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Asthma and Allergy: Protecting Yourself During COVID-19

It’s allergy season again, and this year some experts are predicting the worst seasonal allergy conditions in years. To add more stress, the coronavirus pandemic is upon us – and sometimes it’s hard to know if your symptoms are allergies, asthma, or COVID-19. 

People living with allergies and asthma need answers during this uncertain time. To provide some guidance, MedicAlert teamed up with the Asthma and Allergy Foundation of America (AAFA) for our LIVE Healthy Hour chat. Kenny Mendez, AAFA’s President and CEO talked about asthma, allergies, and staying safe and healthy during COVID-19. Kenny also answered some of your most pressing questions.

MedicAlert Foundation and AAFA recently launched a new partnership to help raise awareness of asthma and allergies, and provide people living with asthma and allergies tools for a better life. MedicAlert is thrilled to kick off the partnership during National Asthma and Allergy Awareness Month.

The highlights of our discussion (lightly edited for print), and links to resources that Kenny shared are below. You can also watch a full replay of the event.

Q. Does having asthma make me more susceptible to COVID-19? What precautions should I be taking?

There’s no data out there now that says people with asthma are more likely to contract COVID-19, or that using an inhaler puts you at risk. However, asthma can be a risk factor for possible complications if you do contract the virus.

The most important thing you can do is to make sure your asthma is controlled, for several reasons. First, you want to avoid an ER visit right now if possible. Second, controlling your asthma will keep you in better health overall.

People are sometimes concerned about steroids and the use of asthma inhalers. There’s no data out now that indicates a risk with respect to use of inhalers. What we’ve been encouraging folks to do is to stay compliant with your medication.

To reduce your risk, you should keep taking your asthma medication as prescribed, and practice the commonsense things – social distancing, washing your hands, and staying home as much as possible.

We also recommend you have an asthma action plan. We have one on the AAFA website. It talks about how to deal with your asthma based on your symptoms, and what you ought to do if you feel an asthma attack coming on, or if you’re struggling with your asthma.

AAFA has a blog that we update on a regular basis - Coronavirus: What People With Asthma Need to Know. The head of our medical scientific counsel, Dr. Mitch Grayson, has also written some things about complying with medication and other questions.

Wearing a MedicAlert ID is another way to protect yourself – if you do have an emergency, having the ID will let people know that you have a condition that needs treatment. And since MedicAlert keeps your health profile on records, they can relay it to first responders in an emergency situation.

Q. How much does having moderate to severe seasonal allergies increase the risk of complications with COVID-19?

Today there’s no data out there that says seasonal allergies increase the risk of complications. Again, it’s too new right now. But to the extent that you have seasonal allergies and that’s a trigger for your asthma, then that’s possibly an issue.

It’s the height of pollen season right now, and that can be a real trigger for those with allergic asthma. That’s why it’s so important to keep taking your asthma medications. Talk to your doctor if you’re struggling with allergies. There are steroid nasal sprays that work for your allergies to help reduce the symptoms. You want to check he weather report for pollen counts, and stay indoors as much as possible. Keeping your allergies and asthma under control is your top priority, especially in this environment.

Q. If I have taken the pneumonia vaccine, will that help prevent COVID-19?

I’m glad someone asked this because the answer is no. I want to make sure everyone realizes that the pneumonia vaccine protects against bacterial pneumonia. So that's something to remember, it protects you from streptococcus pneumonia. It's not going to protect you against the pneumonia that comes from COVID-19 cases. However, anything you can do to prevent yourself from getting pneumonia will help keep you out of the hospital, stay safe and not be exposed to the coronavirus.

Every year as we get close to flu season, we've said to get a flu shot to make sure that you don't end up with the flu because that is a real trigger for complications if you have asthma, and could result in pneumonia.

Q. How do I know if my symptoms are allergies, asthma or COVID-19?

This is a question we get asked a lot. Our team put together a really good visual to help with this - it shows you the various differences between having COVID-19, having a cold, having the flu, or having seasonal allergies. We've been updating it because the CDC just came out with recent guidelines and new coronavirus symptoms. So we try and define them here, and we update them on a regular basis. But there are many symptoms that overlap between COVID-19, a cold, the flu, and seasonal allergies.

Fever, dry cough, and shortness of breath are all the most common symptoms of COVID-19. Sneezing and a runny nose or stuffy nose are more common for a cold or seasonal allergies. But if you have any symptoms, you really need to talk to your doctor. And again, if you're struggling with your asthma or your breathing, make sure you comply with your asthma action plan, keep up with your medications, and make sure that you stay out of the emergency room.

Q. I can’t get my regular allergy shots and my asthma has been terrible – what can I do?

Again, it’s really important to have your asthma action plan. You want to follow the yellow zone instructions, and make sure to call your doctor to let them know that you're struggling with your asthma. They might be able to adjust your asthma and allergy medication to help you keep it under control. Also try and avoid triggers as much as possible. If you have pollen allergies, try and stay indoors. Watch the pollen counts. The other thing that we have on our website are some tips for improving your indoor air quality. We look at various products out there and certify them using a scientific standard to say that they're asthma and allergy friendly.

