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Saturday, April 11, 2020

ARE People With MS at Higher Risk for COVID-19?

A newly published article gives those of us with multiple sclerosis cause for both hope and concern.

 By Trevis Gleason - Last Updated: April 07, 2020

moderate immunosuppression may prevent severe complications associated with COVID-19 infection
The possible hazards of MS disease-modifying therapies differ, so treatment decisions must be individualized. 
iStock (2) 
One thing we seem to hear, see, or read on a daily basis are words like “underlying health condition,” “immune compromised,” and “at-risk population” when the more dire potential outcomes of COVID-19 are discussed.
Many of us assume that those of us with multiple sclerosis (MS) fit into those, and so many other, categories of people who may be particularly susceptible to both the viral disease and its most severe results.
An article, published on March 27 in the journal Multiple Sclerosis and Related Disorders, compiles some of the latest medical thinking about those concerns and relays some unexpected — even hopeful — notes as well.
MS Not the Only Relevant Factor
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It is early days as regards the depth of medical knowledge about this novel coronavirus (SARS-CoV-2), but as much of medicine is dealing with nothing else, much is being learned at a quickening pace.
Some considerations may seem obvious if we really think about them, but MS alone isn’t as much of an issue as the effect that MS, along with other aspects of a person’s life, has on our whole lives.
According to the March 27 article, “Other aspects to consider when assessing a respiratory viral infection include: smoking practices (increased cigarette smoking increases risk); ambulatory status (less mobility increases risk, especially if the patient is in a wheelchair); age (increasing age increases risk); weight (increasing weight impacts on ambulation and respiratory function); underlying respiratory illnesses, such as asthma or COPD. Also, the frequency of necessary attendance at a hospital or healthcare facility for laboratory or MRI testing, but also for infusions, may place the patient at a higher risk of exposure.”
Regarding potential exposure to COVID-19 in a healthcare setting, the article advises, “Visits for MS care should preferably be done by telemedicine or phone.”

Thoughts for Doctors and MS Patients on DMTs

When it comes to disease-modifying therapies (DMTs) for MS, the article’s lead author, Professor Gavin Giovannoni, MBBS, PhD, of the Blizard Institute at Barts and the London School of Medicine and Dentistry, has charted DMT risk categories to advise doctors about starting and maintaining these drugs in the current pandemic, and even about whether to continue a DMT in the event of COVID-19 infection.
You can see the table by opening the link to the whole article and scrolling to Table 1.
This table is, of course, only a guide for MS practitioners and their patients. The article stipulates that “the potential hazards posed by each DMT differ and, rather than imposing a blanket rule, decisions regarding treatment should be individualized and discussed with patients. For some patients, having their MS treated and controlled may be more important than the potential danger of being exposed to and acquiring a more severe COVID-19 infection.”
Could Some DMTs Be Protective?


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The primary objective of this microsite is collate information from the Barts-MS blog and to answer questions about COVID-19 in relation to multiple sclerosis and its treatments. You can either ask questions on the blog or via the Google form below. We will make every effort to keep up-to-date to help everyone get through the next few months.


  • COVID-19 or coronavirus disease 2019 refers to the infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 

  • The disease was first identified in Wuhan, China, and has spread globally, resulting in a COVID-19 pandemic. COVID-19 infection is very non-specific; common symptoms include fever, cough and shortness of breath. Associated flu-like symptoms such as muscle pain, sputum production and sore throat are less common.

  • Please note the COVID-19 refers to corona virus disease due to the SARS-CoV-2 virus that was first identified in 2019. 

  • Please note the majority of COVID-19 cases are mild with a small number progressing to severe pneumonia and multi-organ failure. The mortality of COVID-19 is about 3%, but ranges from ~0.2% in those less than 20 years to up to 15% in those over the age of 80 years. 

