Last updated: 6 November 2020
This page gives the latest guidance on coronavirus and Covid-19 for people affected by multiple sclerosis. The advice for people with MS in the UK has been changing over the last few weeks, and we recognise that interpreting the government guidance for your own personal situation can be difficult.
We will update this page as new information becomes available or advice changes.
See all updates
Added latest general advice and guidance from government on who is considered to be very vulnerable to severe disease, added links to blogs about MS.
Updated to clarify the differences between the advice on staying at home, self-isolating and shielding.
Added update history, impact on MS services, link to UK MS Register survey, local volunteer groups, emotional wellbeing.
Added link to Patient Information Leaflet from the Scottish government which has advice for people with neurological conditions
Added ABN guidance on DMD monitoring, updated link to ABN doc
Expanded section on letters for extremely vulnerable people
Updated links to government guidance
Added link to Neurology Academy webinars on Covid-19 and MS
Added a new section on getting food and essential supplies
Updated to reflect government guidance published 11 May (easing restrictions and guidance on working safely)
Updated to reflect new ABN guidance on the use of DMDs during the coronavirus outbreak
Updated to reflect changes in government guidance from 1 June (easing restrictions)
Updated to reflect changes in government guidance around shielding extremely clinically vulnerable people
Updated to reflect changes in government guidance around face coverings
Updated to reflect self-isolation period extension and changes to government guidance on face coverings
Updated to reflect latest changes to government guidance
Updated to include information on the local Covid-19 alert levels which will apply from 14 October in England. Updated the section on shielding to reflect latest government guidance on protecting extremely vulnerable people
Updated to reflect national restrictions which take effect from 5 November in England
Updated to reflect new ABN guidance on the use of DMDs during the coronavirus outbreak
|18 March||Page created|
|23 March||Added latest general advice and guidance from government on who is considered to be very vulnerable to severe disease, added links to blogs about MS.|
|27 March||Updated to clarify the differences between the advice on staying at home, self-isolating and shielding.|
|31 March||Added update history, impact on MS services, link to UK MS Register survey, local volunteer groups, emotional wellbeing.|
|3 April||Added link to Patient Information Leaflet from the Scottish government which has advice for people with neurological conditions|
|6 April||Added ABN guidance on DMD monitoring, updated link to ABN doc|
|8 April||Expanded section on letters for extremely vulnerable people|
|4 May||Updated links to government guidance|
|6 May||Added link to Neurology Academy webinars on Covid-19 and MS|
|7 May||Added a new section on getting food and essential supplies|
|12 May||Updated to reflect government guidance published 11 May (easing restrictions and guidance on working safely)|
|22 May||Updated to reflect new ABN guidance on the use of DMDs during the coronavirus outbreak|
|1 June||Updated to reflect changes in government guidance from 1 June (easing restrictions)|
|23 June||Updated to reflect changes in government guidance around shielding extremely clinically vulnerable people|
|24 July||Updated to reflect changes in government guidance around face coverings|
|31 July||Updated to reflect self-isolation period extension and changes to government guidance on face coverings|
|28 September||Updated to reflect latest changes to government guidance|
|13 October||Updated to include information on the local Covid-19 alert levels which will apply from 14 October in England. Updated the section on shielding to reflect latest government guidance on protecting extremely vulnerable people|
|5 November||Updated to reflect national restrictions which take effect from 5 November in England|
|6 November||Updated to reflect new ABN guidance on the use of DMDs during the coronavirus outbreak|
What's the risk of catching Covid-19?
If you have MS, you have the same risk of developing Covid-19 as anyone else. People with MS are not at a greater risk than the general public of becoming infected with the coronavirus; your immune system is not weakened by MS.
An exception to this is if you're taking certain disease modifying drugs. Some of these drugs suppress parts of your immune system leaving you at a greater risk of infection. For more details about each of the individual disease modifying drugs see the section on disease modifying drugs. If you are concerned, do check with your MS nurse or neurologist. You should not stop treatment or miss appointments until you have spoken to a health professional.
If you are more severely affected by MS, for example you have difficulty with swallowing, clearing your lungs or are prone to chest infections; or if you have other health conditions, including those affecting the heart or lungs – such as high blood pressure or asthma; you might be at greater risk of complications if you develop Covid-19.
What measures should I be taking to protect myself?
Everyone with MS is advised to follow the social distancing measures.
The government has published guidance for the general public on staying safe through social distancing.* This includes:
- keeping at least two metres from people you do not live with
- wearing a face covering in indoor public settings where social distancing is difficult
- washing your hands regularly and avoiding touching your face.
