Nearly 440,000 adults in Maryland have an underlying health condition that places them at risk for complications from COVID-19, if they were diagnosed with the disease.
Asthma, a respiratory disease that causes the airways in the lungs to constrict or swell, making breathing difficult, is just one of the underlying conditions that can make a person’s COVID-19 prognosis worse. Recent figures on how many children with asthma are in Maryland were not available.
Asthma puts people at risk for lung complications from and complications of COVID-19, a disease caused by a new coronavirus that has infected nearly 350 Marylanders and killed four, said Dr. Barbara Brookmyer, Frederick County health officer.
But before the emergence of COVID-19, the Frederick County Health Department had already focused on raising awareness, Brookmyer said. That is because a fair number of people who have asthma do not have it well-controlled.
On top of that, the weather is warming up, and allergens are coming out, causing some who have asthma due to allergies to have worse lung health, she said.
People might be caught off guard by allergies, as warm weather has come earlier than expected. And others might wait to take care of their lungs until they are wheezing or having trouble, she said.
“That makes us particularly concerned now, because we would like everybody who has asthma to ... have that asthma as well as controlled as possible before they ever become exposed to the coronavirus,” Brookmyer said.
Having asthma does not make people more at risk of getting COVID-19, said Dr. Bobby Mahajan, volunteer spokesman for the American Lung Association. But if a person were to become ill, they could have more complications.
“So what we tell people is again, keep your social distancing,” said Mahajan, medical director of the Inova Interventional Pulmonology and Complex Airways Disease Program at Inova Fairfax Hospital. “Take your medications and, frankly, do your best to flatten the curve and decrease the incidence of infections to overwhelm the hospital systems.”
He recommended those with asthma make action plans, something they should do in general and not just because of COVID-19. But the plan can help if the person is unable to talk due to bad asthma.
In addition, people should work on better controlling their asthma, Brookmyer said. Many people accept their symptoms without contacting a doctor for help.
And a person should not wait until they cannot say three words without taking a breath before seeking emergency help, she said. That could be too late.
Brookmyer suggested people use the rule of twos to assess their lung health. That includes questions like if the person has to use a rescue inhaler more than two times a week, if they wake themselves up coughing twice a month or if they have to refill their rescue inhaler more than twice a year.
If a person answers yes to those questions, it suggests their asthma is not well-controlled and they should seek medical help, Brookmyer said.
One of the problems that have come up with asthma is how to treat it if someone is having a flareup with COVID-19. Early research suggests that steroids could exacerbate COVID-19 symptoms, Brookmyer said.
But in most cases, that has been intravenous steroids delivered at a much higher magnitude than typical asthma care, as this is done in an intensive care setting, she said. For now, those who take inhaled corticosteroids, such as fluticasone and mometasone, should continue to do so.
But people who are on inhaled steroids or ones like prednisone can become more immunocompromised, Mahajan said. They should take the same precautions, such as avoiding groups of people and washing their hands.
Asthma can make it more difficult to tell if a person is having symptoms of COVID-19 or asthma, but Brookmyer pointed to the symptom of a fever as one way to differentiate. She also acknowledged that it is complicated because not all cases have a fever.
However, regardless of whether a person suspects they have COVID-19, if they are having trouble breathing, they should contact their doctor, she said.