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

 

Update – Aug. 24, 2021

We added the following updates to this blog post:

  • FDA approval of the COVID-19 vaccine from Pfizer-BioNTech (Comirnaty)
  • Information on the delta variant of the coronavirus (B.1.617.2)
  • Updated information for fully vaccinated people based on new evidence on the delta variant that is currently circulating in the United States
  • New recommendation for fully vaccinated people to wear a mask in public indoor settings in areas of high transmission.
  • Vaccine recommendations for pregnant and recently pregnant people

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.


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The Latest COVID-19 Guidance

The Centers for Disease Control and Prevention (CDC) has updated its guidance for people who are fully vaccinated against COVID-19 (SARS-CoV-2). You are fully vaccinated two weeks after getting your second Pfizer or Moderna shot or two weeks after getting one Johnson & Johnson shot.

The Delta Variant of the Coronavirus

The delta variant is a strain of the coronavirus that causes COVID-19. Most COVID-19 infections in the United States and in many other countries are currently from the delta variant. It is two times more contagious than earlier strains of SARS-CoV-2, meaning it is spreading very quickly. Some data suggest the delta variant might cause more severe illness in people who are not vaccinated.

It is possible for people who are fully vaccinated to get the delta variant. This happens much less in people who have their COVID-19 shot than people who do not. This is called a breakthrough infection. Symptoms of COVID-19 will be less severe in people who are vaccinated and their risk of being hospitalized or dying of COVID-19 are very low. They are also less contagious, and they will recover faster than people who are not vaccinated.

The CDC recently updated their COVID-19 vaccine recommendations for pregnant people and people who are immunocompromised.

What Activities Can I Do Safely If I Am Fully Vaccinated Against COVID-19?

In May 2021, the CDC updated their guidelines for wearing a mask. When fully vaccinated, the CDC stated you can safely resume activities without wearing a mask and staying 6 feet (2 meters) apart.

But in July 2021, the CDC provided new guidance due to the delta variant and rising COVID-19 cases. It is now recommended that everyone in areas of high transmission wear a mask in public indoor places, even if they are fully vaccinated.

If you have a condition or are taking medicines that weaken your immune system, talk with your doctor about which activities are safe to do.

Should I Still Wear a Face Mask?

While COVID-19 cases continue to rise, it is a good idea to wear a wear a face mask in public places to protect yourself and others, even if you are fully vaccinated. The CDC also recommends wearing a face mask if you are immunocompromised (or live with someone who is) or are at risk of severe disease due to other health conditions.

Wearing a face mask may have other benefits. If you have asthma or allergies, masks can help protect you from pollen and other allergens and irritants that trigger symptoms. Masks also can protect you from respiratory infections like the flu, COVID-19, and even the common cold. Masks provide protection for people who are immunocompromised.

You will still need to follow federal, state, local, tribal, or territorial laws. These jurisdictions, workplaces, and private businesses may still require that you wear masks.

Wearing a face mask is still required when traveling on planes, buses, trains, or other forms of public transportation. Masks are still required at hospitals, airports, bus and train stations, homeless shelters, and prisons.

The CDC recommends universal indoor masking for all teachers, staff, students, and visitors to schools, regardless of vaccination status.

Does My Child Need to Wear a Mask?

COVID-19 vaccinations are now available in the U.S. for everyone 12 years old and older. Children in this age range should get vaccinated as soon as possible so they are protected from COVID-19.

Children should continue to wear a face mask and stay 3 feet apart in all public spaces, including schools if they are:

  • 2 years old and older
  • Too young to receive the COVID-19 shot
  • Are not fully vaccinated

Children with a disability that keeps them from safely wearing a mask and children under 2 should not wear masks.

What If I Have Been Around Someone Who Has COVID-19?

If you are not fully vaccinated and have been in close contact with someone with COVID-19, get tested three to five days after exposure. If you test positive for COVID-19, isolate for 10 days from exposure, or if you have symptoms.

If you are fully vaccinated, you only need to get tested and stay home if you have symptoms. If you test positive, isolate at home for 10 days. If you live or work in a correctional or detention facility or homeless shelter, you should get tested right away even if you don’t have symptoms.

What Should I Do If I’m Not Fully Vaccinated Against COVID-19?

If you have not received a COVID-19 shot yet, plan to get vaccinated as soon as possible. People who are unvaccinated are at the highest risk of getting the delta variant of the coronavirus, spreading it to other people, and becoming hospitalized and/or dying of the virus. If you believe you are not eligible for the vaccine due to your medical conditions, talk with your doctor to see what options may be available to you.

People who are pregnant or thinking of becoming pregnant should get the COVID-19 vaccine. Pregnant people are at a higher risk for severe COVID-19 when compared to non-pregnant people.1 Recent pregnancy (for at least 42 days following the end of pregnancy) may also raise a person’s risk for developing severe COVID-19. If you get COVID-19 while pregnant, you are at increased risk for preterm birth (delivering the baby earlier than 37 weeks) and other poor pregnancy outcomes.2

If you are not fully vaccinated, you will need to continue to take steps to slow the spread of the coronavirus. This includes wearing a mask, staying 6 feet apart, avoiding crowds and poorly ventilated spaces, and washing your hands often with soap and water.

Fully vaccinated people with delta variant breakthrough infections can spread the virus to other people.

What Are the Symptoms of COVID-19 Disease Caused by the New Coronavirus?

In December 2019, a new coronavirus named SARS-CoV-2 started spreading and triggered a pandemic (worldwide outbreak). This new coronavirus causes an illness known as COVID-19.