In England, for four weeks from 5 November, everyone is required to stay at home as much as possible, only go out for specific purposes – such as essential shopping and exercising – and avoid meeting people who you do not live with. Read more about these national restrictions in the government guidance
The government highlights people with MS as a vulnerable group. This is because you could have complications if you were to catch coronavirus (eg, your MS symptoms may flare up). The government advice for vulnerable people states that you:
- should be especially careful to follow the rules and minimise your contacts with others
- should continue to wash your hands carefully and more frequently than usual and maintain thorough cleaning of frequently touched areas in your home and/or workspace.
After 2 December, the government in England is planning to return to a regional approach for controlling Covid-19. Local Covid-19 alert levels will determine the restrictions where you live.
Should I be shielding?
Earlier in the year, a small number of people with MS who were considered extremely vulnerable were advised to follow more restrictive measures called shielding.
Shielding means staying at home as much as possible and keeping visits outside to a minimum. The people who were advised to shield were:
- people with more advanced MS who have swallowing and/or breathing difficulties
- people who are taking certain disease modifying drugs which suppress your immune system and significantly increase your risk of infection.
The shielding programme was paused in August. Since then extremely vulnerable people have been advised to take extra care following the social distancing measures discussed above.
However, following the introduction of national restrictions from 5 November to slow down the rapidly increasing number of Covid-19 cases across England, the government has provided new shielding guidance for extremely vulnerable people to help keep you safe and protected. These new shielding measures state that extremely vulnerable people should:
- stay at home as much as possible, except to go outside for exercise or to attend health appointments
- keep contact with people who aren’t in your household to a minimum, although you can meet with one other person outside if you wish
- work from home – if you can’t work from home, you’re advised not to go into work during these restrictions (read more on the support you may be entitled to)
- avoid all non-essential travel by private or public transport
- avoid going to the shops or a pharmacy – shop online instead, or ask a family member, friend or volunteer to collect and deliver your shopping for you.
These shielding measures apply for four weeks from 5 November to 2 December.
Everyone who’s extremely vulnerable will receive a letter from the government containing details of this new shielding guidance. If you’re in the extremely vulnerable group, it’s likely you would have been advised to shield during the first lockdown.
If you’re in the extremely vulnerable group you can register for support from your local council on the government website.
After 2 December, the government are planning to return to a regional approach. This means guidance for extremely vulnerable people will vary depending on the Covid-19 alert level where you live.
If you are told to shield and you need help getting food and other supplies, read more about the support you can access here.
What can I do to avoid catching Covid-19?
Everyone should do what they can to reduce the spread of coronavirus. Even if you have no symptoms, you could be spreading the virus to other people.
You can reduce your risk of catching coronavirus by stringently following the relevant government guidelines for your own particular situation, whether this is social distancing or shielding. This means:
Limiting contact with other people
- avoid contact with people who have symptoms of coronavirus
- walk or cycle rather than using public transport
- if you need to use public transport, avoid peak times
- work from home, if you can. Your employer should support you to do this
- avoid social activities, events or gatherings of large groups of people
- use phone, online services, or apps to contact your GP surgery or other NHS services
- keep at least two metres away from other people if you do go out
- wash your clothes regularly
- keep indoor areas well ventilated
- if you do meet with friends and family, follow the rule of six, meet outdoors where practical and keep two metres apart.
Taking extra care over hygiene
- wash your hands with soap and water often – do this for at least 20 seconds
- always wash your hands when you get home or into work
- use hand sanitiser gel if soap and water are not available
- cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- put used tissues in the bin immediately and wash your hands afterwards
- do not touch your eyes, nose or mouth if your hands are not clean.
Protecting others by wearing a face covering
A face covering is piece of material that covers the nose and mouth. It can be a scarf, home-made mask or commercially bought mask. Face coverings are worn to protect other people from infection rather than protecting the wearer. Most people with MS will be able to wear a face covering safely.
Face coverings are now mandatory in indoor public spaces across the UK, such as when using public transport and visiting shops.
Face coverings: FAQs
Worried about wearing a face covering? Read our blog post to learn more about:
- when you have to wear them
- what the evidence says
- how to make your own
- and what to do if you can't wear one.
What's the risk if I do catch Covid-19?
For most people, Covid-19 is a mild infection. This is supported by preliminary research from Italy which found that people with MS who contracted Covid-19 did no worse than the general population.
Treatment aims to relieve symptoms while your body fights the infection. There is no specific medication for Covid-19.
If you have MS and get Covid-19, the way your body deals with the infection (for example a fever) can cause a temporary worsening of MS symptoms. Once you’ve recovered from the infection, your MS symptoms will settle down. A more severe infection could potentially trigger a relapse.