  • Other risk factors for severe COVID-19 infection include male sex, smoking, pre-existing lung disease (e.g. severe asthma), comorbidities, in particular, hypertension and diabetes, and possibly being immunocompromised or suppressed. 

  • COVID-19 is spread from one person to another via respiratory droplets produced during coughing and sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of five days.

  • The standard method of diagnosis is by the molecular detection of the virus from a nasopharyngeal or throat swab. A small number of people can present with diarrhoea and the virus can be detected in the stool. 

  • Because the virus is an enveloped virus and has a cell-like membrane it is susceptible to detergents. Therefore frequent hand-washing is one way to prevent infection. Hand sanitizers work as well, but need to contain more than 60% alcohol to disrupt the viral envelope.

  • Other preventive measures include maintaining a distance from others, and trying not to touch one's face. 

  • The use of face masks is more controversial. Face masks are generally recommended for those who suspect they have the virus and for healthcare workers and carers. 

  • At present there is no vaccine or specific antiviral treatment for COVID-19. 

  • The management of COVID-19 involves symptomatic therapies, ventilatory and other supportive care and isolation. 

For more information please follow the UK Governments website or read the wikipedia entry on Coronavirus disease 2019, which is being kept up-to-date.

The best way to answer questions for the pwMS that benefits everyone is to curate them on one microsite (MS-Selfie). Most of the questions will come via our Barts-MS Research Blog. The following are examples of the kind of COVID-19 related questions we will try and answer:

CLICK HERE to READ THE VAST amount of QUESTIONS and  answers provided.

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Friday, April 10, 2020

Pre-Recorded Webinar: Multiple Sclerosis Management During COVID-19, with Mitzi Williams, MD

Published: March 31, 2020            By: NeurologyLive Staff 

Watch Mitzi J. Williams, MD, lead a discussion of the latest best practice guidance and real-world cases of COVID-19 in patients with multiple sclerosis.

Mitzi Joi Williams, MDMitzi Joi Williams, MD
Patients with multiple sclerosis (MS) are among one of the top demographics significantly impacted by the COVID-19 pandemic. Faced with an increased risk of susceptibility, this population is looking to the health care community for guidance on how this risk may impact their current treatment regimens and what they can do to best protect themselves.

While the information regarding COVID-19 infections changes hour by hour, there is a growing pool of real-world reports and experiences being shared online from MS specialists around the world.

In an effort to bring you the latest information being reported and updated guidance from leading MS organizations, NeurologyLive has partnered with the Women Neurologists Group on the live webinar: Impact of COVID-19 on Multiple Sclerosis Management.

The presentation is given by Mitzi Joi Williams, MD, assistant professor of neurology at Emory University and founder and Medical Director of Joi Life Wellness MS Center in Atlanta, Georgia. Williams provides an overview of the latest guidelines, review recently reported cases from neurologists from around the world, and address concerns about adapting patient care.


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Thursday, April 9, 2020

Risk score can predict long-term multiple sclerosis progression

Risk score can predict long-term multiple sclerosis progression
(HealthDay)—A new risk score is capable of predicting long-term multiple sclerosis (MS) progression, according to a study published online March 19 in Clinical Neurology and Neurosurgery.
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Claudia Cristina Ferreira Vasconcelos, Ph.D., from the Universidade Federal do Estado do Rio de Janeiro, and colleagues constructed a clinical risk score for MS long-term progression. The model was derived using data from 288 patients and then validated on an additional 144 patients.
The researchers identified the following prognostic factors that were independently associated with long-term progression: no specific MS treatment before Expanded Disability Status Scale 3, age of onset >30 years, pyramidal and cerebellar impairment as the first manifestation of disease, time interval between the first and second relapses less than two years, and African ancestry. The score was able to predict the progression in the validation sample, as evidenced by no  between the expected and observed number of patients in progression. There were also no significant differences seen between patients with low risk (≤2 points) and high risk (≥3 points) in the derivation versus validation samples. Patients in the derivation  with ≥3 points had a higher risk for progression (hazard ratio, 2.8).
"The identification of unfavorable  has great relevance because there are treatments with different efficacies and safety profiles," the authors write.
Source: Medicalxpress