Now, some new strains (versions) of the coronavirus, such as the delta variant, are spreading. It is normal for a virus to change over time. The new versions are “variants” or “mutations.” Some information shows that the new coronavirus strains may spread more easily than the original strain of the coronavirus.

According to the CDC and the World Health Organization (WHO), COVID-19 symptoms can include:

  • Fever
  • Chills
  • Cough
  • Shortness of breath or trouble breathing
  • Feeling tired and weak
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Stuffy or runny nose
  • Nausea or vomiting
  • Diarrhea

Other symptoms reported are:

  • Pinkeye
  • Painful blue or purple lesions (such as a sore or bruise) on toes (COVID toes)
  • Hives or rashes

If you or someone you know has 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
  • Can’t wake up or stay awake
  • Pale, gray, or bluish tint on lips, face, or fingernails, depending on skin tone

According to the CDC, this list may not include all symptoms. If you have any symptoms that are severe or concerning, call your doctor.

The CDC warns that symptoms may appear two to 14 days after coming in contact with the virus. For many people, they may not have any symptoms at all but can still spread the virus.

How Can I Tell the Difference Between Asthma, 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 asthma, allergies, or a respiratory illness like COVID-19, the flu, or a cold. Respiratory illnesses may worsen asthma, so it’s important to keep taking your asthma medicines. If you have a fever and a cough, call your doctor. If you have seasonal allergies, there are things you can do to treat them at home.



How Does the Coronavirus That Causes COVID-19 Spread?

The coronavirus spreads through close contact from person to person. A person with the virus can spread it to others by talking, coughing, sneezing, singing, or breathing. The virus will be in droplets that are exhaled from the mouth or nose out into the air. These droplets can vary in size from small to large. Large droplets are heavy and quickly fall to the ground/surface below. Small droplets can linger in the air longer and spread more easily. This is called airborne transmission.

People who are within 6 feet (2 meters) of someone who is ill with COVID-19 may be at greatest risk for becoming infected. But it may be possible to catch the virus even if you are more than 6 feet away from an infected person because very small droplets can linger in the air. If someone who is sick coughs on or near your face, you may get infected. People may be infected with the coronavirus and not show any symptoms. They may spread the virus without knowing it. The virus may also spread through direct contact with a person who has COVID-19.

Even if you are fully vaccinated, the CDC now recommends wearing a face mask in places where it’s hard to keep a 6-foot distance from others to help stop the spread of infection. If you aren't wearing a face mask, cough/sneeze into your elbow or a tissue. If you use a tissue, throw it away. In either case, wash your hands after you cough or sneeze.

Who Is at Risk For Severe Illness From COVID-19?

Many studies to date (as of Aug. 24, 2021) show no increased risk of COVID-19 infection or severity of COVID-19 disease in people with asthma.3,4,5 A study published in “The Journal of Allergy and Clinical Immunology: In Practice” (JACI: In Practice) found that people with well-controlled asthma have less severe COVID-19 outcomes than those with uncontrolled asthma.6 Now is the time to talk with your doctor to make sure your asthma is well-controlled.

The CDC continues to list moderate-to-severe asthma as a chronic lung disease that can make you more likely to have severe illness from COVID-19.

Based on existing evidence, the following adults can be more likely to get severely ill from COVID-19:

  • Older adults (the risk increases with age with people over age 65 at highest risk)
  • People who are affected by long-standing systemic health and social inequities including:
    • People who are Black, Hispanic/Latino, or American Indian/Indigenous American
    • People with disabilities
    • People with less access to education, income, and wealth
    • People who live in rural communities
  • People who live in crowded housing conditions (including prisons and jails, group homes, and long-term care facilities)
  • People with chronic medical conditions, such as:
    • Cancer
    • Chronic kidney disease
    • Chronic lung disease, like obstructive pulmonary disease (COPD) or cystic fibrosis (the CDC also lists moderate-to-severe asthma, but data shows asthma does not put someone at higher risk of severe illness from COVID-19)
    • Dementia or other neurological conditions
    • Diabetes (type 1 or type 2)
    • Down syndrome
    • Heart conditions such as hypertension (high blood pressure), heart failure, or coronary artery disease
    • HIV infection
    • Immunocompromised state (weakened immune system)
    • Liver disease
    • Overweight and obesity (body mass index [BMI] over 25)
    • Pregnancy
    • Sickle cell disease
    • Smoking (now or in the past)
    • Solid organ or blood stem transplant
    • Stroke
    • Substance abuse disorders

Children can be infected with the virus that causes COVID-19 and some children develop severe illness. While some children may be at increased risk due to chronic medical conditions, there are no current data that show asthma is a risk factor for severe disease in children, either.

Even though people with asthma are not at the highest risk for COVID-19, it is still important to keep your asthma under control. Common medicines you may take for asthma and related conditions do not increase your risk of getting COVID-19. They will help you keep your asthma under control. You are at greater risk for having an asthma attack if you stop taking your medicines. Take your medicines at the first sign of symptoms as listed on your Asthma Action Plan. Continue to take these medicines as prescribed:

  • Quick-relief medicine (such as albuterol)
  • Inhaled corticosteroids (controller medicines)
  • Oral corticosteroids (such as prednisone)
  • Biologics
  • Antihistamines (allergy medicine)
  • Proton pump inhibitors for acid reflux
  • Nasal allergy sprays
  • Allergy shots

If you have any questions about asthma medicines and the coronavirus, talk with your doctor.

