Last updated: 27 March 2020

The ‘novel coronavirus’ is an infectious disease caused by a virus that had not been previously identified in humans. COVID-19 is a strain of coronavirus which began in December 2019 in Wuhan, China, and has since spread to other parts of the world.

What does COVID-19 mean for people living with MS?

As this strain of the coronavirus is new, the knowledge on how this will affect people with MS is still limited.  This advice is based on the recent ‘Global COVID-19 advice for people with MS’ developed by the MS International Federation (MSIF). This information will be reviewed and updated by MSIF as new evidence about COVID-19 becomes available.

People with underlying lung and heart conditions and those aged over 60 years are more likely to experience complications and become severely ill with the COVID-19 virus. This group will include many people living with MS, especially those with additional health complications, mobility issues and those taking some MS treatments.

All people with MS are advised to pay particular attention to guidelines for reducing the risk of infection with COVID-19. Older people with MS, especially those who also have lung or heart diseases should take extra care to minimise their exposure to the virus.

The World Health Organization recommendations include:

  • Wash your hands frequently with soap and water or an alcohol-based hand rub
  • Avoid touching your eyes, nose and mouth unless your hands are clean
  • Try to keep at least 1 metre distance between yourself and others, particularly those who are coughing and sneezing
  • When coughing and sneezing, cover your mouth and nose with a flexed elbow or tissue
  • Practise food safety by using different chopping boards for raw meat and cooked foods and wash your hands between handling them.

EMSP WHO COVID-19 Coronavirus recommendations public health

In addition, it is recommended that people with MS should:

  • Avoid public gatherings and crowds
  • Avoid using public transport where possible
  • Where possible, use alternatives to face-to-face routine medical appointments (for example, telephone appointments).

Caregivers and family members who live with, or regularly visit, a person with MS should also follow these recommendations to reduce the chance of bringing COVID-19 infection back home.

We also recommend that you check with your local MS organisation who might have already developed recommendations for people with MS in your country with the help of their medical advisory board:

Advice regarding disease-modifying therapies 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.

It is recommended 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.

Advice regarding aHSCT

Autologous Haematopoietic Stem Cell Treatment (aHSCT) includes intensive chemotherapy treatment. This severely weakens the immune system for a period of time. People who have recently undergone treatment should extend the period they remain in isolation during the COVID-19 outbreak. People who are due to undergo treatment should consider postponing the procedure in consultation with their healthcare professional.

Advice for children or pregnant women with MS

At this time there is no specific advice for women with MS who are pregnant or for children with MS. They should follow the general advice above.

It is important to avoid contact with anyone who may have been living or travelling in an area where COVID-19 has been circulating. Get the latest updates on where there have been reported cases of COVID-19 from the World Health Organization here.

You can also find out the answers to some commonly asked questions about COVID-19 on the World Health Organization’s website.

Find out more about COVID-19 in the short informational video below, from the World Health Organization.

Response from the European Union

Working in close cooperation with the World Health Organization (WHO) and EU Member States, the European Union is stepping up coordinated efforts to contain the virus and counter the economic fallout, both inside and outside our borders.

On 11 March, the WHO declared COVID-19 as pandemic. The rapid spread of COVID-19 in Europe in the last weeks, with thousands of cases already reported, has been followed by the cancellation of major events, flight suspensions, bans on large gatherings, massive teleworking, school closure etc.

“We will use all the tools at our disposal to make sure the European economy weathers this storm”, said the President of the European Commission, Ursula von der Leyen, after the EU leaders’ videoconference on the response to the COVID-19 outbreak held on 10 March.

That day, the Commission received a mandate to further step up its response on all fronts and coordinate Member State actions. As a result, the Commission has launched a “Corona Response Investment Initiative” that will mobilize €25 billion to support national health care systems, SMEs, labour markets and other vulnerable parts of economies. Besides, the EU will allocate €140 million of public and private funding for promising research projects on vaccines, diagnosis and treatment.

All efforts will be coordinated through the Coronavirus Response team launched on 2 March, which is composed of five commissioners: Janez Lenarčič, who is in charge of crisis management, Stella Kyriakides, in charge of health issues, Ylva Johansson, for border-related issues, Adina Vălean, in charge of mobility, and Paolo Gentiloni, for macroeconomic aspects.

Coordination with Member States is ensured through different platforms. In order to discuss preparedness measures, including travel advice and coordinated border control actions, the Commission has established the weekly coordination group “COVID 19/ Corona Information Group- Borders”. Health crisis such as potential shortages of personal protective equipment can be addressed in a coordinated manner via the “Cross-border Health Threat Decision”, which has at its disposal an accelerated joint procurement procedure. The European Commission is holding a daily phone conference with the Member States’ Health Ministers and the Ministers of Internal Affairs to coordinate the necessary measures.

Beyond the internal management of the crisis, the EU is committed to global efforts against the spread of the virus worldwide. On 24 February , the European Commission announced a new €232 million aid package “to boost global preparedness, prevention and containment of the virus”. The funds will be allocated to support the WHO (€114 million), take preventive measures in Africa (€15 million), search for a vaccine and fund other research projects (€100 million), and bear the costs of EU citizens’ repatriation flights from Wuhan (€3 million).

Latest

To find out more on the Coronavirus response, visit the constantly updated page of the European Commission here or the page of the European External Action Service (EEAS) here.

EPF calls for treatment and patients’ access to timely and safe treatment

The European Patient’s Forum (EPF) has also recently published its statement regarding the situation, where they called for Member States to put in place effective strategies for protecting those who are most vulnerable. “In particular, countries should give all possible support to their hospitals and healthcare staff. The situation in Italy shows that patients’ lives are endangered when hospitals are overwhelmed. In addition to COVID-19, some patients with chronic conditions, for example cancer and other life-threatening diseases, as well as acute patients, will still need urgent medical care.”

EPF also called on the European Commission to take rapid action in concert and in solidarity to ensure the continuing supply of vital medicines, protective gear and equipment such as respiratory machines where they are needed. They recommend authorities to work with their country’s patient organisations to ensure effective flow of information and to answer their concerns. For more information about EPF’s position please click here.

EMSP Annual Conference 2020

Due to the recent development of the COVID-19 outbreak, it is with great sadness that the EMSP conference committee decided to postpone its annual event to the 20th and 21st November 2020.  As always, our main criteria and interest lie on the safety and protection of our community members.

Mark the new dates in your calendars and stay tuned to receive the update about when the registrations will be re-opened.

We thank you for your understanding!

Resources: MSIF/WHO/EC/EEAS