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COVID-19 Update (March 19, 2020)

By March 19, 2020February 7th, 2022Covid-19, eMS News

— UPDATED Thursday, March 19 —

We have received many questions regarding the current Coronavirus pandemic with COVID-19, and understand your concerns. We’d like to keep you informed throughout this crisis as best we can, and are providing this update with some information for our patients about COVID-19. This information and guidance comes from our medical team at the Rocky Mountain MS Center at University of Colorado.

Coronaviruses are a large class of viruses, which can cause the common cold. COVID-19 is a new variant of Coronavirus, different enough from others that our immune systems have not seen this virus before, resulting in more severe infections in some patients than what we typically see with the common cold. Because this virus is new, we also don’t yet have a vaccine or treatments like we do for the flu. We are still learning much about this virus.

>> Protecting Yourself and Others

Here’s how to help prevent the spread of coronavirus, the flu, and other viruses, according to the Colorado Department of Public Health (CDPHE):

  • Wash your hands for 20 seconds or more with soapy water or, at a minimum, use an alcohol-based sanitizer, which may be less effective than soap and water.
  • Avoid close contact with anyone with cold or flu-like symptoms.
  • Cover coughs and sneezes with a tissue or your inner elbow shirtsleeve.
  • Get your flu shot and stay up-to-date on other routine immunizations.
  • Clean and disinfect frequently touched objects and surfaces such as desks, doorknobs, handrails, etc.
  • Consider limiting your exposure to infection by avoiding large crowds and those who are sick with any of the known COVID-19 symptoms. In the last week, a number of businesses, Universities, Sports Leagues and others have either suspended or limited their activities, travel, participants or fans. Governor Polis called a State of Emergency and on 3/11/2020 has suggested restricting travel.
  • Avoid travel to known high risk areas that may have community spread.

>> What’s the risk if I do catch COVID-19?

For most people, COVID-19 is a mild infection or does not result in any symptoms. There is no specific medication or vaccination for COVID-19. Treatment aims to relieve symptoms while your body fights the infection.

If you have MS and get an infection, be it COVID-19, flu, cold, a bladder infection, stomach upset or any other bug or virus, the way your body deals with the infection (for example a fever) can cause a temporary worsening of MS symptoms. These tend to be a worsening of your “usual” symptoms and are particularly common if you develop a fever. We often refer to this as a pseudorelapse. Once you’ve recovered from the infection, your MS symptoms will settle down. If you are older than 60, or your MS is more severe (for example if you are wheelchair-bound or bed-bound), you may have a higher risk of developing complications from COVID-19 or other infections. If you find it difficult to clear your lungs, there’s an increased risk of a cold or flu developing into a more serious chest infection such as pneumonia.

>> Testing for COVID-19

If feel you may need testing for COVID-19, please call your PCP first. People need to meet the test criteria in order for a doctor to give them an order since the testing can only be done on a limited number of cases daily. Patients at this point need to be symptomatic in order be tested. More information can be found in the CDPHE website below.

>> FOR OUR PATIENTS WHO USE MS DRUGS OR OTHER DRUGS THAT SUPPRESS THE IMMUNE SYSTEM:

These include Ocrevus, Rituxan, Tysabri, Lemtrada, Gilenya, Mayzent, Cladribine, Tecfidera, and Vumerity.

You may be at greater risk of infection with coronavirus, or other infections. And the infections could be more severe, last longer, or have slightly different effects in you. This is true for all infections while taking medications that suppress the immune system. However, many patients on these drugs may well still have the typical mild version of COVID-19 or other infection. The spectrum of illness in those with suppressed immune systems remains mostly unknown, except that older age is clearly a risk for worse disease. We have reports at least of several patients on these treatments who are only having mild symptoms from COVID-19.

Our main concern is to minimize your contact with the healthcare system and to limit unnecessary exposure to the public.

To this end we are recommending those who are on Rituximab and Ocrelizumab infusions for MS to postpone their infusions for 2 months until we have a better feel for how the pandemic continues.

For our NMO patients on Rituximab, we recommend continuing with infusions. This difference is due to MS patients having a longer-lasting effect from these medications.

Patients starting new medications are getting reviewed by providers, but feel free to reach out to the clinic.

Patients on Tysabri and Gilenya should continue treatment due to the risk of rebound disease activity. We are also recommending to continue the other therapies as prescribed.

In general, the risks of MS must be weighed against the risks of infections and other side effects of the medications. Please do not suddenly stop or delay using your oral, injectables, or Tysabri infusion medication without speaking to one of our providers.

Additionally, we are pushing back by a couple of months any screening labs in patients who have been having normal labs and MRIs who are getting normal monitoring without concerning symptoms.

>> Visits by Telehealth

We are converting most (nearly all) visit to telehealth visits, particularly for patients at potential higher risk, such as pregnant patients, those patients over 60 years of age, or on disease modifying therapies. Telehealth clinic visits require a computer or phone with an internet connection that allows you to watch movies or videos. Wifi connections tend to work better and patients need to sign up for access to My Health Connection (MHC). We are still doing in-person visits if needed, and the clinic is still open! Please contact the clinic directly with questions about any upcoming visits: (720) 848-2080.

>> Additional sources of information

 

 

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