Responses are provided as general educational resources and should not be interpreted as diagnoses, prognoses, or treatment suggestions.  Information and perspectives represent the views of the individual author(s); Can Do Multiple Sclerosis is not responsible for the accuracy or currency of the responses.  Readers should consult with their healthcare team.

filtered by: COVID-19 (remove)

Nurse Practitioner Response:

Kathy Costello, ARNP
Vice President of Programs, Can Do MS

Older age is definitely a risk factor for contracting a more serious course of COVID. The age risk is mitigated with immunization. Getting COVID is still possible if immunized, but the risk of a poor outcome (hospitalization, need for ICU and/or death) is far less. Compromised walking and mobility are also risk factors for more severe COVID. 

Neurologist Response

Kathy Costello, ARNP
Vice President of Programs, Can Do MS

A “third shot” and a booster shot are actually two different things.  A third shot is for someone who is immune-compromised – so like someone with an immune compromising disease or on medicine that impairs the immune response to a vaccine. In these people, 3 shots are needed for the initial immunization, and they are each given 28 days apart. People with MS, who have no other illnesses, and are not on an MS medicine that affects the immune response, do not need the three-shot regimen. But they would need a booster. The booster should be given 5-6 months after the initial 2 shots. Boosters are given because the vaccine protection wanes over 5-6 months and needs to be “boosted”. Here is a page from the CDC that illustrates this. Stay Up to Date with Your Vaccines | CDC

Neurologist Response:
Nancy Sicotte, MD
Neurologist

Baclofen has no impact on vaccine response.

Neurologist Response:

Nancy Sicotte, MD
Neurologist

If this is your first treatment of Ocrevus, you should wait two weeks. If you are already on Ocrevus, you should wait four weeks. 

Nurse Practitioner Response:
Kathy Costello, ARNP  Vice President of Programs, Can Do MS

This could be related to having an infection in two ways. First, if you have had a fever, even a small rise in temperature, that could be enough to provoke a pseudo-relapse, meaning a return of old symptoms due to elevated temperature. And, while less likely, having an infection could conceivably provoke MS activity – meaning inflammation that could be responsible for the symptoms.  We recommend reaching out to your MS neurology provider to keep them apprised of your symptoms and determine if any other intervention is needed.

Nurse Practitioner Response:

Kathy Costello, ARNP 
Vice President of Programs, Can Do MS

The cloth masks with a filter insert are likely an improvement over the cloth mask alone; however, the shortcoming of this type of mask is not the filter, but the fit.  Cloth masks tend to gap at the sides and this takes away from the effectiveness of the filter.  So, one way to improve on the effectiveness would be to wear a disposable paper-type mask with the cloth mask over it. This provides a tighter fit and maximizes the filter and the layers of the cloth and paper mask. Would also add that the material that surgical and N-95 masks are made from is much better at trapping and blocking viral particles.

Psychologist Response:
Rosalind Kalb, PhD 
Can Do MS Senior Programs Consultant

Thank you for this very important question. Although a person with MS is not immunocompromised because of the disease itself, certain MS medications, including Ocrevus, can somewhat dampen the immune response to vaccines. However, they still remain highly effective. It’s important for you to discuss the timing of your Ocrevus in relation to any booster vaccine dose you get. It was announced 8-19-2021, that booster shots will become available on 9-20-21 for those who are 8 months out from their initial vaccination(s), with priority given to nursing home residents, healthcare providers, and the elderly, as well as people with weakened immune systems (including cancer and HIV patients). I would recommend that you discuss this with your MS provider. In addition, I recommend that you follow the recommendations provided by the National MS Society (https://www.nationalmssociety.org/coronavirus-covid-19-information/multiple-sclerosis-and-coronavirus/covid-19-vaccine-guidance#section-4), which are updated whenever new data or recommendations emerge from the scientific community. 

Nurse Practitioner Response
Kathleen Costello, MS, ANP-BC, MSCN
Can Do MS Programs Consultant & Vice-President of Healthcare Access for the National MS Society

MS itself is not a risk factor for infection with SARS-COV-2 or for a more serious course of COVID-19. There are risk factors that increase the risk of a more serious course of COVID-19 and any of these can be present in a person with MS.  In addition, several registries have identified people with progressive MS and more mobility compromise as being at higher risk for a more serious case of COVID-19. 