For this reason, the government has included people with multiple sclerosis amongst those considered vulnerable and is asking people to take extra care to avoid infection.
If your MS is more severe, or you have other underlying health conditions, you may have a higher risk of developing complications from Covid-19. For example, if you find it difficult to clear your lungs, there’s an increased risk that coronavirus could lead to a more serious chest infection such as pneumonia.
If you are at risk of severe disease, then you were advised to follow the shielding rules and to stay at home and avoid all face to face contact. This advice was paused in August and the current advice if you were shielding is to take extra care following social distancing measures. It is possible that you may be advised to shield again in the future if there’s an increase in transmission of the virus in the community.
Covid-19 and impact on MS services
NHS services are very stretched, some nurses and doctors have developed symptoms of Covid-19 and are self-isolating, many others have been taken away from MS services to work in A&E, intensive care or on hospital wards.
MS teams are trying their best to keep their service running during this crisis. Where there is more than one MS nurse in the team, they will be trying to keep at least one available to answer calls from people with MS. Where there is just one MS nurse, it may prove impossible to keep the service open. If you are unable to contact your MS team, you can contact your GP or NHS 111 for advice.
If you have an appointment at your hospital, check the hospital website for current arrangements. Most routine outpatient appointments have been canceled, although where possible your appointment will be rearranged as a telephone or video appointment. If there are changes to your appointment, you should be informed by the hospital.
If your questions concern coronavirus, this webpage is updated regularly, so do check here first and let us know if there are additional topics you would like to see covered on this page.
Our Information Team may be able to help so do email your questions to firstname.lastname@example.org
Q&A: Covid-19 vaccines and MS
Wondering what a Covid-19 vaccine would mean for you? We speak to a neurologist about whether a future Covid-19 vaccine would be safe and effective for people with MS.
Covid-19 and steroids for MS relapses
Steroids are not recommended if you have a viral infection as they suppress the immune system which reduces your ability to resist the infection.
Treatment with steroids is likely to increase your risk of a more severe infection with Covid-19. Guidance from the ABN therefore recommends shielding for at least two weeks after treatment to reduce your risk of catching the virus.
You may want to discuss this further with your MS team or GP if you are prescribed steroids while there is significant risk of coronavirus infection.
Covid-19 and employment
The latest guidance advises everyone to work from home wherever possible. Where you can't work from home and your workplace is open, the government is encouraging people travel to work.
The government has published guidelines on working safely during the coronavirus outbreak. The guidance covers steps both employers and employees can take to protect themselves if they are required to return to their place of work.
As people with MS are in the vulnerable group, it would be reasonable for anyone with MS who is employed to request that they work from home if this is possible. Your employer should support you to do this.
If you're extremely vulnerable
In England, for four weeks from 5 November, extremely vulnerable people are strongly advised to work from home. If you can’t work from home, you’re advised not to go into work.
If you can’t attend work because you’re in the extremely vulnerable group, you may be eligible for Statutory Sick Pay, Employment Support Allowance or Universal Credit.
You can use your shielding letter as evidence for your employer that you’ve been advised to follow the shielding guidance and you’re unable to work outside of your home. You may also need to provide this letter to the Department for Work and Pensions if you’re applying for benefits.
You may be eligible for the Coronavirus Job Retention Scheme (the furlough scheme). If you think you’re eligible, you could speak to your employer about the possibility of being furloughed during this period.
Further work advice
ACAS (Advisory, Conciliation and Arbitration Service) has further information on self-isolation and sick pay; social distancing, flexible working and working from home; and options that are available for someone who does not want to go to work because they are concerned about catching coronavirus.
Citizens Advice has comprehensive information on employment, sick pay and benefits for those affected by coronavirus or needing to self-isolate. They also have information on what to do if you're worried about working.
The government has guidance on getting financial support during the Covid-19 outbreak.
If you are concerned about health and safety in your workplace, in the first instance you should speak to your employer to try and resolve the issue. If your concern isn't resolved then you can contact your employee representative, your trade union if you have one, or report your concern to the Health and Safety Executive.
Covid-19 and your physical and mental wellbeing
It is understandable that many of us are worried by the impact that coronavirus is having on the lives of ourselves and our families. Being asked to stay at home and avoid other people can make it feel more difficult than usual to take care of mental health and wellbeing.
Helena from the MS Trust's Information Team takes a look at ways to look after your own mental wellbeing during these strange and scary times.
Our MS Trust Facebook group has over 11,000 members, and is a great space for people with MS to share experiences, ask questions and chat with others who know what you're going through.
