We want to support all of our patients during this uncertain time of COVID-19. Amongst other precautions like offering telehealth options, flexible scheduling and increased office safety protocols, we are also doing our part to ensure people are as educated as possible about the virus.
In this Q&A, Stephanie Hesier APRN-C answers common questions about COVID-19, including risk factors and treatment protocol for asthmatic patients, prevention of the virus, and what to do if you think you’re infected.
Am I more at risk of getting COVID-19 if I have asthma?
People with asthma and other lung diseases are not more at risk of contracting the virus. However, they are at a higher risk having complications from COVID-19. Populations most at risk for complications are those with moderate to severe asthma, particularly those with uncontrolled asthma. If your spirometry results indicate an FEV1 of 70% or less, you are at a greater risk. Also, if you have stopped your daily maintenance inhaler, gone to the Emergency Department, or have needed to see your doctor to treat an asthma flare in the last 2 years, you are more at risk.
Should I stop taking my daily inhaled steroids?
No, uncontrolled asthmatics are more at risk for a poor outcome than controlled asthmatics. You should continue using your daily inhaler to keep your asthma under control and protect you. Stopping your inhaled steroid makes you more vulnerable. There is no evidence suggesting inhaled steroid use decreases your immune system.
Are there any medications that will help avoid getting COVID-19 or treat the COVID-19?
At this point there is no preventive medication or therapy to protect you from the COVID-19, or treatment to stop the disease if you do become ill. There has been talk about Plaquenil (hydroxyquinolone) and Z-Pack (Azithromycin) but this has been shown to not be helpful, so no benefit at all. Supportive care is the only treatment, this means Ibuprofen or aspirin to reduce the fever, fluids to avoid dehydration, albuterol if you have asthma and in worse cases hospitalization. So, if you can stay at home this is the best for everyone, but control the fever, cough and assure good hydration. The only prevention that is proven to help is social isolation, hand washing and cleaning surfaces.
Should I wear a mask in public?
If you have symptoms of a cold, such as a coughing, sneezing, runny nose, aches, fever, chills, or shortness of breath, you should ideally stay at home. If you have a mask, there is no harm in wearing it, as it can possibly help protect you. Just do not go in search of a mask. If you do have a mask, this does not mean that you can stop social distancing. As masks should be reserved for those who work in healthcare.
How should I prepare for COVID-19?
Follow the CDC recommendations, which include the following:
- Keeping at least 6 feet of space between yourself and others
- Avoid crowds and any non-essential travel
- Stay home as much as possible
Essentially act as though you have the virus, which puts you in the mindset to you keep your distance from others. Clean and disinfect frequently touched surfaces like tables, doorknobs, handles, toilets, sink faucets.
Follow your Asthma Action Plan
If you were recommended to use a daily inhaler, KEEP using it. Know how to use your inhaler properly. The biggest trigger of asthma is a virus of any kind. So, if your asthma flares you would use your albuterol inhaler or nebulizer and if you need more than 4 doses in a 24-hour period we recommend considering the use of prednisone. That said, make sure you have your prednisone and albuterol at home. If you are running low on inhalers or medications, please call us so we can get a refill for you.
Can I use oral steroids?
The use of oral steroids is dependent on the type of symptoms you might have. It is safe to use oral steroids, prednisone if needed. It is important to keep your asthma under control and especially control any asthma exacerbation as quickly as possible. Follow your asthma action plan if needed.
What If I am on a biologic?
Biologics that we prescribe for our asthma, atopic dermatitis, urticaria and migraine patients, are completely safe and do not decrease or suppress the immune system. The Xolair, Fasenra, Cinqair, Nucala, Dupixent, Ajovy, Aimovig, Emgality are safe and should not be stopped.
Bullying in the workplace:
We have had discussions with patients complaining of bullying or feeling uncomfortable while at work. These individuals have had a cough or the sniffles and are being accused of having the COVID-19. We recommend that individuals that do have any symptoms stay at home for at least a 14-day quarantine period. But individuals that have coughing due to reflux, or individuals with allergies are not ill and should be fine at work. But due to the paranoia They have been pressured to stay at home or stay away. If you have this problem or are uncertain of your symptoms, please contact our office by phone or email.
What should I do if my college-aged child wants to hang out with their friends?
We have some families who quarantine with their children. Many older children are back from college and are either staying isolated with the rest of the family, or they are wanting to visit their friends or go out. We recommend that the child stay home, but if they are going out then consider setting up a living space away from the rest of the family, with a separate bathroom, television, computer area and very important they are not allowed to enter the kitchen, no hugging and maintain social isolation from at least 6 feet away.
If you are infected with COVID-19
Nebulizing machines can aerosolize the virus, allowing the virus to persist in droplets in the air for 1-2 hours. Thus, you should use the nebulized albuterol in a location away from family members. Experts suggest areas in the home such as porch, patio, or garage. Essentially, any area that is easily cleaned or may not need cleaning. You can still use your pump inhaler without concern.
If you are infected, please remain quarantined in your house. However, if you are having worsening for symptoms please contact us or the COVID hotline.
Centers for Disease Control and Prevention. (2020). Risk of severe illness from COVID-19. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/asthma.html
Moore, A. (2020). COVID-19 and asthma: What patients need to know. Retrieved from https://www.aaaai.org/conditions-and-treatments/library/asthma-library/covid-asthma