If you need to take quick-relief medicine (such as albuterol) for an asthma episode, use an inhaler (with a spacer if directed by your doctor) 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.

Disparities Among Black, Hispanic/Latino, and Indigenous American Communities

Black, Hispanic/Latino and American Indian/Indigenous Americans are experiencing a major impact from COVID-19. Data collected in the United States and in the United Kingdom shows that people in these groups along with lower-income groups have been 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-19.6,7

To stay up to date on COVID-19 and asthma news, join our community so you will be alerted when new information is available.


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

The following eight steps will help you avoid COVID-19, the flu, and other respiratory infections:

1. Get your vaccines.
Vaccines can help protect you, your loved ones, older adults near you, teachers, and essential workers from getting a respiratory infection. They can also cut down your symptom severity if you do get sick. Vaccines reduce the burden on our health care system by reducing the number of people who get COVID-19 or the flu.

Everyone who is 12 years and older can get the COVID-19 vaccines for free with no out-of-pocket costs in the United States. On Aug. 23, 2021, the FDA approved the Pfizer COVID-19 vaccine for ages 16 and older. It has been named Comirnaty [koe-MIR-nah-tee]. Experts expect the FDA to authorize more COVID-19 vaccines as they complete clinical trials.

Visit vaccines.gov to find out where you can get the COVID-19 vaccine near you. Most people can get the COVID-19 vaccine with no issues. Allergic and adverse reactions are rare.

Talk with your doctor before you get a COVID-19 vaccine if you have a:

  • Moderate or acute (short-term) illness
  • Current case of COVID-19
  • History of severe allergic reactions (anaphylaxis) to a vaccine (not including mRNA COVID-19 vaccines) or injectable medicine
  • History of an allergic reaction to PEG or polysorbate

The following people can get a COVID-19 vaccine:

  • People age 12 and older
  • People with medical conditions
  • People who are immunocompromised or immunosuppressed
  • Pregnant and lactating (nursing) people
  • People with allergies to food, pets, insects, venom, pollen, dust, latex, and oral medicines
  • People with a non-serious allergy to other vaccines or injectable medicines
  • People with a family history of anaphylaxis or any other history of anaphylaxis to anything other than a vaccine or injectable medicine

Your doctor may need to give you more information about the vaccine depending on your condition.

If you have a history of severe allergic reactions (anaphylaxis), you may be monitored up to 30 minutes after the shot. For everyone else, you will be monitored for 15 minutes after the shot.

On Aug. 12, 2021, the FDA authorized an additional vaccine shot, or third dose, of the Pfizer or Moderna COVID-19 vaccines. This is only for people who are moderately to severely immunocompromised. Other fully vaccinated people do not need an additional or booster dose right now. If you take a high dose of corticosteroids (like prednisone), have received an organ transplant, or have other serious health conditions, talk with your doctor about your vaccine options.

If you take daily oral steroids or injectable steroids like prednisone, talk with your doctor about getting a third shot. People taking inhaled corticosteroids or biologic medicines for asthma or allergies are not considered in this group.

Some people should talk with their doctor about risks and benefits before getting a COVID-19 vaccine. If you do get the vaccine, get the shots in a clinic or doctor’s office:

  • People with a moderate or acute (short-term) illness (such as the flu)
  • People with a history of severe allergic reactions (anaphylaxis) to another vaccine or injectable medicines
  • Anyone who has had a severe or immediate allergic reaction to previous dose or any ingredient (also called “excipients” or “components”) of a COVID-19 vaccine
  • People who have a history of an allergic reaction to PEG or polysorbate

If you have a reaction to the first dose of an mRNA vaccine (Pfizer-BioNTech/Moderna), talk with your doctor about your options.

People who currently have or recently had COVID-19:

  • Should finish self-isolation and talk to their doctors about when to get the vaccine

If you received COVID-19 antibody treatment, you will need to wait 90 days after receiving the treatment to get a COVID-19 vaccine.


pfizer covid-19 vaccine chart-v2
Click here for larger view


Getting a flu shot every year is recommended for everyone, especially people who are at high risk for both complications from the flu and COVID-19.

People with asthma should take precautions when any type of respiratory illness is spreading in their community. During flu season (usually October through May) it’s important that people with asthma get the flu shot. It is possible to get COVID-19 and the flu at the same time. Once you get a flu shot, it takes about two weeks for your body to build the immunity to the flu. The flu shot will not protect you from getting COVID-19.

People who have certain medical conditions, are age 65 and older, or are under 6 should get the pneumococcal vaccine, if they haven’t gotten it in the past. If you have asthma, talk with your doctor to see if you should get the vaccine. The pneumococcal vaccine protects against a bacterial pneumonia (from streptococcus pneumonia), but it will not protect against the pneumonia that COVID-19 causes. You do not have to get it every year like the flu shot.

Even if you are fully vaccinated against the coronavirus, flu, and pneumococcal disease, you can continue to protect yourself from respiratory infections by following the tips below.

2. Wear a mask.

A face mask needs to fit snug on your face, and cover your nose, mouth, and beard completely. Wear a mask when you leave your home, if you are caring for someone at home who is sick or have been exposed to someone with COVID-19. People with asthma should be able to wear face masks. If you adjust your mask often, then it probably doesn’t fit well. You may have to try different styles before you find one that fits best and is most comfortable.

The WHO recommends three layers:

  • An outer water-resistant layer (such as polyester or polyester blend)
  • A middle layer of non-woven fabric (such as polypropylene)
  • An inner layer of cotton

Ask people who are not fully vaccinated to wear a mask when they are around you or in your home.

