The Muscular Dystrophy Association (MDA) has provided recommendations for people in the neuromuscular community regarding the current COVID-19 pandemic. Noting that current guidelines from public health agencies focus on travelers, specific age groups, and people with respiratory illness, the MDA recognized a need for people with neuromuscular disease and their caregivers to have guidance as well.
People with neuromuscular disease often have respiratory complications related to muscles of the diaphragm and chest wall and thus may also have higher risks. This is also true for people with movement disorders and multiple sclerosis. In addition, anyone who has been treated with immunosuppressive therapy may have higher risk and thus, these recommendations should be of use to those communities as well. Many neurologic conditions affect respiration and anyone who has difficulty breathing from any condition may find the recommendations, summarized below, helpful.
For people with any of these conditions, it is important to seek prompt medical attention if anyone in their household has symptoms consistent with COVID-19 (fever, cough, difficulty breathing) or exposure to someone with documented COVID-19 disease or exposure. Before seeking care, individuals should contact their health care providers to ensure proper precautions are taken when accessing care. Guidelines for such precautions are available from the Centers for Disease Control (CDC) and are linked to from the MDA recommendations.
If medical emergencies occur, the dispatch personnel should be alerted that evaluation for COVID-19. is occurring. Worsening symptoms or shortness of breath should prompt a visit to urgent care or an emergency department.
Preventive measures for contracting the disease include avoiding close contact with people who are ill, washing hands for at least 20 seconds frequently, covering coughs or sneeze with a tissue or elbow and disposing of tissues in trash immediately after use. Cleaning and disinfecting frequently touched surfaces are recommended and use of a face mask when sick are helpful (although masks are NOT recommended for people without COVID-19 symptoms).
Caregivers and household members of people with chronic medical conditions, such as neuromuscular disease should be especially vigilant to avoid spread of the disease if they have symptoms or documented exposure. The MDA recommends that people with neuromuscular conditions and their caregivers work together to identify a backup caregiver who will be available in the event that the caregiver gets sick. Caregivers should wash their hands or use hand sanitizer before and after providing care (eg, feeding, bathing, and dressing).
The recommendations also include a brief explanation of COVID-19 and how it is transmitted (person-to-person through respiratory droplets, surfaces exposed to the virus, and late in the disease, exposure from stool). The highest risk is from people who have become sick from the virus; however, transmission can occur before symptoms, which makes it challenging to prevent person-to-person transmission.
Chia-Chun Chiang, MD, and Juliana VanderPluym, MD, FRCP, FAHS
Deena E. Kuruvilla, MD, FAHS
Michelle L. Dougherty, MD, FAES, FAAN