COVID-19 Measures and Cocooning

Guidance on cocooning has recently changed as restrictions in relation to COVID-19 are relaxed.

All people living with MS regardless of whether they are taking a disease-modifying therapy or what disease-modifying therapy they are taking should adhere to Public Health advice in relation to COVID-19. Some people living with MS need to adhere to further guidance and ‘cocoon’.

Frontline workers in the health sector living with MS should be redeployed so they are not working directly with COVID-19.

COCOONING

Those who are over 70 or in extremely medically vulnerable groups have been asked to take extra care by cocooning

This following information was written with input from a group of neurologists in Ireland. Individual hospitals may send different communication to their patients. If you are concerned or need further guidance on the below, please contact a member of your healthcare team.

Within the MS community, those on the following disease-modifying therapies should cocoon:

  • Alemtuzumab (Lemtrada) (If they have had second dose they should cocoon and if not they should not at this time take a second dose)
  • Ocrelizumab (Ocrevus)
  • Rituximab (Rituxan)
  • Cladribine (Mavenclad)

Additionally:

  • Those with a significant disability should cocoon
  • Those who have had stem cell transplant should cocoon

Here you can download a poster which can be printed and displayed on your door to advise visitors to stay away and deliveries to be left outside.

Those on dimethyl fumarate (Tecfidera) and Fingolimod (Gilenya) are theoretically at an increased risk though this is currently unsupported by data.  However, if they are concerned about risk it is reasonable for them to request that they work from home where possible and cease working where it is not possible to avoid risk, in order to avoid COVID-19. Local neurologists should support this.

All other people living with MS should adhere to the guidelines set out by Government and Public Health.

If anyone is concerned about their risk they should make contact with their GP or neurology team for further information.

Further information on at-risk groups and who should cocoon can be found here


HOW TO COCOON

Do

  • Stay home as much as possible.
  • You can meet others in small groups.
  • You can have a small number of visitors to your home.
  • Wear a face covering when you meet with anyone indoors – ask them to wear a face covering also if they cannot maintain a 2 metre distance.

Don't

  • Do not attend gatherings where you cannot maintain a 2 metre distance from other people.
  • Do not have any contact with anyone who is unwell.

If you are cocooning and living with other people

It is important to minimise all non-essential contact with other members of your household while you are cocooning.

All people over the age of 70 or have a condition that makes them very high risk from coronavirus should cocoon. 

Those in your household who do not need to cocoon can help you by:

  • Following hand hygiene advice at home.
  • Maintaining a 2 metre distance from you.
  • Spending as little time as possible in shared spaces in the home.
  • Opening windows to let fresh air into shared spaces. 
  • Use separate towels including hand towels and tea towels.
  • Cleaning cutlery, dishes and cookware thoroughly.
  • Cleaning a shared bathroom after each use – by cleaning every surface they have touched. 
  • Frequently cleaning objects that they touch often (door handles, kettles, phone, remote controls, light switches etc.) using your usual household cleaning agents. 

Carers

You should still see those who provide you with essential support, including healthcare workers; people providing personal support; social carers. 

  • These people should not visit if they are unwell.
  • Wash their hands when they arrive. 
  • Try to stay 2 metres away from you, if possible.

If your carer becomes unwell, they will not be able to care for you until both the following apply to them:

  • 5 days with no fever
  • 14 days since their symptoms first appeared

Contact the person who arranged your care to arrange another carer.

Meeting people from other households

It is best if you chose a small social group of 6 people and limit your interactions to these same people.

If your healthcare team has advised against meeting other people, you should always follow that advice. 

Those you meet should:

  • Inform you if they are unwell prior to meeting them. If they are unwell do not meet them. 
  • Maintain a distance of 2 meters from you.
  • Meet for a short period of time.
  • Wear a face covering if they cannot maintain a 2 metre distance from you.
  • Wash their hands and follow good hygiene practices.
  • Avoid physical contact including handshakes/hugs etc.

