact us using out contact form or phone 0800 67 45 63 (+64 3 366 2581) and we will see how we can be of assistance.
If you are on a regular medication for MS or a related condition then it is recommended that you should continue to take this medication because of the very real risk of relapse when medication is ceased.
With regards to specific therapies:
Please note: The situation with COVID-19 is quickly changing and this advice may too.
Image by Thor Deichmann via Pixabay