Risk factors include:
• People over the age of 60 (and older age is a risk factor for anyone)
• People (anyone; MS or no MS) with diseases of the heart or lungs (such as hypertension and cardiovascular disease)
• People with obesity (body mass index of 30 or higher) (MS or no MS)
• People with more progressive MS
• People with higher levels of disability (for example, an EDSS score of 6 or above)

If someone does become infected, they may experience a temporary worsening of MS symptoms – which is not uncommon when someone with MS has an infection, particularly if the infection is associated with fever.  Also, sometimes new symptoms may appear, so any new or worsening symptoms should be reported to the MS provider.

In general, people with MS who are on a disease modifying therapy should continue their therapy. Below is information about the disease modifying therapies and possible risk of a more severe course of COVID-19.  This is from the Multiple Sclerosis International Federation Global Advice that was updated last month with input from the National MS Society.
• Interferons (Avonex, Betaseron, Extavia, Plegridy, Rebif) and glatiramer acetate are unlikely to impact negatively on COVID-19 severity. There is some preliminary evidence that interferons may reduce the need for hospitalization due to COVID-19.

• The limited evidence available suggests that people with MS taking dimethyl fumarate (Tecfidera), diroximel fumarate (Vumerity), teriflunomide (Aubagio), fingolimod (Gilenya), ozanimod (Zeposia) and siponimod (Mayzent) do not have an increased risk of more severe COVID-19 symptoms or death.
• Therapies that target CD20 – ocrelizumab (Ocrevus) and rituximab (Rituxan)– may be linked to an increased chance of being admitted to hospital or requiring intensive care treatment due to COVID-19. This preliminary finding requires further investigation. People with MS who are currently taking ocrelizumab (Ocrevus) or rituximab (Rituxan) and are living in a community with a COVID-19 outbreak should be extra vigilant and may want to consider self-isolation to reduce their risk of infection.
• More data on the use of natalizumab (Tysabri), alemtuzumab (Lemtrada) and cladribine (Mavenclad) during the COVID-19 pandemic are required to make any assessment of their safety.
• People with MS who are currently taking alemtuzumab (Lemtrada) or cladribine (Mavenclad) and are living in a community with a COVID-19 outbreak should discuss their current lymphocyte (white blood cell) counts with their healthcare professional. If their counts are considered to be low they should isolate as much as possible to reduce their risk.

There are many questions that come up about MS and COVID-19.  Please reach out to an MS Navigator (1-800-344-4867) or https://www.nationalmssociety.... who can help direct you to the information and resources to answer your questions or concerns. 

Psychologist Response

Roz Kalb, PhD

Senior Programs Consultant

The COVID-19 crisis is creating anxiety in all of us. It is a new experience with uncertain outcomes, and no easy answers. None of us is comfortable with this kind of uncertainly, isolation, and limited access to things that are important to us. That being said, it is important to remember that families affected by MS have a lot of experience dealing with unpredictable symptoms, periodic isolation, inability to do at least some things the way they did them in the past. They have already learned to be creative and flexible in the face of challenges. So I would encourage you to look at the strengths you bring to this current situation. Ask yourself how you have coped with anxiety in the past and identify strategies that have worked for you in other situations. Here are some suggestions that may help:

 

  • Share your feelings with others your trust. Allow yourself 10 or so minutes each day (using a timer) to talk about your anxieties and then focus your attention on another task or pleasurable activity.

 

  • Limit your time listening to the news. Pick one credible source of COVID information you trust and check it 1-2 times per day. Other time, focus on things you enjoy.

 

  • Use virtual platforms to connect with people you enjoy spending time with. Catch up on each other’s health and then talk about books, movies, hobbies, or anything else that offers opportunities laughter. Have a shared happy hour, cook/eat a meal with others, play games. It’s all possible virtually, and it can reduce your anxiety.

 

  • Experiment with activities that calm you – meditation, prayer, spending time in nature, gardening, trying your hand at painting or drawing, writing in a journal.  The Can Do MS Coronavirus and You page has a Daily Reflections worksheet and other resources on mindfulness that may be helpful.

 

  • Practice gratitude. Remind yourself each day of things you are grateful for and that bring your joy. 

 

  • Help someone else – virtually. Helping someone else feel better is a wonderful way to feel better yourself.

