As people with a chronic illness, particularly inclusive of those who are immune suppressed, the Myasthenia Gravis community should be very familiar with the precautions needed to stay safe from infections. With the COVID-19 virus spreading it is important for patients and their families to be extra vigilant. This includes:

• Keep your distance from other people and avoid all larger gatherings. Stay engaged with your community via the telephone.
• Washing and carefully drying hands and household surfaces frequently and thoroughly. Using a detergent solution in warm water is best and washing or discarding the drying cloth is ideal. Using hand sanitisers in between hand washing opportunities is also important.
• Be very aware of where your hands have been and do not let them come to your face.
• Stay at least 1.5 metres from anyone with a cough. Wearing a mask is not required unless you have a cough.
• If you become unwell, seek prompt medical support and identify the issue to the attending medical staff as early as possible. Calling ahead is the best protocol.
• Government hotline numbers are National - 1800 020 080, Queensland - 1343 2584. Utilise your GP and the local hospitals. Call ‘000’ if very unwell.
• Think about how you will manage if you become sick and who will support you. This includes how to quarantine yourself in the home to protect anyone else living with you. Be sure to put the toilet bowl lid down before flushing and wash all bathroom surfaces regularly.
• Be prepared by having adequate stocks of your medications.

The MAA Medical Advisory Board recommends the following:

• Avoid all non-essential travel outside of Australia.
• Continue immunosuppression as usual.
• Patients experiencing flu like symptoms or URTI (Upper Respiratory Tract Infection) symptoms should call in advance to discuss postponement of any neurologist appointments and to get advice on how to manage their attendance at hospitals for infusions whilst they are unwell. For IVIG patients for whom the timing of their infusions is important, they should definitely speak to their treating neurologists if they are unwell.
• For all patients, good hand hygiene etc is advised.
• The situation is fluid and is likely to worsen before it gets better although there is NO NEED TO PANIC. The illness is mild in most patients.
• All patients should be up to date with influenza and pneumonia vaccination.

For monitoring of the global situation, Johns Hopkins live map monitoring is useful and also www.worldometers.info/coronavirus/
The Queensland health department have advice on the virus via the following website www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/coronavirus
The Centre for disease Control and Prevention has a range of helpful tips.
Please visit https://www.cdc.gov/coronavirus/2019-ncov/community/index.html
The gps-can.com.au website has some very good advice also.