3. Keep a physical distance from other people.

In general, the more closely you interact with other people and the longer that interaction, the higher the risk of coronavirus or flu spread. Try to stay home when possible. Avoid large crowds of people, especially in indoor locations. When in public, keep at least 6 feet apart. Stay away from people who are sick or have been in contact with someone who is sick. Even when you’re at home with family, don’t share makeup, food, dishes, or eating utensils.

Other tips to help you stay home more often and help reduce the spread of respiratory infections like coronavirus:

  • Stock up on 14 to 30 days’ worth of supplies (such as medicines)
  • Use online ordering for food deliveries
  • Switch to mail-order pharmacy if your insurance plan covers it
  • Avoid non-essential travel
  • Skip indoor parties and gatherings with people who don’t live with you if there isn’t a way to maintain physical distancing of at least 6 feet

See the CDC’s guidelines on how to protect yourself at specific locations and in certain situations, such as shops, public places, gatherings, and more.

4. Ventilate indoor air.

Being outdoors is generally safer than indoors because there is better air circulation outside. Keep your indoor spaces well-ventilated by opening windows or doors, using fans, running air cleaners, or using air filters in your HVAC system.

Current evidence shows the risk of the coronavirus spreading is much lower outdoors than indoors. Good ventilation in your indoor environment may help reduce the spread of the new coronavirus. It may also affect the risk of transmission (how fast it spreads). To help reduce the spread of the virus that causes COVID-19 in your home or business, consider these steps:

On days when pollen is low and air quality is good, open your windows to let in fresh air. Run your HVAC system as much as possible (especially when windows are closed). Use high efficiency air filters in your HVAC system and replace them at least every three months.

5. Avoid unnecessary travel.

The CDC recommends avoiding domestic and international travel until you are fully vaccinated against COVID-19. You will still have to wear a mask when you travel on planes, buses, trains, and other forms of public transportation. If you absolutely must travel and you aren’t fully vaccinated, traveling in your personal car is probably safest because it’s easier to limit the number of people you are exposed to. If you plan to travel, check CDC travel precautions.

Remember that the biggest risk of getting any illness on a plane, train, or bus comes from the people in the row in front and behind you and those right beside you. Sit in a window seat with an empty middle seat if possible. Ask to be reseated if someone in the row in front or behind or next to you appears ill. Think about bringing antiseptic wipes to wipe down your armrests, tray table, headrest, and other areas you will be touching.

6. Wash your hands often.

Use soap and warm water to wash your hands for 20 to 30 seconds. Always wash your hands before and after eating and after coughing or sneezing. If you don’t have access to running water, use an alcohol-based hand sanitizer that is at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol). Don’t touch your eyes, nose, or mouth.

Before using your hand sanitizer, make sure it hasn’t been recalled for containing harmful ingredients by checking the FDA’s recall list. The FDA has recalled several hand sanitizers because they have methanol. Methanol is toxic and can make you sick if you put it on your skin. Some hand sanitizers have even been mislabeled as containing ethanol, but really contain methanol.

Not all hand sanitizers are effective at killing germs. To sanitize your hands for the new coronavirus, look for a hand sanitizer that contains:

  • At least 60% ethyl alcohol (ethanol), or
  • At least 70% isopropyl alcohol (isopropanol)


7. Regularly disinfect commonly touched surfaces.

Surfaces can contain viruses and bacteria that can make you sick if you touch the surface and then touch your mouth, nose, or eyes. Using a household cleaner that contains soap reduces the number of germs on surfaces. In most situations, cleaning alone with remove most virus particles on surfaces. According to the CDC, you probably don't need to disinfect to reduce the transmission of COVID-19 at home.

Use a disinfectant cleaner to clean commonly touched surfaces like door handles/knobs, remote controls, cell phones, steering wheels, tabletops, light switches, etc. if someone in your home has been sick within the last 24 hours.

Products that clean, sanitize, or disinfect may trigger asthma. When using these products, open windows, run exhaust fans, avoid spraying them into the air, and wear gloves and a mask to protect yourself. If you can, have someone else do the cleaning while you are in another room or outside of the home. The Environmental Protection Agency (EPA) recommends the use of EPA-registered household disinfectants. When choosing a disinfectant, look for products that are non-scented. Also look for asthma-safer ingredients like hydrogen peroxide, lactic acid, citric acid, and alcohol-ethyl or isopropyl alcohol.

According to the CDC’s How to Clean and Disinfect, clean surfaces first with soap and water to reduce the number of germs, then use a disinfectant to kill the germs. The things you touch a lot should be cleaned often, like tables, doorknobs, countertops, handles, toilets, etc. Follow manufacturer’s instructions for cleaning keyboards, phones, and touch screens.

You can buy many cleaning supplies that disinfect. If you want to use products you may already have at home, try these:

  • Use hydrogen peroxide (3%) full strength to kill the new coronavirus. Leave it on surfaces for 1 minute before wiping.8
  • You can make your own disinfectant with bleach. Add 1/3 cup of household bleach to one gallon of cold water in a well-ventilated area or outside. Wear gloves and a mask, and do not mix other cleaning products (especially ammonia) with bleach. Mix small batches and throw away after 24 hours. Bleach can trigger asthma and is harsh on the skin, so use with caution. Wash your hands after using the bleach solution.

Vinegar and essential oils (like tea tree oil) are not EPA-registered disinfectants and will not kill COVID-19.

8. Take care of your health.

Take your daily asthma medicines to keep your asthma under control. Eat well and get enough sleep.