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Ursolic Acid, Compound in Fruit Peels, Promotes Myelin Repair, Early Study Finds

Ursolic acid, a compound found in some herbs and in the peels of certain fruits, promoted nerve cell repair and restored the myelin sheath covering and protecting nerve endings in a mouse model of multiple sclerosis (MS), a study reported.
Due to its strong anti-inflammatory and immunomodulatory properties, ursolic acid was seen to have “great potential” as a treatment candidate for MS, especially when the disease reaches its chronic, progressive stage, the researchers said.

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Many medications currently used to manage MS belong to a class of compounds known as immunomodulatory agents. These therapies focus on lowering the activity of the immune system, in an attempt to prevent immune cells from attacking nerve cells.
While quite useful in reducing the inflammation that marks acute phases of MS, these medications have no effect on neurodegeneration, and do not promote the repair of the myelin sheath that is progressively destroyed over the course of the disease. For these reasons, immunomodulatory agents are less suited to patients at a chronic-progressive stage of MS.
“An MS therapy that has both immunomodulatory and neurodegenerative effects would be highly beneficial,” the researchers wrote.
A team led by investigators at Thomas Jefferson University found that ursolic acid, a natural anti-inflammatory compound found in some herbs and fruit peels like apples and prunes, halted neurodegeneration and promoted myelin repair in mice with experimental autoimmune encephalomyelitis (EAE), a disease that mimics MS in humans.
In their experiments, the team treated sick EAE animals with a purified form of ursolic acid.
“Many experiments have looked at mice in the acute phase, when disease is just starting or at the peak. Instead, we tested whether this compound was effective in chronic disease, once there has already been chronic damage to tissues of central nervous system,” Guang-Xian Zhang, PhD, professor of neuroscience at the Sidney Kimmel Medical College at Thomas Jefferson University, and a co-senior study author, said in a press release.
Ursolic acid was administered orally to EAE mice at different doses.
“By administering different doses, we found that 25 mg/kg/d of UA [ursolic acid] is the optimal dose for suppressing EAE severity; this dose was therefore used in all subsequent in vivo [in a living organism] experiments,” the investigators wrote.
To assess the compound’s effectiveness, researchers started treating mice with ursolic acid at a daily dose of 25 mg/kg, 60 days after EAE onset. Treatment lasted for 60 days.
After 20 days of its use, they started noticing the first improvements in animals’ overall condition. Mice that were completely paralyzed and unable to move at the experiment’s start regained their ability to walk, despite still showing signs of weakness.
“It’s not a cure, but if we see a similar response in people, it would represent a significant change in quality of life. And most significantly, it’s a reversal, which we really haven’t seen before with other agents at such a late stage of disease,” Zhang said.

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Tuesday, April 7, 2020

Bristol Myers Squibb Expands Patient Support Programs to Help Newly Uninsured Patients in the U.S.

For those in US, P.R and US Virgin Islands

Immediate Relief Available
PRINCETON, N.J.--()--Bristol Myers Squibb (NYSE: BMY) today announced an expansion of its existing patient support programs to help eligible unemployed patients in the U.S. who have lost their health insurance due to the COVID-19 pandemic.
The expanded program offers access to any branded Bristol Myers Squibb medicine for free, including some of its most widely prescribed products, as well as those prescribed via telehealth services. The program features:
  • Immediate access for patients who have lost their employment and health insurance;
  • A simple, single point of entry;
  • Streamlined enrollment process; and
  • Vouchers to assist with continuity of care for several self-administered BMS medicines, for eligible patients
All Bristol Myers Squibb patient support programs, as well as, additional eligibility requirements, can be reached by calling (800) 721-8909 or by visiting
“The COVID-19 pandemic has created unprecedented financial challenges for patients and families, adding considerable new stress to the millions of Americans who have lost their jobs and health insurance,” said Giovanni Caforio, M.D., chairman and chief executive officer, Bristol Myers Squibb. “As more patients face difficult decisions in their daily lives, it is important to continue their treatments.”
Bristol Myers Squibb’s Response to COVID-19
Bristol Myers Squibb recognizes this is a challenging time for everyone. The company will continue to take all necessary actions to promote public health and carry out its mission of providing life-saving medicines to the patients who depend on us. Please visit to learn more about our actions to date.
About Bristol Myers Squibb   - click to read


