With the rapid escalation of the COVID-19 outbreak, we want to acknowledge the many impacts on our network of partners both personally and as stakeholders working to reduce the burden of asthma. We hope you, your families and your colleagues are staying healthy.
First, we want to take a moment to discuss the COVID-19 risk for people with asthma. Are people with asthma at greater risk for becoming severely ill with the virus? The World Health Organization says yes. But, at this point in time, the current body of research—which is growing by the day—is less conclusive. What we know for sure is that people with asthma should take precautions with any respiratory virus. That includes the precautions that everybody should be taking— social distancing, washing hands, avoiding touching the face, etc. It also includes keeping asthma well controlled through following medication regimens and avoiding or reducing exposure to environmental asthma triggers.
Regarding medications, there has been a lot written about the use of oral steroids in recent medical literature on COVID- 19. Oral steroids reduce inflammation. They are prescribed by doctors to reduce inflammation in the lungs, which is present in people with COVID-19. However, oral steroids impair the immune system’s ability to fight the virus and indeed experts say that use of the drug for COVID-19 could cause significant harm. But, oral steroids remain an important tool for people with asthma when their asthma is severely out of control. Doctors agree that, in those cases, it’s still important to use them. This means that it’s more important now than ever to help individuals keep their asthma well controlled by following medical providers’ instructions, including using inhaled corticosteroids to keep inflammation down and reliever medications for asthma exacerbations.
Of course, reducing exposure to environmental asthma triggers is also an important piece of asthma management. A lot of common household cleaners are respiratory irritants. In fact, bleach has been labeled an asthmagen, meaning it can cause asthma in otherwise healthy people. As grocery stores struggle to keep cleaning products on their shelves, we know that the use of cleaning products has increased. We can help increase awareness of the risks among families affected by asthma and help them identify asthma-friendlier alternatives.
We also want to express our concern about the disproportionate impact of the coronavirus on low-income communities and communities of color. Low-income individuals are more likely to live in overcrowding situations (thus increasing risks of spread of disease), more likely to work in service jobs (where they may be more at risk of exposure, less likely to have paid sick leave, and more likely to face reduced hours or lay-offs), and more likely to be uninsured or underinsured (making access to essential care more challenging). Since low-income communities are already at higher risk for asthma, this is particularly concerning. We applaud California’s leadership for already taking steps to address some of these inequities and will continue to work arm-in-arm with our partners to promote health equity.
Lastly, we know that most of us have already been impacted by the COVID-19 outbreak, even if we are currently healthy. Here in Oakland, we are part of a new “shelter in place” order and are all working from home. As we all work to adapt to these new schedules, using new ways to meet virtually, and being flexible in the face of continuously changing information, we remain committed to our mission and our partnerships.