Tagvaccines

#MSCOVID19 info wars

It is one thing calling for scientists to turbocharge the development of a coronavirus vaccine but quite another to get the population to have the vaccine. The anti-vaxxers are organising rapidly and have started circulating content with false information to achieve their aims. The movie plandemic is one example and is covered in a very good article in the New York Times today.   The primary...

#MSCOVID19 Endemic musings

Fudging the issues or bumbling along is how the public, opposition politicians and the journalists are interpreting the Government’s handling of the exit strategy for the COVID-19 epidemic in the UK. I don’t agree. I think the Government has a clear plan, which is being driven primarily by economic considerations.  The primary objective of the lockdown was to protect the NHS and this has...

#MSCOVID19: immunosuppression & vaccine-readiness

It is always a good idea to learn from others. We have stressed that the uneventful recovery from COVID-19 involves two processes. Firstly, an appropriate antiviral response, which is needed to clear the virus and secondly an anti-inflammatory response to prevent the delayed immunological damage to the lung that triggers ARDS (acute respiratory distress syndrome), which is the main cause of death...

#MSCOVID19: wow!

I am on call at the Royal London Hospital and sitting in my office digesting some of my daily COVID-19 reading. However, something has just hit me between the eyes and I have to say wow aloud!  WOW!! The paper and editorial below show you just how infective SARS-CoV-2 really is and why we are not going to win this battle for our vulnerable people without an effective anti-viral and/or...

#MSCOVID19: good news for anti-CD20ers

I am being asked why I have moved ocrelizumab and other anti-CD20 therapies into the low-risk categories of DMTs in my latest version of my DMT table. The reasons I use to justify the change are several-fold. Anti-CD20 therapies deplete B-cells and only have a small impact on T-cell counts and innate immune cell function. This is important because anti-viral responses don’t seem to be affected to...

#MSCOVID19: vaccines and DMTs

So if you are someone with MS who is shielding or being very careful about social distancing and want to avoid getting COVID-19 you may be considering what your own exit strategy is. How do you de-risk yourself and prevent yourself from becoming infected with SARS-CoV-2?  At present, it looks as if the UK government’s strategy is to ring-fence you with people who are immune to SARS-CoV-2...

Pandemic

Yesterday I had the experience of a patient with highly active MS pull out of being treated with ocrelizumab (Ocrevus) because of concerns around being infected with the coronavirus COVID19. I suspect this will be the first of many patients with multiple sclerosis to do so.  It is clear that COVID19 epidemic is now a pandemic, i.e. it has involved enough continents and countries to be considered...

Measles encephalitis the unknown known

Barts-MS rose-tinted-odometer – zero stars We ran our third triMS-online this week and apart from a technical problem in the satellite symposium it went reasonably smoothly. The participants were very engaged and asked lots of questions. The topic of vaccination was particularly well received. Which vaccine? Component or live vaccines? When to give the vaccines and whether or not to delay...

The cause of MS

When I posted the link to our EBV and MS meta-analysis on social media yesterday I was taken to task because of the slow progress we have made in MS prevention.  Why has no preventative action been taken yet? What are they waiting for? I have had MS for more than 50 years and in all those decades the Epstein- Barr virus has been a usual suspect over and over and over again. Had glandular fever...

Measles a known unknown

I was called to casualty to assess one of my patients with MS who was on natalizumab. She had been admitted with a temperature, confusion, seizures and a generalised skin rash. Within thirty minutes of seeing her, she went into status epilepticus and had to be sedated, intubated and admitted to ITU. Within 72 hours she was dead. At post-mortem, she had a measles pan-encephalitis. Four days before...

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