Having visitors in your home

  • Maintain a 2 metre distance.
  • Wear a face covering when you meet with anyone indoors – ask them to wear a face covering also if they cannot maintain a 2 metre distance.
  • Ensure visitors are not unwell.
  • Avoid physical contact including handshakes/hugs etc.
  • Visitors should only stay for a short period of time. 
  • After visitors leave, clean surfaces they have been in contact with your usual household cleaning agents

If you choose to visit someone else’s household

  • Maintain a 2 metre distance from other people.
  • Wear a face covering when you meet with anyone indoors – ask them to wear a face covering also if they cannot maintain a 2 metre distance.
  • Inform the person/people that you plan to visit.
  • Ensure nobody in the household is unwell. If someone is unwell do not visit them.
  • Avoid physical contact including handshakes/hugs etc. 
  • Wash your hand when you return home.

Meeting people outdoors

If you choose to meet people you should:

  • Only meet in small groups.
  • Only meet for a short period of time. 
  • Maintain a 2 metre distance from others in the group.
  • Avoid physical contact including handshakes/hugs etc.
  • Wash your hands upon arrival home.

Going for a walk

  • Keep a distance of 2 metres from others.
  • Avoid other people as much as possible. 
  • Avoid contact with surfaces.
  • Avoid physical contact including handshakes.
  • Wash your hands upon returning home.

Going for a drive

  • Share the journey only with those who live with you or someone in your core group of family or friends.
  • You should both wear face coverings. 
  • If you need to share a journey with someone outside of your core group, such as a taxi, you should both wear face coverings and keep as much distance as possible.
  • Keep a distance of 2 metres from other people when you are out. 
  • Wash your hands upon returning home. 

Going on public transport

If you need to use public transport:

  • Try to travel during off-peak times where possible.
  • Wear a face covering.
  • Maintain a 2 metre distance from other people.
  • Wash your hands upon returning home.

Going to restaurants

Should you choose to go to a restaurant, you should assess the risk involved.

The restaurant you choose should:

  • Have entry and exit that allows you to keep 2 metres away from others.
  • Be large enough to accommodate 2 metre distancing between tables.
  • Follow public health advice in relation to strict hygiene measures.

To minimise your risk, you should:

  • Keep the visit as short as possible.
  • If you wish, you can inform the service provider that you are cocooning.
  • Wear a face covering when you move around the restaurant.
  • Wash your hands upon returning home.

Shopping

If you are cocooning, it is best to ask friends or family to go grocery shopping for you as it can be difficult to maintain a 2 metre distance from others in shops.

If you do go shopping, you should:

  • Go during dedicated shopping hours for those who are cocooning. This information is available from your local supermarket or on their websites. 
  • Keep a distance of 2 metres from you and others in the shop.
  • Wear a face covering.

Further info: https://www2.hse.ie/wellbeing/shopping-safely-coronavirus/shopping-safely-coronavirus.html

Carers visiting your home

Using services where social distancing is not possible

When engaging with some services, a 2 metre distance from others is not possible. An example of this is a hair salon. You should assess the risk before using these services and use your best judgment.

To minimise your risk you should:

  • Tell the service provider you are cocooning when you make your appointment.
  • Limit your number of visits to such services.
  • Keep appointments as short as possible.
  • Ask for an appointment at a time of day when the service has as few other customers as possible.
  • Ensure the service follows public health advice in relation to strict hygiene measures and understands your needs.
  • Wear a face covering.
  • Wash your hands upon returning home.

Get support while cocooning

Community supports are available for people who are cocooning.

These supports include collecting groceries, medications and other essential items.

Information on community supports can be found here: https://www.ms-society.ie/covid-19-community-response-forums-helpdesk-numbers

Further Information

Further information on cocooning can be found on the HSE website - https://www2.hse.ie/conditions/coronavirus/cocooning.html


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