Managing your asthma during COVID-19

The risk of COVID-19 to respiratory health and asthma

COVID-19 is a new, highly infectious respiratory disease caused by the latest outbreak of coronavirus. COVID-19 can impair respiratory tract function (nose, throat and lungs), increasing the risk of asthma attacks, pneumonia and acute respiratory disease^[1]. Out of those who are infected by COVID-19, many experience mild symptoms such as a fever, dry cough and tiredness; some may even be infected and not experience any symptoms^[2]. However, a small proportion of those infected with weaker immune systems due to underlying health conditions or as a result of old age, may develop more significant respiratory difficulties and complications^[3].

Those with asthma are deemed to be at an increased risk of developing more significant respiratory symptoms following COVID-19 infection; in addition to COVID-19 symptoms acting as a trigger for asthma symptoms^[4]. Therefore, it is essential to ensure the continued use of asthma medication to effectively regulate symptoms during the outbreak. Furthermore, additional measures to optimise asthma management should be ensured to help avoid COVID-19 infection; or following infection, minimise the exacerbation of asthma symptoms.

6 important measures to manage your asthma during the outbreak

As outlined by Asthma UK and the NHS, these 6 measures are essential to effective asthma management during the COVID-19 pandemic:

1. Ensure preventer inhaler use as prescribed: Make sure you use your preventer inhaler daily to minimise the risk of coronavirus triggering an asthma attack. Colds and flu are known triggers of asthma, COVID-19 has very similar symptoms and is regarded as a significant asthma trigger.
2. Use reliever inhaler when needed: Have your reliever inhaler (usually blue) close by and use it if you experience a flare up of asthma symptoms. COVID-19 social distancing and isolation measures may significantly change and influence your daily routine and cause unanticipated exposure to other triggers. As we enter Spring, pollen (in addition to hay fever) may pose a significant trigger for asthma, therefore, it is important to ensure allergen triggers are accounted for and well managed.
3. Follow your Asthma Action Plan: Complete and use an Asthma Action Plan to help monitor and recognise asthma symptoms as they develop.
4. Keep A peak flow diary: If you have a peak flow meter, keep a peak flow diary. A peak flow meter is used to quickly and easily assess airflow. It can be an effective method of monitoring asthma symptoms, especially if you think you may have COVID-19 as you can refer to your peak airflow diary when speaking with medical professionals.
5. If you smoke, go smoke free: Smoking decreases respiratory function, which can increase the risk of serious respiratory complications as a result of COVID-19 infection, quitting will help to minimise this risk.
6. If you think you have COVID-19, don’t panic: Follow the NHS advice updates and monitor your asthma and COVID-19 symptoms closely. If you have difficulty breathing or symptoms last longer than 7 days, be sure to seek further advice by calling 111 or if necessary, 999 for emergency care.

Advice for those with severe asthma

The government has also outlined more stringent measures and advice for those deemed extremely vulnerable. If you have ‘severe asthma’ or a severe respiratory condition, it is important to refer to ‘shielding’ guidelines which consist of a series of more strict measures to further minimise interaction and risk of exposure to infection.

These measures consist of:

• Do not leave your house.
• Strictly avoid anyone displaying COVID-19 symptoms.
• Do not attend gatherings. This includes seeing family, friends or visiting special events.
• Do not go out for shopping, leisure or travel. Arrangements should be made for essentials to be left at your door.
• Use remote technology such as a phone, internet and social media to stay connected with those that can help.

For the latest advice on protective measures for the extremely vulnerable, visit the GOV.UK information page here.

Reliever and preventer asthma inhalers

Reliever and preventer inhalers are acknowledged as two effective treatments to treat asthma and reduce the severity and likelihood of asthma attacks.

Reliever inhalers (usually a light blue colour) contain bronchodilators (such as Salbutamol and Turbutaline) to offer immediate relief from asthma symptoms by delivering the medication directly to the lungs to relax the surrounding airways. They are essential at treating symptoms at the onset of an asthma attack; asthma sufferers should keep them close by at all times in the event of developing asthma symptoms^[5]. The delivery mechanisms consist of metered dose inhalers (MDIs), breath actuated inhalers (BAIs) and dry powder inhalers (DPIs). MDI’s involve an aerosol spray that is activated upon breathing in, BAI’s invlove automated medicine spray stimulated when you begin to inhale and DPI’s consist of medicine in power form rather than a spray. The Ventolin Evohaler is a popular, effective metered dose inhaler offering rapid relief from asthma symptoms. Furthermore, a spacer can be used to improve and enhance the delivery of the MDI. The Aerochamber Plus Asthma Spacer is essential at making inhaling the medication easier, more effective and more efficient.

Preventer inhalers can be used alongside reliever inhalers to help reduce the likelihood of an asthma attack. Preventer inhalers (usually a brown colour) aim to prevent the onset of asthma symptoms. They contain steroid medication (such as Beclometasone, Fluticasone and Budesonide) to control airway swelling and inflammation; including reducing the sensitivity to asthma triggers^[6]. Asthma triggers such as colds and flu, pets, dust and pollen can irritate the airways and consequently lead to an asthma attack. Preventer inhalers are usually taken daily and continuously to prevent the triggering effect of prominent asthma triggers, stopping asthma symptoms from developing.

Latest COVID-19 Advice

It’s especially important to follow COVID-19 preventive measures closely to ensure excellent hygiene, sufficient social distancing and if necessary self-isolation, to reduce the risk of COVID-19 exposure, infection and transmission.

The latest advice from the Government outlines that you should stay at home and only leave for essential reasons such as for medical needs, shopping for essentials, exercise and for work (if absolutely essential). Should you leave your home, it is important to keep at least 2m distance between yourself and other people.

In summary

• Aim to implement the 6 advised asthma management measures above if possible.
• Try to implement stringent preventative measures outlined by the Government such as ensuring excellent hygiene, social distancing and self-isolation to minimise the risk of COVID-19 infection and transmission.
• Keep updated with COVID-19 news and updates from a reliable source to remain informed.

Current as of: Tuesday 24th March 2020