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These are the Times That Try Men’s Souls - written by an MS patient

Written by award winning writer, Cathy Chester         - April 6, 2020

I held off writing about the current pandemic because the amount of information we’re ingesting changes so quickly. My usual positive slant on life and living with MS won’t cut it this time. What we’re facing now is scary and unprecedented in modern times.
My focus remains the same, to educate, inspire and empower you as much as possible. And if there’s one thing I hope you come away with after reading this post (despite it being so clichĂ©) is that we really are in this together.
It’s our responsibility to not only help ourselves right now but also help others whenever we can.
It’s an anxious time to be alive with the rampant spread of coronavirus affecting our world. The growing number of people testing positive, many losing the battle, turns normal everyday stress completely on its ear.
Now it’s a whole new ballgame. I think from here on in we’ll be referring to our lives in terms of of pre-virus and post-virus.
Disputes on who’s responsible for COVID-19 or what steps should have been put into place prior to it seem senseless right now. Our main focus is fighting the monster that’s destroying thousands upon thousands of lives, and following mandates to stay home, practice physical distancing, and washing our hands often to “flatten (or crush) the curve.”
The World Health Organization (WHO)  recommends the following:
  • Wash your hands frequently with soap and water (Author’s Note: For at least 20 seconds or the length of time it takes to sing HAPPY BIRTHDAY) or use an alcohol-based hand sanitizer that contains at least 60 percent alcohol.
  • When coughing and sneezing cover your nose and mouth with a flexed elbow or tissue. Discard the tissue in the trash.
  • Keep at least 6 feet of distance between yourself and others, particularly those who are coughing and sneezing.
  • Avoid touching your eyes, nose, and mouth with your hands.
  • Practice food safety by using different chopping boards for raw meat and cooked foods, and wash your hands between handling them.
CLICK here to continue reading and watch needed videos


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The hypothesis that immunosuppression may protect you from severe COVID-19 is gaining traction. New data released on the 4th April 2020 from the UK’s Intensive Care National Audit & Research Centre suggests it may. When comparing 2249 patients admitted to ITU in the UK with severe COVID-19 the proportion of immunocompromised patients was 3.7x lower than the proportion of immunocompromised patients admitted to ITU with viral pneumonia (the comparator) between 2017 and 2019 (2.3% vs. 8.5%). This was a highly significant difference (p<0.00001).
This clearly justifies the current research strategy being tested across the planet to see if immunosuppressive therapies may improve disease outcome in patients with COVID-19.

Does this mean we can now assume that immunosuppression protects against severe COVID-19 and COVID-19-related ARDS (adult respiratory distress syndrome)? Not yet. The UK’s ITU cohort of severe COVID-19 is biased in that those patients who are deemed too frail and/or disabled may never get to ITU, which may include a disproportionate number of immunosuppressed patients. Whereas this specific bias is unlikely to apply to ITU admissions between 2017 and 2019 (viral pneumonia cohort) when there was no such pressure on resources.
Despite this caveat, this is an important tidbit of information that will allow pwMS on immunosuppression to sleep a bit easier. I sincerely hope the wider MS community will reconsider their advice about not giving MS DMTs that are if anything mildly immunosuppressive to patients with active MS. By not treating our patients we may unintentionally be increasing their chances of developing severe COVID-19. Could our guidelines be another example of the law of unintended consequences? Let’s hope the real-world data that is being collected at present will answer this question.
CoI: multiple                    CLICK here to see this article