Mind has some great suggestions of ways to help us all cope. These include ways to connect with other people, through phone calls or social media; planing how you are going to spend your time; finding ways to relax and be creative; ways to keep your mind stimulated.
NHS advice on mental wellbeing:
Of course, it's also important to remain as active as possible, so do check out our stick man exercise routines, our Move it for MS exercise videos with Mr Motivator or our neuro-Pilates routines. None of these exercises require special equipment and can easily be done in your living room or back garden!
Local support groups
Around the country, volunteers have formed local groups to support the most vulnerable in their community. Help could involve activities from running errands to the shops, to making phone calls, to providing a friendly voice of reassurance. Covid-19 Mutual Aid has a list of local groups.
I need help getting food and essential supplies
There are various sources of support available if you need support getting food and other essential supplies.
- Local authority – Your local authority may be able to provide support to vulnerable people and those who are self-isolating.
- NHS Volunteer Responders – These volunteers can help people with shopping, prescription collection or a friendly chat. All people with MS meet the criteria to get support through this programme. To arrange support, call 0808 196 3646 (8am to 8pm).
- Covid 19 Mutual Aid UK – There are mutual aid groups all over the UK that are providing support to vulnerable people in the community. The groups are run by volunteers who can help you with running errands, food shopping and emotional support. Search for your local group
- Local businesses – Increasingly, small local businesses, like farm shops, cafes, pubs and restaurants, have adapted their services and are supporting people in the community by offering food deliveries in their local area. It's worth investigating what's being offered by local businesses where you live. Have a look on their website or social media pages, or alternatively give them a call.
- Supermarkets – You may be eligible for priority delivery slots.
- National Assistant Helpline (Scotland) – The Scottish government has launched a helpline for vulnerable people who don't have family to support them and aren't in touch with any support groups in their local community. If you live in Scotland and need help with food shopping, picking up a prescription, emotional support or finding local volunteer groups, call 0800 111 4000 (9am to 5pm).
Find out more
The NHS website has further advice on COVID-19, which covers the risk of catching it, simple ways to avoid catching or spreading it, and what to do if you are worried you might have caught it
Government guidance on social distancing for everyone, including those considered clinically vulnerable
Government guidance on shielding to protect people who are considered clinically extremely vulnerable
Foreign Office advice on travel to affected regions
Association of British Neurologists guidance on disease modifying drugs
How to stay calm and carry on during the coronavirus crisis when you have MS - a blog by Helena from the MS Trust
Coronavirus and MS - a podcast from the MS Trust
Patient Information Leaflet from the Scottish Government on how the coronavirus might affect people with neurological conditions
The Neurology Academy has been running a series of webinars since late March 2020 examining the impact of Covid-19 on people with MS and discussing how care and management of people with MS needs to change at this time. You can view the webinars by clicking on this link (opens in an external window). You can view all the webinars which have run to date and also register for upcoming webinars which are listed on the same page.
- Journal of Neurology 2020;267(5):1567-1569. Full text Multiple sclerosis and the risk of infection: considerations in the threat of the novel coronavirus, COVID-19/SARS-CoV-2.
- Multiple Sclerosis and Related Disorders 2020;42:102192. Full text COVID-19 in persons with multiple sclerosis treated with ocrelizumab - A pharmacovigilance case series.
- Journal of Neurology 2020;267(10):2790-2796. Full text COVID-19 in teriflunomide-treated patients with multiple sclerosis.
- JAMA Neurology 2020;77(9):1079–1088. Full text Clinical Characteristics and Outcomes in Patients With Coronavirus Disease 2019 and Multiple Sclerosis.
- Nature Reviews Neurology 2020;16(9):493-505. Full text Neurological immunotherapy in the era of COVID-19 - looking for consensus in the literature.
- Multiple Sclerosis Journal 2020;26(10):1256-1260. Full text COVID-19 in multiple sclerosis: The Dutch experience.
The new normal has left those with MS behind. With delays in diagnosis, specialist services and healthcare, a donation from you to the MS Trust can give people the support they need during these uncertain times.
Top tips for coping with the coronavirus lockdown
Helena and Marissa, two members of MS Trust team who live with MS, chat about how they are coping with self-isolation, and the things that are helping them get through this very strange time.
The MS Trust's Janice answers some of your coronavirus questions
If you've ever called our Enquiry Service, you may have spoken to Janice, she's also ensuring our new A to Z page on the coronavirus is kept up to date with the latest information and guidance. Last week, we chatted to her about the coronavirus and what it might mean for people with MS.