Pollen (such as grass or ragweed pollen) may impact people 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 CDC is recommending that people see their health care providers again. If you stopped seeing your allergist or getting allergy shots (immunotherapy) during the COVID-19 pandemic, consider making an appointment soon. Keeping up with your regular allergist visits is an important part of keeping your asthma controlled.

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

During the COVID-19 pandemic, many people with asthma have wondered if they should monitor the amount of oxygen in their blood. COVID-19 has been known to sometimes reduce blood oxygen levels. But monitoring your blood oxygen levels is not a recommended part of home management of asthma.

Pulse oximeters (or “pulse ox”) are used by doctors to measure how much oxygen your blood is carrying. Some people with COVID-19 experience a drop in their oxygen saturation in their blood. Many people with COVID-19 are using pulse oximeters at home to watch their oxygen levels even though they are not as accurate as medical grade devices.

In general, peak flow readings or keeping a symptoms diary are the most common ways to manage your asthma (along with an Asthma Action Plan). A pulse ox may be added to this, but it is important to discuss this with your doctor. There are many ways home pulse oximeters can provide inaccurate readings. Normal pulse oximeter readings range from 92 to 100%, with 90% or below usually considered low, although some people have lower oxygenation levels normally. It is important to remember that the symptoms you feel should always come before pulse ox and peak flow numbers.

There are no data demonstrating that monitoring your pulse ox through an oximeter or smartphone app will help manage your asthma. As always, talk to your doctor about the best ways to monitor your symptoms and asthma control.9

Similarly, there is no recommendation to use an at-home pulse oximeter to determine if you have COVID-19. Doctors may recommend using a pulse oximeter to keep an eye on oxygen levels for people with confirmed COVID-19 and high risk factors. Some people with mild to moderate COVID-19 may need to use supplemental oxygen at home.

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 health department within 24 hours. 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). 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.

How Can I Deal With Stress During the COVID-19 Pandemic?

Even though the number of COVID-19 cases have gone down, nearly everyone is still experiencing stress because of the pandemic. Some also are concerned as more activities return and businesses increase capacity and relax mask mandates. Stress can affect your well-being and quality of life. It can be an asthma trigger. It’s important that you continue to 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 good sleep habits
  • 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.

Other COVID-19 Resources to Help You Stay Safe and Healthy

What People With Asthma Need to Know About Face Masks During the COVID-19 Pandemic

The COVID-19 Vaccine: The Latest Information for People With Asthma and Allergies

Cleaning Your Hands With Soap Vs. Hand Sanitizer: What Is Best to Protect Yourself From COVID-19 and Other Illnesses?

Please Don’t Stop Taking Your Asthma Medicines Due to the Coronavirus – a guest blog post from Dr. Mitchell Grayson

Protecting Your Hands From Eczema During Coronavirus and Flu Outbreaks

Why Healthy Indoor Air Quality Is Important When Spending More Time Indoors Due to COVID-19

Managing Asthma at School During the COVID-19 Pandemic – AAFA’s COVID-19 and Asthma Toolkit for Schools

COVID-19 Guidelines for Schools and the Impact on Kids With Food Allergies

FDA Approves Generic of Proventil HFA Albuterol Inhaler to Meet Demand Due to COVID-19


Medical Review, Mitchell Grayson, MD, August 2021.

References
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6. Huang, B. Z., Chen, Z., Sidell, M. A., Eckel, S. P., Martinez, M. P., Lurmann, F., Thomas, D. C., Gilliland, F. D., & Xiang, A. H. (2021). Asthma disease Status, COPD, and COVID-19 severity in a large Multiethnic POPULATION. The Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2021.07.030
7. 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...post-analysis-shows/
8. 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
9. 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/

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We have updated this blog post to reflect more recent information on the 2019 new coronavirus (COVID-19). Even though coronavirus numbers have risen worldwide, people in the U.S. are still at a greater risk of getting the flu. 

Keep washing your hands and avoiding people who are sick. And don't forget to follow your Asthma Action Plan if you start feeling ill. 

I have intermittent asthma. I usually manage my symptoms (wheezing during the pollen season) with antihistamines and sometimes the Ventolin inhaler. I had an attack about a month ago and the last time before that was 10 years ago. For the most recent attack, I was prescribed Deltacortril for five days, and they certainly sorted the problem. The doctor also suggested I take a preventive inhaler to keep the asthma at bay.

However, I read on the internet that the preventive inhaler which delivers a small dose of steroids can weaken the immune system. So in light of the coronavirus outbreak, should I not take the preventive inhaler? I should add the I travel overseas regularly. 

Hi @Azmtick - those are all great questions!

Many long-term controller or preventative medicine inhalers do contain an inhaled corticosteroid. These prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available. It's important to keep taking your controller medicine even when you don't have symptoms because they prevent asthma symptoms. Stopping your controller medicine may increase your asthma symptoms and the risk of complications if you do get the coronavirus, flu or other illness. If you are concerned about the steroid affecting your immune system, discuss that with your doctor.

Travel can expose you to germs. There are steps you can take to reduce your exposure and hopefully avoid getting sick. This article has lots of tips on traveling with asthma and allergies.

Kathy P posted:

Hi @Azmtick - those are all great questions!

Many long-term controller or preventative medicine inhalers do contain an inhaled corticosteroid. These prevent and reduce airway swelling. They also reduce mucus in the lungs. They are the most effective long-term control medicines available. It's important to keep taking your controller medicine even when you don't have symptoms because they prevent asthma symptoms. Stopping your controller medicine may increase your asthma symptoms and the risk of complications if you do get the coronavirus, flu or other illness. If you are concerned about the steroid affecting your immune system, discuss that with your doctor.