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Use of Cloth Face Coverings to Help Slow the Spread of COVID-19

How to Wear a Cloth Face Covering

Applying a face mask - step 1
Cloth face coverings should—
  • fit snugly but comfortably against the side of the face
  • be secured with ties or ear loops
  • include multiple layers of fabric
  • allow for breathing without restriction
  • be able to be laundered and machine dried without damage or change to shape

CDC on Homemade Cloth Face Coverings

CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.
CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.
Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
The cloth face coverings recommended are not surgical masks or N-95 respirators.  Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.
Applying a face mask - step 2

Should cloth face coverings be washed or otherwise cleaned regularly? How regularly?

Yes. They should be routinely washed depending on the frequency of use.

How does one safely sterilize/clean a cloth face covering?

A washing machine should suffice in properly washing a face covering.

How does one safely remove a used cloth face covering?

Individuals should be careful not to touch their eyes, nose, and mouth when removing their face covering and wash hands immediately after removing.
Sew and No Sew Instructions

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Monday, April 6, 2020

FDA Removes Pregnancy Category C Warning From Certain MS Medications

Clinical Neurology News/Neurology Reviews, By Lucas Franki
April 2, 2020

The Food and Drug Administration has updated the labels for peginterferon beta-1a (Plegridy) and interferon beta-1a (Avonex) to include more information about usage of these medications during pregnancy and breastfeeding in women with multiple sclerosis (MS).

The FDA based the decision on data from more than 1,000 real-world pregnancies, including pregnancies from a large epidemiologic study and published studies over several decades, which found no connection between use of interferon-beta products during early pregnancy and an increased risk of major birth defects, according to the FDA.

As a result, the labels for both medications will no longer have the pregnancy category C designation; however, patients should continue to notify their health care provider if they are pregnant or plan to become pregnant.

The FDA decision to remove the warning follows a similar decision by the European Medicines Agency last year.

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“Many women with MS are diagnosed during their childbearing years. With this important update for Plegridy and Avonex, healthcare providers have more data to inform appropriate treatment paths for patients who may be pregnant or planning for pregnancy,” said Bernd Kieseier, MD, MHBA, executive director and head of global MS at Worldwide Medical, Biogen, in a press release.

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Curious about Telemedicine for Multiple Sclerosis (MS)?

Have a seat, relax and watch: AaronBoster, MD's newest video: 

In this video Dr. Boster demonstrates a #telehealth appt. with an MS Patient

The purpose of this video is to show people how easy a telemed visit can be.. 

Curious about Telemedicine for MultipleSclerosis? 


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CDC Statement for Healthcare Personnel (OR ANYBODY) on Hand Hygiene during the Response to the International Emergence of COVID-19

CDC recommendations reflect the important role of hand hygiene for preventing the transmission of pathogens in healthcare settings for a wide range of pathogens. The ability of hand hygiene, including hand washing or the use of alcohol-based hand sanitizers to prevent infections is related to reductions in the number of viable pathogens that transiently contaminate the hands. Hand washing mechanically removes pathogens, while laboratory data demonstrate that 60% ethanol and 70% isopropanol, the active ingredients in CDC-recommended alcohol-based hand sanitizers, inactivates viruses that are genetically related to, and with similar physical properties as, the 2019-nCoV.
While the exact role of direct and indirect spread of coronaviruses between people that could be reduced by hand hygiene is unknown at this time, hand hygiene for infection prevention is an important part of the U.S. response to the international emergence of COVID-19.
CDC recommends the use of alcohol-based hand sanitizers with greater than 60% ethanol or 70% isopropanol as the preferred form of hand hygiene in healthcare settings, based upon greater access to hand sanitizer. Health care providers who use alcohol-based hand sanitizers as part of their hand hygiene routine can inform patients that they are following CDC guidelines.
Article source


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Sunday, April 5, 2020

Coronavirus CDC Update - April 4, 2020

Frequently asked Questions             - April 4, 2020 Update

Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

What should I do if I feel sick?
If you’ve been exposed to the Coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

How do I get tested?
If you’re sick and you think you’ve been exposed to the new Coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

How does coronavirus spread?
It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out.