 

  • To the extent that you can stay active while quarantining and practicing safe social distancing, exercise can help with managing anxiety.  This Can Do MS webinar has some great information on “working out your worries.”  The Coronavirus and You webpage also has suggestions for at-home exercises.

 

I hope that you can find a strategy among these suggestions that helps you feel better. If, however, your anxiety continues to get the better of you, your sleep is disrupted, or you just can’t get to a better place, don’t hesitate to reach out to your healthcare provider for help. Virtual counseling sessions are increasingly available. You can also call a National MS Society MS Navigator (1-800-344-4867) for support and referrals.  

Nurse Practitioner Response

Kathy Costello,  MS, ANP-BC, MSCN

Vice President of Healthcare Access, National MS Society


Having MS does not make someone more susceptible to the coronavirus infection and there is no indication that having MS will make the infection worse or provoke more complications.  Certain DMTs may possibly increase the risk of getting COVID – but that is not known with 100% certainty.  If someone is concerned with the DMT he or she is taking, a call to the MS provider for discussion is warranted.

I recently presented at a panel on COVID-19 questions for Can Do MS.  Here is the link to this video.  Please also check the Can Do MS Coronavirus and You webpage.

Psychologist Response

Roz Kalb, PhD - Senior Programs Consultant

I think this may be a question that lots of families are dealing with right now. We all miss one another and feel anxious about our loved ones’ well-being. Having two grown children myself, I know that we miss being able to be together and take care of each other. However, the guidelines for health and safety right now are very clear – the way we can protect ourselves and others most effectively is by staying put where we are so that we don’t inadvertently carry the virus from place to place.

 

Since the elderly seem to be the most vulnerable to COVID-19, it is particularly important for those of us who are over 60 to remain in our homes without visits from others. I would urge you and your son to connect virtually through one of the many available platforms, such as FaceTime, Zoom, or Skype. That will allow your son to see and talk with you, both to confirm that you are OK and to get the comfort of talking with his mother during this time of crisis. You can support each other and feeling very connected, even if it’s virtual. Setting up a regular time to connect can be fun and comforting for both of you.

 

This may be difficult for your son to hear, so you’ll want to make sure you are communicating clearly and empathetically.  The Can Do MS Coronavirus and You has some Communication Tips, and this webinar and library article focuses on communicating with family.

Nurse Practitioner Response

Kathy Costello,  MS, ANP-BC, MSCN

Vice President of Healthcare Access, National MS Society


According to the Red Cross, it is safe to donate blood. 

Here is the link to their webpage on coronavirus and blood donation: https://www.redcrossblood.org/donate-blood/dlp/coronavirus--covid-19--and-blood-donation.htm



Psychologist Response

Roz Kalb, PhD

Senior Programs Consultant

We are all having to be more cautious during this difficult time.

I think your best strategy is to worry less about whether other people have COVID and focus instead on doing everything you can to follow the guidelines from the Centers for Disease Control for optimizing your own safety. The fact is that the virus spreads in communities because many people have COVID without knowing it. They aren’t lying or hiding it, they simply don’t know they have contracted the virus because they have no symptoms. This means that we need to stay at home except for essential trips out – occasionally to the grocery store, for example – and otherwise isolating ourselves as best we can, washing our hands often and well, and making sure that we clean everything that comes into the house from the outside (our mail, clothing we wear when we go out, and so on. It is normal to be cautious but by taking the best possible care of yourself you can feel more secure.

 The Pew Research Center recently published this article suggesting that the coronavirus is indeed impacting our social trust.   

Nurse Practitioner Response

Kathy Costello,  MS, ANP-BC, MSCN

Vice President of Healthcare Access, National MS Society


First, I am eternally grateful that nurses are providing care on the front line of the COVID crisis.  There is a risk of coronavirus to every healthcare provider, but having MS does not increase that risk. 

If the person is on a DMT, there is possible increased risk with some of the treatments – although this is not 100% certain.  Please check the National MS Society website for more information about DMTs during the COVID crisis: https://www.nationalmssociety.org/What-you-need-to-know-about-Coronavirus-(COVID-19)/DMT-Guidelines-for-Coronavirus-(COVID-19)-and

Please continue to check the Can Do MS Coronavirus and Youwebsite for more resources.