Travel can expose you to germs. There are steps you can take to reduce your exposure and hopefully avoid getting sick. This article has lots of tips on traveling with asthma and allergies.

Thanks Kathy P. That's very useful advice.

I can't find any information anywhere about patients with asthma (specifically) and COVID-19 mortality rates. I am a relatively healthy individual with mild but persistent allergy triggered asthma. My singulair seems to keep it under control. I've had the flu twice this season (different strains) with no complications. But, I am curious, so these are my questions:

 

  1. I've heard that the jury is still out on what exactly causes respiratory complications from viruses in people with asthma. Some say it's an overproduction of mucus that can become infected and/or cause an increased inflammatory response. Others say that inhaled steriods do little to one's general immune system, but could leave the lungs more vulnerable to pathogens. Both seem plausible to me, but I'm no doctor. What's your take, @AAFA Community Services ? (please no stock response like "always wash your hands" ... I'm already there, haha)
  2. Those at elevated risk include people with chronic respiratory diseases like asthma. I also know that, at least in Wuhan, COVID-19 killed significantly more men than women. Culturally in Wuhan, men smoke significantly more than women, though some doctors believe biological differences may be to blame. I know that published recommendations are general in nature on purpose because you can never be too safe, but do you have any statistics about how many cases included asthma patients and what those outcomes were? There are a million different respiratory diseases but us asthmatics are concerned specifically about asthma. 

Hello @I Am Curious
I am happy to hear you weathered two different flu virus strains this year without complications! Most healthy people recover from flu without complications (and is what is being seen in coronavirus COVID-19 as well).  But when you have asthma, it can put you at higher risk because asthmatic lungs already have swelling.

When you have a respiratory infection, your immune system responds by creating more mucus and releasing substances from your cells to fight the virus or bacteria - but this also creates swelling/inflammation. When this happens in airways that are already compromised, it can make it much harder to breathe because the airways become more narrow. Imagine a straw that is filled with pudding and then trying to move air through that straw.

People at highest risk of complications from the flu:

  • Older age (our elder population is at greatest risk)
  • Asthma (especially untreated or uncontrolled asthma can mean there is more swelling in the airways to start with)
  • Other health conditions (heart disease, diabetes)
  • Being pregnant 
  • Kids under age 5, but especially those under age 2


Researchers and public health officials are still trying to determine risk factors for COVID-19.  It should be similar to other viruses in the same family. At this time, people at highest risk for COVID-19 are defined as:

  • People living in same household as someone with laboratory-confirmed COVID-19 infection and are not using home isolation techniques
  • People in or who traveled in Hubei Province, China

The definitions for medium and low risk are available here: https://www.cdc.gov/coronaviru...risk-assessment.html

I think it is helpful to know that walking past someone in public has no identifiable risk of COVID-19 infection. It appears to be that you have to have much closer contact (like living together, or being seated within 6 feet on a flight) for it to spread. 

At this time, asthma is not a risk factor for COVID-19 (although this could change). A look at 140 cases found no one with asthma: https://onlinelibrary.wiley.com/doi/10.1111/all.14238

People with asthma should continue to take the same precautions to avoid any respiratory illness - wash hands often, don't share food/drinks, try to avoid being right next to someone who is coughing/sneezing, etc. 



Melanie Carver
Chief Mission Officer 
Asthma and Allergy Foundation of America


Ready to take control of asthma? AAFA's free online course at www.aafa.org/asthmacare will help you!

Distributed via the CDC Health Alert Network
February 28, 2020, 1505 ET (3:05 PM ET)

Update and Interim Guidance on Outbreak of Coronavirus Disease 2019 (COVID-19)
Summary
The Centers for Disease Control and Prevention (CDC) continues to closely monitor and respond to the COVID-19 outbreak caused by the novel coronavirus, SARS-CoV-2.


This CDC Health Alert Network (HAN) Update provides updated guidance on evaluating and testing persons under investigation (PUIs) for COVID-19. It supersedes guidance provided in CDC’s HAN 427 distributed on February 1, 2020.
The outbreak that began in Wuhan, Hubei Province, has now spread throughout China and to 46 other countries and territories, including the United States. As of February 27, 2020, there were 78,497 reported cases in China and 3,797 cases in locations outside China. In addition to sustained transmission in China, there is evidence of community spread in several additional countries. CDC has updated travel guidance to reflect this information (https://www.cdc.gov/coronaviru...travelers/index.html).

To date, there has been limited spread of COVID-19 in the United States. As of February 26, 2020, there were a total of 61 cases within the United States, 46 of these were among repatriated persons from high-risk settings. The other 15 cases were diagnosed in the United States; 12 were persons with a history of recent travel in China and 2 were persons in close household contact with a COVID-19 patient (i.e. person-to-person spread). One patient with COVID-19 who had no travel history or links to other known cases was reported on February 26, 2020, in California. The California Department of Public Health, local health departments, clinicians, and CDC are working together to investigate this case and are identifying contacts with whom this individual interacted.

CDC, state and local health departments, other federal agencies, and other partners have been implementing measures to slow and contain transmission of COVID-19 in the United States. These measures include assessing, monitoring, and caring for travelers arriving from areas with substantial COVID-19 transmission and identifying cases and contacts of cases in the United States.

