We caught up with Sarah White, MS specialist nurse at St George’s Hospital in London, to find out answers to some of the most common questions that are cropping up about the coronavirus and MS. Sarah talks about the impact the coronavirus is having on MS services, what you should do if you can’t get hold of your MS team, how you can stay well during the outbreak, what is happening with routine appointments and the latest guidance on self-isolating and shielding.
Simple measures can help reduce the spread and severity of infection among those living with people who have covid-19, say experts in The BMJ today.
Professor Paul Little at the University of Southampton and colleagues say people caring for household members who are unwell should be encouraged to take measures such as handwashing and cleaning, avoiding sharing rooms and surfaces, managing incoming deliveries, and ventilating rooms to limit transmission.
Evidence suggests that “viral load” – the number of viral particles that start the infection off – is likely to be important for covid-19, they explain. In general, the higher the viral load the easier it is for the infection to get hold and the more severe the infection is.
But while government policy is aimed at reducing transmission of covid-19 between family units, less attention has been given to transmission between family members, they write.
One intervention that could be rapidly disseminated in this pandemic and that has been shown to reduce incidence, transmission, and severity of seasonal flu is ‘Germ Defence’ – a website that provides advice on infection control measures and helps users think about when and how to carry out key infection control behaviours.
It is not practical for people at home to use the same methods that are used to protect hospital workers from infection from patients, explain the authors. But there are many other ways to try to reduce exposure to virus in the home, and they’re explained in GermDefence.org.
Originally developed during the H1N1 pandemic, the website is now being adapted for covid-19 and is set to be rolled out nationally and internationally to help limit transmission of covid-19 as well as the other viruses that are still causing the majority of respiratory illnesses in the current pandemic, they say.
Use of such behavioural interventions “could support public health advice to improve infection control in families,” they conclude.
Ask an MS Expert is a webinar series from the National Multiple Sclerosis Society featuring presentations from experts in Multiple Sclerosis care and offering a question and answer session for those living with MS. This installment takes a look at common questions surrounding the impact of coronavirus (COVID-19) on treatments for MS – including antimalaria drugs, Ibuprofen, plasma and steroids. This episode also talks about keeping connected during a time of social distancing and highlights resources for staying informed and connected.
For more information on Coronavirus (COVID-19) and MS – please visit http://www.nationalMSsociety.org/COVID19
Life in lockdown can be especially challenging for families with complex needs. 11-year-old Hannah cares for her brother David, who has autism. She also looks after her mum Vivienne, who has spinal nerve damage, chronic fatigue and chronic pain.
A study reported in the journal Cell Metabolism on April 30 adds to the evidence that people with type 2 diabetes (T2D) are at greater risk of a poor outcome should they become infected with the virus that causes COVID-19. But there is some encouraging news: people with T2D whose blood sugar is well controlled fare much better than those with more poorly controlled blood sugar.
“We were surprised to see such favourable outcomes in well-controlled blood glucose group among patients with COVID-19 and pre-existing type 2 diabetes,” says senior author Hongliang Li of Renmin Hospital of Wuhan University. “Considering that people with diabetes had much higher risk for death and various complications, and there are no specific drugs for COVID-19, our findings indicate that controlling blood glucose well may act as an effective auxiliary approach to improve the prognosis of patients with COVID-19 and pre-existing diabetes.”
More than 500 million people around the world have T2D. While it was clear that people with this condition fare worse with COVID-19, Li and colleagues wondered what role a person’s blood glucose control might have on those outcomes.
To find out, they conducted a retrospective longitudinal multi-centered study including 7,337 confirmed COVID-19 cases enrolled among 19 hospitals in Hubei Province, China. Of those, 952 people had T2D and the other 6,385 did not. Among those with diabetes, 282 had well-controlled blood glucose; the other 528 did not.
The data showed that people admitted to the hospital with COVID-19 and T2D required more medical interventions. Despite those interventions, they also had significantly higher mortality (7.8% vs. 2.7%) as well as a greater incidence of multiple organ injury.
However, those with well-controlled blood sugar and COVID-19 were less likely to die than those whose blood glucose was poorly controlled. Meanwhile, those with well-managed T2D also received less of other medical interventions including supplemental oxygen and/or ventilation, and had fewer health complications.
The researchers say the new findings offer three main messages for people with diabetes:
The researchers say they will continue to study the relationship between T2D and COVID-19 outcomes. The hope is to learn more about the underlying biology that is leading to poorer outcomes for people with T2D and high blood sugar.