COVID-19, Asthma and Allergies: You’ve Got Questions…
Allergy & Asthma Network compiled a list of questions regarding COVID-19 (novel coronavirus) that people asked during our “Distinguishing the Difference: COVID-19 vs. Allergies vs. Flu” webinar on March 17. The webinar was hosted by Allergy & Asthma Network President and CEO Tonya Winders and board-certified allergist and immunologist Purvi Parikh, MD.
When should a person be tested for COVID-19?
Testing is recommended for people experiencing a fever, severe breathing difficulties, cough and chest tightness – in which case hospitalization may be necessary as well.
Not everyone should be tested. The majority of patients experiencing mild symptoms can assume they have it and recover at home.
What are mild COVID-19 symptoms?
Mild symptoms involve a fever of 100.4 or 100.5 degrees and a cough that is controlled with over-the-counter medications. More severe symptoms involve higher fever, difficulty breathing, chest tightness and an uncontrolled cough.
If you are experiencing difficulty breathing and have bluish lips or face, is this a 911 call or a call to the primary care doctor for COVID-19?
With any severe breathing difficulty, seek emergency care. If you are concerned about a fever or other non-emergency symptoms, call your primary care doctor.
If a child is coughing but has no other COVID-19 symptoms, what should be done?
If there is, in addition to coughing, a fever of 100.4 or higher and difficulty breathing, contact your doctor.
Yes. They are 2 separate viruses.
What is the recommended treatment for COVID-19?
There are no known treatments for COVID-19 at this time. Your doctor will likely evaluate you based upon your severity and symptoms. If symptoms are mild, your doctor may recommend Tylenol as that is the best option at this time to reduce fever. (NSAIDs like Motrin may worsen the virus.) Also, keep drinking fluids. If you experience respiratory problems due to asthma, use your breathing treatments.
Are there any medications being used to treat COVID-19, including those known to cause allergic reactions?
No. There are no specific medications that treat COVID-19 at this time.
What is the effectiveness of antivirals in treating COVID-19?
Antivirals are being studied and there is promising data coming out of China, but it’s too soon to consider antivirals as a treatment. Researchers are also studying the effectiveness of antiretrovirals (used to treat HIV) and anti-inflammatories such as chloroquine.
Should people who are immunocompromised and on biologics stop their medications?
Don’t stop your medications. Discuss any specific concerns with the provider.
If a person has a latex allergy and needs to seek care for COVID-19, are there any special considerations?
As with any time a person with latex allergy interacts with healthcare professionals, let the providers know about the allergy early.
Should allergy patients stop allergy shots?
No. Communicate with your allergist about best practices.
What happens to people after they have COVID-19?
The medical community is still learning about the disease and long-term effects. Some reports have shown that those who experience severe illness may be left with lung scarring, which could lead to long-term lung issues. In people with mild cases, most make a full recovery.
Are there any reports of pregnant women with COVID-19 or data on newborns?
There is no specific data at this time.
How long are people carriers of COVID-19?
It has an incubation period of 15 days, so about 15 days.
Is the 14-day quarantine enough to help ensure a person is clear from the virus?
In general, yes.
Should people be concerned if they recently traveled or have travel plans?
Follow CDC guidelines for COVID-19 and travel recommendations.
Are there any natural or homeopathic remedies to help in the treatment or prevention of COVID-19?
There are no known natural or homeopathic approaches to aid in treatment or prevention of COVID-19.
However, in general, keeping the body healthy to fight off any infections is good practice. And, of course, routine handwashing.
Are there any measures to help boost the immune system?
In general, get quality sleep, exercise, eat a nutritious and well-balanced diet and go outside to expose yourself to sunlight and absorb vitamin D. And, of course, routine handwashing.
What is the recommended cleaning for hard surfaces?
Clorox wipes, soap and water.
Should people be concerned over exposure to COVID-19 from packages, surfaces, drive-through services and deliveries?
There are some reports of fecal-oral transmission, so ensuring that people practice good hand hygiene and use gloves when appropriate is essential. However, keep in mind that any contact creates potential exposure.
COVID-19 can be spread from animals to people and people to animals. Is contact with pets safe?
The World Health Organization has said dogs are safe. That being said, if you are under quarantine with COVID-19, you should limit your contact with all pets and consider having someone else care for the pet while you recover.
Is there a possibility the virus, once its prevalence has been reduced, may come back?
The virus has declined in China, so for now we will have to follow examples from around the world.
What is the status of the COVID-19 vaccine?
It will probably be at least 18 months before a commercial vaccine is available.
How can the public be reassured when there has been such inconsistent messaging?