Q. Do any over the counter allergy medications compromise your immune system or make you more susceptible to coronavirus?

This is the kind of thing that we want to make sure people understand - those medications do not suppress your immune system. There could be rumors out there, but what we're trying to communicate is that OTC allergy medications and antihistamines do not suppress your immune system. There's no data that shows that using them increases your chances of getting COVID-19 or any other virus or bacterial infection.

Q. Is there any data on patients with asthma who have contracted COVID-19? Does having asthma increase the fatality rate?

This is a question that we've been struggling with and trying to keep monitoring because the pandemic and the data we're getting when people with asthma have contracted COVID-19 is still in its early stages. So there's not a lot of great data out there, and there's some conflicting data. There have been some early reports out of Wuhan, Europe and New York that indicates that while asthma may increase your risk of complications or severe illness, it may not be as high of a risk factor as obesity, high blood pressure, heart disease, diabetes, kidney failure, liver disease and some of the other secondary health problems. Again, the important thing is to not let up on your medications and to follow your asthma action plan. You must keep your asthma under control. Doctors have pointed out that having asthma under control is better than struggling to manage it along with the virus at the same time. As for the question on fatality rates - we’re unclear about that right now. We still need more data.

Q. Why is there a run on asthma inhalers?

AAFA has been spending a lot of time on this. We’re talking to the manufacturers of the medication, talking to the pharmacies, talking to the health insurance plans. What's happened is that this is demand driven. There are two things that just recently happened with the CARES Act that was passed by Congress. First, the government allowed you to fulfill 90-day prescriptions without prior authorization. That was to avoid you having to go into the pharmacy directly. So there's increased demand there because people want to get their medications up front.

The other wrinkle that's going on is that one of the treatments in the standard of care for asthma and other respiratory issues is to use a nebulizer with albuterol. And albuterol is what's in some inhalers, which is a rescue medication. It’s sometimes administered through a nebulizer that creates a mist in aerosol where you can inhale it.

But in using that nebulizer, as you inhale it and exhale it, it could spread the virus. So the recommendation was changed and there's been an increase in demand for the albuterol canisters. They've recommended not using nebulizers in a hospital or clinical situation, and instead use the inhalers that contain the albuterol to limit possible spread of the virus.

What we've tried to communicate is that it’s important is keep a 30-day supply on hand, but don't stockpile. Because that doesn't do anyone any good. We're trying to keep listening to the public too. We sent a survey out just to hear whether there are shortages. There might be some spot shortages that we've heard around the country. But what what's really driving the run or some of the shortage rumors on asthma inhalers is this change in treatment protocol, combined with folks trying to fill their 90-day prescriptions.

AAFA has a good article on possible albuterol shortages, so I would read that to learn more. There’s also a new generic of the Proventil albuterol inhaler that was just approved by the FDA.

Q. If my kid with allergies has an anaphylactic reaction, should I take him to the emergency room?

So this is something that’s changed a little bit with COVID-19. If your child has a severe allergic reaction, anaphylactic, it’s important that you’re carrying the epinephrine auto injectors. You should use that epinephrine immediately and call your doctor. In the past the standard of care was to use the epinephrine and then go to the emergency room. The change in practice now under COVID-19 is to use the auto injector immediately, and call the doctor right away. If the symptoms don't improve, use the second dose of epinephrine. For anyone who has anaphylaxis, you should always carry two auto-injectors. Just in case the first one doesn't work.

If the symptoms don’t improve, you want to give the second dose. And if that person needs emergency medical attention, definitely call 911. It's important not to avoid emergency care because of COVID-19 fears. But in this case, the slight nuance here is to call your doctor right away if you're having to administer epinephrine, and then they can they can work with you. For example, one of the doctors on our board said he had a patient who had anaphylaxis. The caregiver gave the child the medication and the doctor agreed to stay on the line through the phone and through face time video to observe the child for 30 minutes to make sure he was okay.

Q. What other resources does AAFA offer for people with asthma and allergies?

One of the best things that AAFA has is an online community. It's completely free. You log in and there's a support network there. There are people who are experiencing what you're feeling, or you can ask questions of them and they'll answer.

We've also got self-paced online learning courses. AAFA has a partnership with the CDC where we've developed this online curriculum. There are courses on asthma care for adults and managing your child's food allergies, among others.

Through Kids with Food Allergies, we have an online recipe database called Safe Eats that's tested and populated by our community. You can search for recipes that are free of specific allergens.

MedicAlert Foundation thanks Kenny and AAFA for helping our members better live with asthma and allergies right now. For more resources on managing through the COVID-19 crisis, visit MedicAlert’s Coronavirus Resource Center. There you’ll find information from trusted sources on what COVID-19 means for those living with specific medical conditions. There are also resources for staying sane and healthy during this unprecedented time.