Recognizing persons at risk for COVID-19 is a critical component of identifying cases and preventing further transmission. With expanding spread of COVID-19, additional areas of geographic risk are being identified and PUI criteria are being updated to reflect this spread. To prepare for possible additional person-to-person spread of COVID-19 in the United States, CDC continues to recommend that clinicians and state and local health departments consider COVID-19 in patients with severe respiratory illness even in the absence of travel history to affected areas or known exposure to another case.

I’m not sure the flu comparison is terribly helpful here. There is a flu vaccine which at least keeps some types of flu at bay, if not all. Despite the fact that we are generally familiar with coronaviruses, there is much we still don’t know about this one. For example, there seem to be indicators that people are spreading the virus while asymptomatic, but no one is sure how. If this is indeed the case, then that makes infection control much more difficult. 

I’m worried about my baby. She’s 15 months old, which means her immune system is weaker than an adult’s and her lungs are still developing. She was diagnosed with asthma after two hospitalizations for Rhino/Entero-induced bronchiolitis and a previous bout of RSV-induced bronchiolitis and flu. Fortunately we live in a quite isolated wilderness area but we are scheduled for medical appointments next week and for the foreseeable future to learn more about her asthma and also to see a speech pathologist, since all of this sickness seems to have set her back linguistically. Also, her dad works for a large company in an urban area, and if the above asymptomatic transmission is indeed true, he could bring it home without knowing it. We are of course worried about flu as well, but she has at least had her flu shot and so have we. We are following infection control protocol but I think it’s a pipe dream to think this thing won’t reach our state (New York).

The yardsale at the federal level is not helping. I have no faith in their capability to confront this. I hope our state health department is better.

Both my young adult kids have Flu- and cold-virus induced asthma.  One of them is on the other side of the country at college.  What do we know about the risk of Covid-19 with patients with this type of asthma?  They both had their flu shots last fall.  Should we be stocking up on anti-viral medication or Prednisone?  The anti-viral medication really helped reduce the symptoms my son experienced in years past when he got the flu (which he got despite getting the flu vaccination).

I just read an article today that stated do not take steroids for the corona virus.  It makes it worse.
1. is this true?

2. nebulizers and rescue inhalers are essentially steroidal.  Does this also apply to them?  
3. should we try to avoid using this if we contract the virus?  

Welcome Evita - those are all great questions! We are currently working with our medical scientific council to update the blog based on the lastest information known about the virus. 

Thank you all for submitting your questions! We are working on updating our blog above with updated numbers and recommendations. We have also sent a list of questions to our Medical Scientific Council and will share the information as soon as we hear back from the council.

Stay safe and keep washing your hands!



Melanie Carver
Chief Mission Officer 
Asthma and Allergy Foundation of America


Ready to take control of asthma? AAFA's free online course at www.aafa.org/asthmacare will help you!

We need a practical article that will be radically honest and realistic about how to survive this as immune-compromised people. What concrete steps should we take WHEN (not “if”) this virus spreads to our community? For example, I am doing the following: procuring an N95 mask to use in public when the virus becomes pervasive; filling all prescriptions I may need if I get sick (inhalers, prednisone, etc.); getting the pneumonia vaccine to prevent the secondary infection if I can; stocking  up on goods in case I need to quarantine myself from the outside world for either protection or illness; meeting with my doctors for input; and starting an elimination diet to reduce the load on my immune system PLUS getting good sleep and exercise and increasing nutrient-dense foods. LET’S GET SPECIFIC PLEASE.

Welcome CoachBW - we are working on getting the blog updated and have asked our medical advisors specific questions.

Your plan follows many of the CDC recommendations for how to prepare your household for a possible COVID-19 outbreak.

One reminder about masks is that they are most effective when worn by someone who is sick to prevent the spread of the virus through cough droplets. In general, masks don't provide much protection to someone who is not sick. You'd have to be directly coughed/sneezed on by someone who is sick for the mask to help. This is why healthcare workers wear them - they are in close proximity when treating a patient. If your mask does become contaminated, you can spread the virus to your hands when removing it.

The droplets containing the virus are heavy and land on surfaces that are then touched transferring it to your hands. I know people are sick of hearing it, but this is why handwashing is the #1 defense against this or other respiratory viruses.

CoachBW posted:

We need a practical article that will be radically honest and realistic about how to survive this as immune-compromised people. What concrete steps should we take WHEN (not “if”) this virus spreads to our community? For example, I am doing the following: procuring an N95 mask to use in public when the virus becomes pervasive; filling all prescriptions I may need if I get sick (inhalers, prednisone, etc.); getting the pneumonia vaccine to prevent the secondary infection if I can; stocking  up on goods in case I need to quarantine myself from the outside world for either protection or illness; meeting with my doctors for input; and starting an elimination diet to reduce the load on my immune system PLUS getting good sleep and exercise and increasing nutrient-dense foods. LET’S GET SPECIFIC PLEASE.

I absolutely agree with you CoachBW.  I've been all around the internet looking for solid advise.  I thought this would be one place where i could get some specific advice.  Hoping better answers come sooner than later.

The title of your article is misleading; there is no information in your article specific to people suffering from asthma. Contracting coronavirus and having asthma as an underlying condition has been highly publicized as leading to critical health issues or fatalities. Your article offers nothing specific to asthma. You should consider changing the article title to: Coronavirus: What You Need to Know, since the content is general information for the public, until you actually have content for an article pertaining to coronavirus with asthma as a comorbidity. Very disappointed.

Aetzel Griffioen posted:

Thank you for updating your article with specific advice regarding yesterday's comments placed below.

