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Coronavirus (COVID-19) and JM

What You Need to Know

Updated as of March 10, 2020

On behalf of our Juvenile Myositis community, the Cure JM Foundation Board of Directors and Staff have been monitoring the novel coronavirus (COVID-19) situation in the United States by monitoring reports from the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the National Institutes of Health (NIH), and JM experts. We are providing the following information to help you be informed and make the best possible decisions for you and your family. Please consult your healthcare provider regarding medical decisions. It is important to note that information about COVID-19 changes daily, if not more frequently, so please check-in with reputable sources such as the CDC, your state and local public health agencies and your physician.

What are the symptoms and the severity of Coronavirus?

According to the CDC, the following symptoms may appear 2-14 days after exposure: fever, cough, and shortness of breath. However, the complete clinical picture is not fully understood. Illnesses have ranged from mild (including with no reported symptoms) to severe, resulting in death. The CDC currently believes it’s possible for those with mild to no symptoms to still spread the virus and that someone could spread the virus prior to showing symptoms.

What can I do to protect my JM child?

An important course of action is to be aware, informed, and take practical steps to limit your child’s exposure.

According to the Centers for Disease Control and Prevention (CDC), the novel Coronavirus — COVID 19 — is transmitted principally by coming into contact with an individual carrier who transmits the virus either directly through sneezing or coughing, which releases the virus in droplets, potentially affecting others in close proximity (within approximately 6 feet). These droplets can possibly settle in the mouths or noses of people close by or potentially be inhaled into the lungs.

The CDC also states that “it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.”

Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at National Institutes of Health (NIH) and a world expert on communicable diseases says that families who should be most concerned are those with family members who have underlying conditions. One of those underlying conditions he mentions is anyone on immunosuppressive drugs.

Dr. Fauci further notes that if you have an underlying condition, you fall into a category where you may want to take extra precautions. “In general,” he says, “be careful and don’t put yourself at extra risk.”

Dr. Fauci says the most effective response right now is “social distancing” — separating yourself from groups or crowds, thereby lowering transmission risk.

Here’s a great checklist from the CDC on what you can do to protect you and your family.

Are there other precautions I should take?

The virus can live on surfaces for a period of time, so it is possible to contract the virus from surfaces such as airplane seats, on public transportation, or common desks or cafeteria tables at school. A JM doctor suggests the following, additional precautions: elbow bumps, instead of handshakes; pressing elevator buttons with your knuckle, not your fingertip; and minimizing contact with surfaces.

According to the CDC, the virus can be killed by cleaning with disinfectants, such as diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants. If someone in your household becomes ill, the CDC recommends the person who is ill avoid unnecessary contact with others in the household, wear a mask, and, if possible, use a separate bathroom. They should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in the home.

The CDC states the probability of indirect transmission can be reduced by frequent handwashing and to be careful about touching your mouth or nose as this is one way infections are transmitted from surfaces to humans. See video link at https://youtu.be/IisgnbMfKvI

HAND WASHING 101

Wash your hands as soon as you walk through the door of your home.

Should my family travel? Should I travel?

Limiting your JM child’s exposure is an individual decision based on common sense and consulting with your physician. For example, traveling on a commercial flight surrounded by individuals who may have been travelling from COVID-19 hotspots (known or unknown) would carry greater risk than attending school in a community with no known reported cases. Public transmission risks are generally greater in urban areas than in rural, but regardless of where you live, a single affected individual could turn any location into a higher risk location. For more information, see this Directory of Local Health Departments.

Again, Dr. Fauci from the NIH notes that the degree to which any family chooses to limit travel depends on each family’s situation or category. Dr. Fauci makes the specific point that while COVID-19 may not pose a significant threat to a healthy younger person, anyone exposed to, and who contracts the virus, could bring it home to more vulnerable individuals within their own family.

Are children less impacted than adults?

According to the CDC, “There is no evidence that children are more susceptible to COVID-19. In fact, most confirmed cases of COVID-19 from China have occurred in adults. Infections in children have been reported, including in very young children. There is an ongoing (CDC) investigation to determine more about this outbreak. This is a rapidly evolving situation…”  However, it was reported that only 2% of cases thus far have affected children according to Nancy Messonnier, M.D., Director, National Center for Immunization and Respiratory Diseases.

Should I keep my child out of school?

This is a decision only you can make as a parent, along with your healthcare provider, based on your child’s situation and what you see occurring in your community.

Does my JM child have a greater health risk if he or she contracts the virus?

In an interview on NBC's "Meet the Press,” Dr. Fauci said the elderly and those with "underlying conditions" are "overwhelmingly" more likely to have complications if they catch the COVID-19.

COVID-19 typically presents as a respiratory illness. If you know your JM child has had lung or other organ involvement, you may wish to take extra precautions against exposure. Please consult your physician for any specific medical advice.

Should my child be tested?

If you believe your child may have been exposed to someone affected with COVID-19 or is showing the typical symptoms of COVID-19, please contact your medical provider immediately. Again, symptoms include fever, cough, and shortness of breath.

Should I have a supply of drugs on hand?

Please talk to your physician or pharmacist to assure that you will have access to the drugs your child is taking in case there is an outbreak in your area and you need to stay home for an extended period of time. We recommend having several weeks supply on hand. Your pharmacist may be able to work with your insurance company to fulfill your next prescription early. Some prescriptions can be filled by mail order and some IV medications can be provided by home healthcare. Have over-the-counter pain relievers on hand as well.

Should I take my child off of any medications?

Experts recommend that you continue your child's medications as prescribed, and check with your physician before making any changes to your child's medications.

Mental Health and Coping Skills

Concern over COVID-19 can make families anxious. This anxiety can be heightened for families with chronic health conditions like Juvenile Myositis.

This article from the National Association of School Psychologists presents some strategies to help cope with some of the feelings that your child may experience during this time. Please consult a physician if you have any concerns about your child, yourself, or anyone in your family.

Other helpful links:

Centers for Disease Control and Prevention (CDC)
www.cdc.gov/coronavirus/2019-ncov/index.html
www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html
www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

U.S. State and Local Health Departments
www.naccho.org/membership/lhd-directory

World Health Organization (WHO)
www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Cure JM Foundation Website Links
Possible Drug Shortage Advocavy Letter for your Congressional Representatives
Keeping Your Family Safe