Unlock 1: Pulmonologist shares important tips for those suffering from respiratory conditions

With the lockdown finally easing and Unlock 1.0 making its way, it is extremely crucial to ensure that all precautions are taken prioritizing safety. As COVID-19 hits the respiratory organs the hardest, it is essential to practice good breathing techniques. India accounts for 42% of all global asthma deaths making it the asthma capital of the world. Chronic respiratory conditions account for a massive health burden in India. In India, around 93 million people suffer from chronic respiratory issues; out of this, around 37 million are Asthmatics. 

In view of the effect of respiratory viruses on asthma, it is of paramount importance that Asthmatics take utmost care in the current times. In order to completely stop/prevent virus-induced exacerbations from occurring, good asthma management would be critical to implement. Respiratory viral infections are the primary cause of asthma exacerbations. For patients at risk of asthma, or with existing asthma, viral respiratory tract infections can have a profound effect on the expression of disease or loss of control. It is important to know that currently there is no evidence of increased infection rates in those with asthma. 

However, there is an estimation, which states that patients with moderate-severe asthma could be at greater risk for more severe disease, but there are no published data to support this.

Below are some of the important tips recommended:

Patients with asthma should never stop taking their corticosteroid inhaler unless asked to do so by a medical professional. Stopping the steroid inhaler could put the patient at a higher risk of complications with infections as it would impair asthma control. 

People with asthma are placed on steroid inhalers to keep their asthma under control. In the current pandemic, the best thing a person with asthma can do (with respect to asthma) is to get and keep their asthma under control. 

Stopping a steroid inhaler will put the person at risk for developing an asthma exacerbation. 

In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, where the individual has a much higher risk of being exposed to someone with an infection. So, in a way, by continuing to keep asthma under control, the person with asthma is actually reducing their chance of exposure to viral infections.

Inhalers should never be shared with others. Wash the inhalation devices regularly to keep them hygienic and clean.

It is recommended to use an MDI with a Spacer to relieve acute symptoms. The use of Nebulisers should be avoided as they carry a high risk of transmitting viral infections because they generate aerosols that can spread infectious droplets for several meters. 

Though asthma is associated is with cough and breathlessness, fever is unusual. In such a situation asthmatic, must immediately consult the doctor and follow all instructions given.

Guidelines for people who are at very high risk in the current situation because they have a severe respiratory condition, including severe asthma and COPD. 
 
People with moderate to severe asthma may be at higher risk of getting very sick from viral infection.  These infections can affect your respiratory tract (nose, throat, lungs), cause an asthma attack, and possibly lead to pneumonia and acute respiratory disease.

 Keep your asthma under control by following your asthma action plan.

Continue your current medications, including any inhalers with steroids in them (“steroids” is another word for corticosteroids).

Don’t stop any medications or change your asthma treatment plan without talking to your healthcare provider.

Discuss any concerns about your treatment with your healthcare provider.

Talk to your healthcare provider, insurer, and pharmacist about creating an emergency supply of prescription medications, such as asthma inhalers. Make sure that you have 30 days of non-prescription medications and supplies on hand too in case you need to stay home for a long time.

Avoid your asthma triggers.

As more cases of viral infection are discovered and our communities take action to combat the spread of disease, it is natural for some people to feel concerned or stressed. Strong emotions can trigger an asthma attack. Take steps to help yourself cope with stress and anxiety.

Besides these, 
Take everyday precautions to keep space between yourself and others.

When you go out in public, keep away from others who are sick.

Clean your hands often by washing with soap and water or using an alcohol-based hand sanitizer.

Avoid crowds and people who are sick.
 
Why and how inhalation therapy is a better way to control asthma even during the current situation? 

It is important to continue taking your controller medications and do not stop them. In the current situation, the best thing a person with asthma can do is to get and keep their asthma under control. Stopping a controller medication will put the person at risk for developing an asthma exacerbation—especially as we enter the spring allergy season. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care, where the individual has a much higher risk of being exposed to infections. So, in a way, by continuing to keep asthma under control, the person with asthma is actually reducing their chance of exposure to infectious viral.

By Dr. C Vijay Kumar, Pulmonologist, Apollo Hospitals, Jublihills, Hyderabad. 

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