You are welcome, Aetzel. Thank you for your patience while we continue to update the article as more information is made available. 

Lorene 

Lorene Alba, AE-C

Director of Education 

AAFA 

Thank you for the updates! Super helpful!

I just wanted to point out that the one study that found no to link to increased risk of complications in persons with asthma also didn't  study anyone with asthma. Ie none of the 140 had (or knew they had) asthma. I think that's an important detail. The wording of the study itself,  concerning asthma and allergic diseases, is misleading until you read the whole thing. Two patients had COPD and they both had grim outcomes. Take what you want from that, but, because of the lack of asthma specific information published, I'm thinking either not a lot of asthma patients have gotten it (doubtful considering air quality in some places), or there just hasn't been enough time to compile info. It's hard to be patient since it's very clear that healthcare workers and researchers are likely overwhelmed in the areas hardest hit, but we have to try. Get enough sleep, stay hydrated, eat nutrient rich foods, take supplements, stay active and avoid large crowds. Most importantly, get or keep your asthma under control and wash your hands. 

Thank you again for getting this information for us. Please continue to keep us posted with allergy and asthma specific information.

I Am Curious posted:

Thank you for the updates! Super helpful!

I just wanted to point out that the one study that found no to link to increased risk of complications in persons with asthma also didn't  study anyone with asthma. Ie none of the 140 had (or knew they had) asthma. I think that's an important detail. The wording of the study itself,  concerning asthma and allergic diseases, is misleading until you read the whole thing. Two patients had COPD and they both had grim outcomes. Take what you want from that, but, because of the lack of asthma specific information published, I'm thinking either not a lot of asthma patients have gotten it (doubtful considering air quality in some places), or there just hasn't been enough time to compile info. It's hard to be patient since it's very clear that healthcare workers and researchers are likely overwhelmed in the areas hardest hit, but we have to try. Get enough sleep, stay hydrated, eat nutrient rich foods, take supplements, stay active and avoid large crowds. Most importantly, get or keep your asthma under control and wash your hands. 

Thank you again for getting this information for us. Please continue to keep us posted with allergy and asthma specific information.

Absolutely agree with you on this.  That study is not particularly helpful and I’m unclear ho they came to the conclusion they did without the direct study of asthmatics.  It’s hard not to panic.

I just think that N95 masks can be helpful. They found the size of the corona virus and those masks block that size particle and yes it needs a tight seal but that is perfectly possible to teach people what that is. It can help. And high-risk population should know this and have time to irder and waut fir one before it gets widespread. And its possible to make enough for everyone including healthcare workers. And it doesnt need to be mandated fir everyobe, it usnt 100 percent, but it can help...   I feel it is deceptive and inappropriate and lowers trust for the CDC and WHO and surgeon general to tell the public it wont help them. Yes you have to remove it correctly. Yes you have to get the right size and not have a beard probably. Just give us the real facts and information that yes it can be helpful:

"N95 masks fulfill the filtering efficiency criteria of the National Institute for Occupational Safety and Health (NIOSH) and are approved for protection against droplet and airborne transmission of 95% of particles greater than 0.3 microns in size. N95 masks, which must be fit tested, are believed to offer protection against the contact and droplet spread of the coronavirus."

https://www.apsf.org/news-upda...oronavirus-covid-19/

https://www.google.com/amp/s/w...QFKAGwASA%253D#ampf=

https://smartairfilters.com/en...s-n95-surgical-mask/

 

i suffer from seasonal allergies & it’s been bad especially in NYC ... my doctor 🥼 gave me a cortisone shot on the buttocks to i believe reduce my allergies symptoms  & told me i won’t have to do it again till next month... my question is , if the cortisone shot weakens the immune system was it a smart decision to trust my doctor while the corona virus is out & around my state & actually my county ... i can’t imagine why he wouldn’t take that into consideration & discuss it with me before giving me the shot. i work with people everyday & i feel exposed & anxious now that i have this shot & i have to go to work & possibly be exposed to a virus that can be deadly. please i hope anyone can guide me or help me with this.

I have asthma but it is well controlled with medication. My 4 year old son also has mild asthma that is typically aggravated by colds. He is too young for control medications at least based on his pattern of symptoms. He uses a nebulizer when he is sick. We are traveling in a few weeks and I am very concerned about him. I am trying not to be paranoid but, it is hard when so little is known. He is 4 so handwashing is a constant battle. I feel like I should put a mask on him at least on the plane? I don’t know what to think or do at this point. 

Julio Feria posted:

i suffer from seasonal allergies & it’s been bad especially in NYC ... my doctor 🥼 gave me a cortisone shot on the buttocks to i believe reduce my allergies symptoms  & told me i won’t have to do it again till next month... my question is , if the cortisone shot weakens the immune system was it a smart decision to trust my doctor while the corona virus is out & around my state & actually my county ... i can’t imagine why he wouldn’t take that into consideration & discuss it with me before giving me the shot. i work with people everyday & i feel exposed & anxious now that i have this shot & i have to go to work & possibly be exposed to a virus that can be deadly. please i hope anyone can guide me or help me with this.

Usually one shot doesn't do enough to weaken your immune system. The dosage is too small and it's only a one time thing. If you were to get shots frequently and on a regular basis, it would have more of an effect on the strength of your immune system and your doctor would be required to let you know. But in an otherwise healthy individual with only one shot, you should be in the clear. This is just what my doctor told me. I'm no doctor. If you to be super thorough, call your doctors office or health insurance nurse line

Last edited by I Am Curious