The public needs to be reassured on the facts – 80% of people who contract the disease recover fully, there are groups that are highly affected such as those who are over 80 or who have high-risk medical conditions. Be sure you’re getting your information from trusted sources.
Why is there such strict social distancing given the relatively few number of cases in the United States?
It’s a concern because there is no vaccine and the strain of virus is unknown. The United States is following the examples from other countries given the deaths of high-risk patients.
Asthma Management Questions
Are people with asthma or COPD at greater risk for COVID-19?
Yes. Those with compromised immune systems, underlying respiratory conditions and heart conditions are at higher risk from complications from COVID-19. If asthma is not well controlled, that is an additional risk. Asthma needs to be as well-controlled as possible.
Thus, it is important to know the symptoms – fever of 100.4 or higher, cough and difficulty breathing. If you are over 65 or you have a known underlying medical condition such as a compromised immune system, heart or lung condition, or you have had recent travel, you should contact your healthcare provider.
Has bronchospasm been reported with COVID-19?
It is known to cause cough, but there are not specific details on bronchospasm.
Should people with mild asthma be as concerned over the virus as those with more severe asthma?
Anyone with underlying respiratory issues is more at risk. However, those with severe asthma already have their routine daily activities more impacted by asthma, so reach out to your doctor if you have to use your albuterol inhaler more frequently or you’re sleeping poorly to discuss getting better control of asthma.
Are people with mild to moderate asthma more at risk to exposure when going outside?
No. Spending time outside and getting vitamin D is good practice as long as people continue to practice social distancing.
Should parents with children living with asthma be concerned about COVID-19?
Yes, anyone with an underlying respiratory condition should be concerned. Fortunately, children seem to respond better and recover faster. Be prepared to contact the provider if the child develops a fever and a cough.
Chest tightness and breathing difficulties due to asthma are common during high pollen season for people with asthma. With COVID-19, what should be considered typical and what isn’t?
Approach all breathing difficulties the same way for COVID-19, asthma, and allergies. If there is difficulty breathing, an inability to catch your breath, severe symptoms, dizziness or lightheadedness, seek medical care immediately.
Should asthma patients on oral corticosteroids continue taking this medication?
Don’t change your asthma treatment plan without a conversation with your doctor. Any concern over treatment should be discussed with your doctor.
If you have been off asthma controller medications for a while, should you go back on those if you’re not experiencing any symptoms of asthma?
If you are not experiencing asthma symptoms, there is no need to restart asthma medications. If you are experiencing symptoms again, reach out to your doctor.
What do asthma patients who use nebulizers for treatment need to know?
It is very important that if you are a patient with COVID-19 or suspected COVID-19 and using a nebulizer at home, keep in mind that the virus may persist in droplets in the air for 1-2 hours. It is best to administer nebulizer medication in a location that minimizes exposure to non-infected members of the household. The location could include outside on a porch or patio or in a garage, where air is not recirculated into the home. It should also be in a location where nearby surfaces can be easy to clean (or may not need cleaning).
Should asthma patients update their Asthma Action Plan based upon COVID-19?
If your asthma remains well controlled and you don’t need albuterol more frequently, you’re sleeping well and not missing work or school, you should not need to update your Asthma Action Plan.
Stress is known to worsen asthma symptoms. What should be done to manage stress in this uncertain time?
Use strategies for stress management – sleep, good nutrition, medication, praying, avoid television. Try to find practical solutions to problems.
Should a person with asthma be concerned over potential shortages of quick-relief or controller medications?
At this time, there are no known shortages, but patients with asthma are encouraged to have a 1-month to 90-day supply on hand.
Does COVID-19 leave people with lung disease or lung scarring?
This is unknown. In most cases, patients recover fully.
If a student at school has a temperature of 99.4 or greater, how do school nurses determine if that student should be tested for COVID-19?
With COVID-19, there is normally a fever of 100.4 or greater. Other signs to watch for that would suggest testing is necessary: known exposure to COVID-19, travel to an affected area, or a household family member who traveled. If those criteria are met, then discuss testing with the parent.
Why are childcare facilities closing?
Many are closing — it depends on the state. CDC is recommending that, if there is minimal or moderate spread of COVID-19 in your community, you should cancel events for groups of 10+ people or hold them virtually in order to slow the spread of the virus. If there is substantial spread of COVID-19 in the community, the event should be canceled. This has provided guidance for schools and childcare facilities.
With the overall health risk to children considered low, what are your thoughts on the recommendation to close all schools?
This is all about “flattening the curve,” which means reducing community spread. This gives the healthcare system the capacity to respond.