Update – May 20, 2020
We added the following updates to this blog post:
- New resource on improving indoor air quality
- Symptoms that require emergency treatment
- Ways to manage stress
- New questions on how to use disinfectant cleaners safely with asthma
- Updated answer to the question on travel
Other resources available include:
- Protecting Your Hands From Eczema During Coronavirus and Flu Outbreaks
- Please Don’t Stop Taking Your Asthma Medicines Due to the Coronavirus – a guest blog post from Dr. Mitchell Grayson
- Coronavirus (COVID-19) Crisis: Some States Open Enrollment for Health Insurance
- Albuterol Inhaler Shortage Due to COVID-19 Could Impact People With Asthma
- FDA Approves Generic of Proventil HFA Albuterol Inhaler to Meet Demand Due to COVID-19
- Asthma and Allergy Caucus to FDA: Take Action to Prevent Albuterol Shortages
- Why Healthy Indoor Air Quality Is Important When Spending More Time Indoors Due to COVID-19
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.
According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), COVID-19 symptoms can include:
- Shortness of breath or trouble breathing
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
- Feeling tired and weak
Other symptoms reported are:
- Stuffy or runny nose
- Diarrhea or nausea
- Painful blue or purple lesions on toes (COVID toes)
- Hives or rashes
If you have these emergency warning signs, call 911 or go to the emergency room immediately:
- Trouble breathing or shortness of breath
- Pain or pressure in the chest that doesn’t go away
- Newly confused or can’t wake up
- Bluish tint on lips, face or fingernails
According to the CDC, this list may not include all symptoms. If you have any symptoms that are severe or concerning, call your doctor.
Most children tend to have mild COVID-19 symptoms that are similar to a cold. They may have:
- 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.
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, may be 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
- 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 nay still be spreading even though activity has decreased. If you have symptoms of a cough or fever, call your doctor. If you have the flu, there are antiviral treatments available.
Disparities Among Black, Latino and Native American Communities
Communities of color are experiencing a major impact from COVID-19. Recent data collected in the United States and in the United Kingdom shows that black, Latino and Native American patients along with lower-income groups are disproportionately dying from COVID-19. This is likely due to long term disparities in care. Counties in the U.S. with a black majority have six times the rates of deaths from COVID-19.4
Physical (Social) Distancing Guidelines for People at High Risk
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.
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 high 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.
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 have various testing options, and your doctor or department of health can tell you what to do.
Many doctors have been offering telehealth (video or virtual appointments) – although doctors may reduce telehealth appointments as practices open back up. If that is an option, ask your insurance company if telehealth is covered under your plan. And 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:
- Wash your hands before putting on a face covering or mask.
- Fully cover your mouth, nose and beard. Make sure there are no gaps between the face covering or mask and your skin.
- Avoid touching the face covering or mask while using it.
- 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.
- 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.
- 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 Keep Appointments With My Allergist During the COVID-19 Pandemic?
Many health care providers are beginning to see patients in their offices again. As they open up, procedures may change. They may reduce the number of people in the waiting room. They may also take your temperature and ask you about symptoms. You may also be asked to wear a mask.
Your doctor may also ask you to track your peak flow readings at home instead of doing lung function tests in the office to reduce the chance of spreading the virus.
With 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.
How Can I Deal With Stress During the COVID-19 Pandemic?
Nearly everyone is experiencing stress because of the COVID-19 pandemic. Stress can affect your well-being and quality of life. It can be an asthma trigger. So it’s important that you take care of yourself during this time.
Find some self-care practices that work for you. Some examples are:
- Try a hobby
- Take breaks from the news and social media
- Take care of your body through exercise, healthy eating and getting enough sleep
- Practice deep breathing and stretching
- Keep in touch with friends and family
The CDC also offers more information on coping with stress.
When you have a chronic disease like asthma, taking part in a support group can have many benefits. AAFA has free online support groups for people with asthma and allergies. For support and encouragement through the COVID-19 pandemic, join the AAFA community.
What Do People With Asthma Need to Know About the New Coronavirus? Frequently Asked Questions Answered by Dr. Mitchell Grayson
1. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020;69:382–386. DOI: http://dx.doi.org/10.15585/mmwr.mm6913e2
2. Asthma Is Absent Among Top Covid-19 Risk Factors, Early Data Shows. (n.d.). Retrieved from https://www.nytimes.com/2020/0...rus-asthma-risk.html
3. Air pollution linked with higher COVID-19 death rates. (2020, April 7). Retrieved from https://www.hsph.harvard.edu/n...ovid-19-death-rates/
4. Thebault, R., Tran, A. B., & Williams, V. (2020, April 7). The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved from https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/
5. Heneghan, C. (2018, January 30). Self-management of asthma – is there an app or pulse oximeter for that? Retrieved from https://blogs.bmj.com/bmjebmsp...-app-pulse-oximeter/
6. Kampf, G., Todt, D., Pfaender, S., & Steinmann, E. (2020). Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection, 104(3), 246–251. doi: 10.1016/j.jhin.2020.01.022