The situation with the coronavirus (COVID-19) is fast moving, and it can feel like advice is changing every day.
If you have a neurological condition, you may be worrying about whether this affects your risk with the virus.
The Association of British Neurologists (ABN) is an organisation that produces guidelines for the treatment of neurological conditions. They have consulted with their experts and have developed guidelines around managing the risk with coronavirus for people with neurological conditions. This will help you and your healthcare team to make the right choices for you and your treatment.
What do the guidelines say?
Coronavirus is a new virus so scientists and medical staff are learning more about it every day. So the ABN’s guidance is based on the best information available right now. As we learn more about the virus, the guidance may evolve over time.
There are a few factors that particularly influence people’s risk with the virus. We have summarised these below, but for information on your specific condition go to the ABN website. Any decisions about your condition or treatment are individual to you, so you must not make any changes without speaking to your medical team.
What are my risks?
All of us should be doing what we can to reduce our risk of becoming infected with coronavirus, and of passing the virus on to others. The best advice is to stay at home and to wash your hands frequently. There is very good information available on the NHS and Government websites.
The ABN guidance looks in particular at your risk of becoming very unwell if you are infected with the virus. It also looks at the combination of factors that could affect this risk. In general, these are:
- the type of condition you have, and how it affects you
- the treatment your are having for your condition
- your level of frailty (that is how easily your body recovers from illness)
- any other health conditions you may have
Depending on these factors, you may be at a “low”, “moderate” or “high” risk of becoming very unwell with this virus. However, the ABN says that most people, even those who are high risk, should recover fully.
What action do I need to take?
The guidance looks at the things people need to do to avoid becoming infected with coronavirus. Depending on your level of risk, you may need to follow different rules. The ABN’s advice is that:
- people who are low or moderate risk should follow the existing rules about social distancing
- people who are high risk should follow the rules about social shielding
If you are at high risk, you may already have been contacted by the NHS with advice on shielding yourself from infection. If you believe that you are high risk but have not been contacted by 29th March, then speak to your medical team.
How can my condition affect my risk?
Having a neurological condition does not necessarily mean that you have a higher risk than other people. But you may be at higher risk if:
- your condition affects your breathing, swallowing, or heart muscles
- your immune system is not working normally.
Some conditions like Parkinson’s disease or motor neurone disease can affect breathing and swallowing when they are more advanced. If you have a mild or moderate form of these conditions then your risk is not increased.
How can my treatment affect my risk?
Many people with neurological conditions have treatment that affects their immune system. This can affect their risk of becoming infected and of becoming very unwell with the COVID-19 virus. However, these treatments can also be extremely important in keeping you healthy with a neurological condition. So your medical team will need to balance the risks of your existing condition against the risks of the virus.
In most cases, the ABN guidance says that the risks of stopping treatment are greater than the risks of becoming infected. So they would not advise changes in most cases. There are some particular cases where your healthcare team might want to discuss changes with you:
- If you have multiple sclerosis then your treatment might be complex, and your neurology team may recommend changes.
- In some cases your neurology team may decide to delay starting your treatment, or restarting treatment, until the risk from COVID-19 is lower. They would only make this decision if they feel it is safe to do so.
- Some treatments may need you to come into hospital. In the current conditions this may not be safe, so your neurology team will discuss this with you.
If you do become infected with coronavirus and are very unwell, your medical team may decide to stop or adjust your treatment for any existing health problems to help you recover more quickly from the virus. You should not do this on your own, or without proper medical advice.
How can other conditions affect my risk?
Many people with neurological conditions also have other health problems that can affect their risk with coronavirus. The ABN guidance says your risk is higher if you:
- have a condition that affects your lungs, kidneys or liver
- have heart disease
- are diabetic
- are pregnant
- are over 70
If you have another health condition then you should be aware that you are at a higher risk of becoming very unwell with the virus, and should follow the current advice closely.
Having a neurological condition can in many cases affect your risk with the coronavirus. However, every person’s situation will be different and you should discuss with your medical team if you are worried.
For most people, the ABN's advice is to closely follow the rules around social distancing, to lower your risk of becoming infected. If you are higher risk, then you should follow the advice on social shielding.
If you think you are high risk, but have not been contacted with advice on shielding yourself from the virus, then contact your medical team to discuss.
Last updated: 12/05/2020