Coronavirus (COVID-19): What People With Asthma Need to Know

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Note: Because this is a constantly changing situation, any data in this blog post may not represent the most up-to-date information. We will update this blog when possible.

What Is the New Coronavirus (COVID-19)?

A coronavirus is a type of virus that often occurs in animals. Sometimes, it can spread to humans. This is rare.

In December 2019, a new illness called COVID-19 started spreading. COVID-19 is caused by the SARS-CoV-2 virus. Experts think people first caught the virus at a fish and live animal market. Now it is spreading from person to person.

According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), COVID-19 symptoms can include:

  • Fever
  • Cough
  • Shortness of breath or trouble breathing
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell
  • Feeling tired and weak

Other symptoms reported are:

  • Stuffy or runny nose
  • Diarrhea or nausea
  • Pinkeye
  • Painful blue or purple lesions on toes (COVID toes)
  • Hives or rashes

Most children tend to have mild COVID-19 symptoms that are similar to a cold. They may have:

  • Fever
  • Cough
  • Vomiting and diarrhea

The CDC believes symptoms may appear two to 14 days after coming in contact with the virus. WHO has declared it a global pandemic (an outbreak of a new virus that spreads easily).

How Can I Tell the Difference Between COVID-19, the Flu, a Cold or Seasonal Allergies?

Some symptoms are similar between these respiratory illnesses. This chart can help you figure out if you may be feeling symptoms of allergies or a respiratory illness like COVID-19. If you have a fever and a cough, call your doctor. If you have seasonal allergies, there are things you can do to treat at home.

comparison of COVID-19, flu, common cold and allergy symptoms
Click to see larger image

All of these conditions may worsen asthma, so it’s important to keep taking your asthma control medicines.

Information is still changing. We will update this chart as new evidence comes out.

How Does COVID-19 Spread?

The virus is thought to spread through talking, coughing or sneezing. The virus will be in droplets that are coughed out into the air. These are heavy droplets and they quickly fall to the ground/surface below.

People who are within 6 feet (2 meters) of someone who is ill with COVID-19 may be within the zone that droplets can reach. If someone who is sick coughs on or near your face, you may get infected. Studies now show that some people may have COVID-19 and not show symptoms. They may spread the virus without knowing it.

This is why the CDC now recommends everyone wear a cloth face covering in places where it’s hard to keep a 6-foot distance from others to help stop the spread of illness. If you aren’t wearing a face covering, cough/sneeze into your elbow or a tissue. If you use a tissue, throw it away. In either case, throw it away. In either case, wash your hands after you cough or sneeze.

COVID-19 may also live on surfaces that people have coughed on. If you touch a surface with the virus on it and then touch your mouth, nose or eyes, you may get sick.

Who Is at Risk From COVID-19?

An initial review of U.S. COVID-19 cases of people with underlying conditions shows that people with chronic lung disease, including asthma, are at higher risk of hospitalization for COVID-19.1 But early data from New York state suggests people with asthma have a lower death rate if they do get COVID-19.2

According to the WHO and the CDC, the highest risk groups include:

  • People caring for someone who is ill with COVID-19
  • People over age 65
  • People who live in a nursing home or long-term care facility
  • People who are pregnant
  • People with chronic medical conditions, especially if they are not well-controlled, such as:
    • People with a body mass index over 40
    • Serious heart conditions
    • Diabetes
    • Chronic kidney disease and on dialysis
    • Liver disease
    • Immunocompromised people, such as those on cancer treatments
    • Asthma (and other lung diseases)

People with asthma should take precautions when any type of respiratory illness is spreading in their community.

In the U.S., the flu and other illnesses are still spreading. If you have symptoms of a cough or fever, call your doctor. If you have the flu, there are antiviral treatments available.

Physical (Social) Distancing Guidelines for People at High Risk

The CDC has released physical distancing guidelines for people at high risk (such as people with asthma):

  • Stock up on supplies (a 14- to 30-day supply)
  • Take steps to keep a distance from others (physical distancing, about 6 feet)
  • Avoid people who are sick, limit close contact and wash your hands often
  • Avoid crowds as much as possible
  • Avoid non-essential travel

Clean and disinfect your home and car regularly, especially items you touch often like doorknobs, light switches, cell phones, car door handles and steering wheels, etc. The CDC has released guidelines for people at high risk (including people with asthma):

  • Stock up on supplies (a 14- to 30-day supply)
  • Take steps to keep a distance from others (social distancing, about 6 feet)
  • Avoid people who are sick, limit close contact and wash your hands often
  • Avoid crowds as much as possible
  • Avoid non-essential travel
  • Clean and disinfect your home and car regularly, especially items you touch often like doorknobs, light switches, cell phones, car door handles and steering wheels, etc.

The CDC also recommends you stay home as much as possible. Try to find ways to have food and supplies delivered to your home.

Air Pollution

A study out of Harvard shows that people who live in areas in the U.S. with high air pollution may be more likely to die from COVID-19.3 If you live in a high-pollution area, try to reduce how much you are exposed to outdoor air pollution. Stay home as much as possible to avoid traffic. Keep your windows closed and use central air conditioning if you have it. Change or clean your air filters properly according to the manufacturer’s instructions, as well. Watch air quality reports and stay inside on days when air quality is worse.

How Can I Avoid Getting COVID-19 and Other Respiratory Infections?