It may also be transmitted when we touch a contaminated surface and then touch our face.

Is there a vaccine yet?
No. The first testing in humans of an experimental vaccine began in mid-March. Such rapid development of a potential vaccine is unprecedented, but even if it is proved safe and effective, it probably will not be available for 12 to 18 months.

What makes this outbreak so different?
Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.
What if somebody in my family gets sick?
If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom.
If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables.
Don’t forget to wash your hands frequently.

Should I stock up on groceries?
Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

Can I go to the park?
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

Should I pull my money from the markets?
That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

What should I do with my 401(k)?

Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”

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Nonprofit Charities: The Next COVID-19 Victims

With fundraising events canceled and incomes fading, nonprofits are set for difficulties, even as needs rise.

By: Trevis Gleason - April 2nd 2020

man with piggy bank virus coins photo illustration
Nonprofit patient advocacy groups will likely be strapped for cash following the pandemic.
iStock; Everyday Health

They closed all of the McDonalds here in Ireland last week. The radio reports told of the vastness of the closures. Not just the jobs at the restaurants were affected, but all the way down the chain; from local farmers who supply the beef or grow grain for the buns to the haulers and equipment-repair workers, the closures will hurt.
Then the reporter mentioned something I hadn’t thought of: Millions of dollars for the Ronald McDonald Houses are collected in change canisters at the counters of these establishments. This will be a massive blow to the charitable organization that allows parents of ill children to stay near the hospitals where they are being treated.
Not too long after that report, I started seeing more evidence of what we can expect to be a hard punch to the whole of the nonprofit, charity, and patient advocacy sector.

MS Walkathons, Bike Tours, Gala Dinners: Canceled

Walks, runs, luncheons, gala dinners, pub crawls, church gate collections … they’re all being canceled. For the likes of multiple sclerosis (MS) organizations around the world, these events earn the revenue upon which they budget services to our lot.
Tens of thousands of people raise millions of dollars for a long list of organizations that provide programs, services, advocacy, and awareness to and for the global MS community.
Top that with major donors, who often quietly give large sums, being affected by a historic downturn in the world’s financial markets, so their gifts and endowments will surely dwindle as well.

We’ve Seen This Before, During the Great Recession
I wasn’t much involved in the sector when the 9/11 economic difficulties hit. I wasn’t diagnosed five months yet at the time.
I do, however, remember how deeply the global slowdown of 2007 to 2009 — dubbed by many the Great Recession — took its toll on both local and national MS organizations. There were reductions in services, valuable (and loved) staff had to be laid off, and some organizations even had to fold or merge with others to ensure that people with multiple sclerosis got the services and support they so desperately needed, particularly in difficult economic times.
And now, this.
The strongest charities will have adequate reserves to see them through, even if it is with reduced staff and restricted services. Smaller organizations, however, the ones who often make the most direct impact on the lives of those of us living with this disease, may not make it to the other side of the economic crisis that will be the inevitable result of the COVID-19 pandemic.

Other Concerns Take Precedence for Now

Right now, as people we know are social distancing, self-isolating, and awaiting test results, this mayn’t seem like the most important subject. And it’s not. There are many other concerns for people in the international MS community. But I asked myself the other day, “How does this end, and what will it all look like after?”
For the MS community, as well as innumerable patient advocacy charities around world, what it looks like and what they will be able to do after the pandemic resolves will be of great importance in the months and years to come.
Wishing you and your family the best of health.

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