Physical Therapist Response

Jean Minkel, BS, PT

First and foremost, wheelchair riders need to be very aware of their surroundings and to slow down to a speed that allows you to maintain 6 feet from others in your environment.  It is really up to you, the wheelchair rider, to maintain the distance between you and others in the environment.  I would also recommend getting a tape measure and identify a point 6 feet from the center of your body so you have a better idea of the physical distance when spacing yourselves from others.

Unfortunately, there may be situations where social distancing will be difficult.  Many stores have special hours set aside for vulnerable customers, including those in wheelchairs.  I also recommend taking other precautions like wearing a mask and sanitizing your wheelchairs. 

My colleague, Peter Axelson, who is a manual wheelchair rider, also provides the following advice about the steps he is taking as precautions during this time of virus concern.  I think this type of thinking is very helpful for any wheelchair rider.

For more info on wheeled mobility options, here is a link to a webinar that I co-presented with fellow PT Faith Saftler Savage.


Physical Therapist Response

Mandy Rohrig, PT, DPT - Senior Programs Consultant

I can appreciate the dilemma involving having another person coming into your home during the pandemic.  While it is a wonderful opportunity to have her come to your home as it allows you to continue to participate in rehabilitation and exercise, you must also consider the amount of exposure she has had with the other clients and other people.  While there is no definitive recommendation or standard of practice at this time, I would encourage you to have a thoughtful dialogue with your PT and perhaps other members of your healthcare team about the risk of her coming into you home versus the benefits and necessity of PT at this time.   Can formal PT be “held” until the situation improves?  Are there virtual PT opportunities?  Can you continue with your current home exercise program at home and sustain your progress?  I would also encourage you to talk with your PT about the organization’s cleaning strategies and personal/patient protection approaches given the pandemic.  Clear and ongoing communication with your PT is key to developing a strategy that works best for you!


Registered Dietitian Response:

Mona Bostick, RDN, LDN
Can Do MS Programs Consultant

There is a lot of misinformation going around the internet regarding foods and supplements promoted to “boost” the immune system.  The Novel Coronavirus-19 is new and evidence to support specific dietetic recommendations is not yet available in the scientific literature. It’s human nature to be looking for extra help to protect yourself from the coronavirus and COVID-19. But it is important to know that this is not how the immune system works.  There really is no silver bullet.

There is no food, supplement or combination of both to heal or even treat the COVID-19 virus. Full stop.  The very best way to support your immune system is by engaging in health promoting behaviors every day.

These habits include:

  • Don't smoke. Smoking harms the immune system and can make the body less successful at fighting disease.
  • Exercise regularly.
  • If you drink alcohol, drink only in moderation.
  • Get adequate sleep.
  • Wash your hands frequently!
  • Try to minimize stress. Stress weakens the immune system
  • Make sure your vaccines are up-to-date, especially the flu vaccine.
  • Feed your body! Do not restrict foods. Doing so may deprive your body of important nutrients. 

The best way to support your immune system everyday with your eating pattern is to include:

  • lots of colorful plant foods at all of your meals and snacks. Variety is just as important as quantity (shoot for at least 2-3 cups per day).
  • Lean Proteins
  • Beans and Legumes
  • Nuts and Seeds
  • Whole Grains
  • Healthy Fats
  • Low-Fat Calcium Foods
  • Stay hydrated with water!

While limiting:

  • Saturated Fat
  • Sodium
  • Added Sugars
  • Highly Refined Foods

And avoiding entirely:

  • Trans Fats (Hydrogenated and Partially Hydrogenated Vegetable oil)

Building an eating pattern around these guidelines should provide adequate vitamins, minerals and phytonutrients for your immune system as well as the rest of your body.

Regarding supplements: If you are clinically deficient in a nutrient (as directed by your physician), or your diet is deficient in a nutrient (as may be the case if you are vegan- B12 -or a diet avoiding dairy which may require additional calcium then supplementing may be warranted. Again, under the guidance of your healthcare team. With any supplement, remember, they are not regulated, and more is not better.

The human body prefers to get nutrients from food. Nutrients from food come packaged in a healthy fiber and antioxidant filled “containers” which deliver nutrients in the manner our body finds easy to use. It is not necessary – and in fact may be harmful- to megadose vitamins and minerals. Fat soluble vitamins like A, D and E can become toxic at high levels.

Taking supplements will NOT impact the coronavirus. Learn more about supplements.

More Resources

Tips for safe food shopping and preparation

Tips for stocking up your pantry