The steps you take to avoid the flu and other respiratory infections will also help protect you from COVID-19:

  • Wash your hands often with soap and warm water for 20 to 30 seconds, and always after coughing or sneezing. If you don’t have access to running water, use an alcohol-based hand cleanser that is at least 60% alcohol.
  • Don’t touch your eyes, nose or mouth.
  • Stay away from people who are sick or have been in contact with someone who is sick.
  • Don’t share makeup, food, dishes or eating utensils.
  • Wear a cloth face cover per new CDC guidelines.
  • Take your daily asthma medicines to keep your asthma under control.

Spring pollen is increasing across the U.S. too. Seasonal allergies can affect people with allergic asthma. If pollen allergies trigger asthma symptoms for you, be sure to follow your allergy treatment plan to keep your allergies under control to prevent asthma episodes or attacks.

The most important thing you can do right now is to keep your asthma under control. If your asthma is not under control, call your doctor right away.

If you do get sick, call your doctor and follow your Asthma Action Plan.

There is no vaccine for COVID-19. Get the flu shot if you haven’t already – it’s not too late to protect yourself from the flu. The flu season can last as late as May.

If you plan to travel, check CDC travel precautions.

If I Think I Have COVID-19, What Should I Do?

If you start having symptoms of COVID-19, call your doctor or your local department of health right away. Many states are adding testing options daily, and your doctor or department of health can tell you what to do.

If you have Medicare, you might be able to have a virtual visit with your doctor. The government has expanded the coverage of telehealth services during the COVID-19 crisis.

Should I Wear a Mask or Face Covering to Prevent Spreading COVID-19?

Previously, the CDC and the WHO recommended that people not wear masks to avoid spreading and getting COVID-19. This was based on previous concerns that using masks incorrectly could actually spread the virus more.

New evidence shows that as many as 25 to 50% of people with COVID-19 may not show symptoms, which means you can spread the virus before you know you have it.

The CDC now recommends that Americans wear cloth face coverings when you leave home to keep you from accidentally spreading the virus. A face covering can catch droplets from your mouth and nose so you don’t spread them to people nearby. You can use a scarf, a bandanna or a homemade mask. Use material that you can machine wash and dry without damage.

To tell if a homemade face covering will be sufficient, shine a light through it. If you can see the light through it, it will not offer sufficient protection. Your face covering may need multiple layers. Make sure your face covering blocks the light but still allows you to breathe through it.

Because of the limited supply, the CDC urges you NOT to purchase surgical, N95 or any other kind of medical mask. We need to save the supply for health care workers who already don’t have enough supplies.

You must still continue to practice physical distancing even if you wear a face covering. A face covering will not give you 100% protection from catching COVID-19. But it will help you and others reduce the chance of spreading it, especially if you aren’t showing symptoms.

It is important to follow proper steps when using a face covering or mask. Follow these steps when using a face covering or mask:

  1. Wash your hands before putting on a face covering or mask.
  2. Fully cover your mouth, nose and beard. Make sure there are no gaps between the face covering or mask and your skin.
  3. Avoid touching the face covering or mask while using it.
  4. If your face covering or mask gets damp, replace with a clean one and wash if reusable. If it’s disposable, throw it away and replace with a new one.
  5. Remove the mask from behind, trying to not touch the front. Wash washable face coverings right away. Throw away disposable masks into a closed bag or trash can.
  6. Wash your hands with hot water and soap for 20 to 30 seconds.

Masks may not be appropriate for children age 2 and younger. It’s best to keep kids at home where they do not need to wear a mask.

Should I Continue to Get Allergy Shots During the COVID-19 Pandemic?

With spring pollen spring pollen high in many parts of the U.S., regular allergy shots are an effective way to help you manage your allergy and allergic asthma symptoms. Check with your allergist’s office to find out what changes they have made to how they are giving allergy shots. Continue with your allergy shot schedule unless your allergist tells you differently, practicing proper physical distancing.

Should I Avoid Taking Ibuprofen If I Get COVID-19?

According to the U.S. Food and Drug Administration (FDA), there is not enough evidence yet to know if ibuprofen and other NSAIDS (a type of medicine that reduces swelling) makes COVID-19 symptoms worse.

If you are concerned about taking ibuprofen when you have COVID-19, ask your doctor if you can take acetaminophen (Tylenol) to reduce your fever.

Are people with asthma at higher risk of more severe symptoms from COVID-19? (Update 4/16/20)

According to a study looking at U.S. patients with COVID-19, it does appear that people with underlying health conditions like chronic lung disease are at higher risk for hospitalization with COVID-19.¹ It is less clear if they have more severe disease. In fact, in New York state there is some evidence of a lower death rate from COVID-19 in those patients with asthma.²

Some people have concerns about the steroids in their asthma inhalers weakening their immune system. What should people know about inhaled corticosteroids or oral corticosteroids (such as prednisone)?

It is very important to keep your asthma under control. This often requires the use of an inhaled corticosteroid (also called a maintenance or long-term control medicine) that you take every day, and sometimes oral steroids like prednisone. Steroids are not a risk
for people with asthma, so continue to take your medications as prescribed.

If I use a nebulizer at home, could it spread the coronavirus through the air (even if I don’t know if I have it)? (Updated 4/16/20)

If you need to take quick-relief medicine (such as albuterol) for an asthma episode, use an inhaler (with a spacer) if possible. Using a nebulizer can increase the risk of sending virus particles in the air if you are sick. But if you have a nebulizer and solution, it is OK to use it to treat an asthma episode. When using a nebulizer, limit the number of people in the room or use it in a room by yourself.

The biggest risk to people with asthma is not treating asthma symptoms when needed at home. This can lead to visits to overcrowded emergency rooms with no hospital beds. Uncontrolled asthma is a much higher risk to your health than COVID-19.

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