Helping Children Manage Asthma in the Era of COVID-19

Mother helping child use nebulizer

For parents of children with asthma, 2020 was a stressful year. Asthma can be a scary diagnosis to begin with, and to add on COVID-19 — a devastating respiratory virus that turned into a global pandemic — well, that didn’t exactly help matters. But many parents of children with asthma may have seen fewer serious flare-ups with their child’s asthma during 2020.

A Positive Trend

Despite all the devastating news that came out of the COVID-19 pandemic, there were some positives as well. Data from last year shows that children had fewer serious asthma attacks that required an ER visit. The data also showed a drastic reduction in the flu and respiratory syncytial virus (RSV).

Looking at all the Possibilities

There are many theories about the reduction in severe asthma attacks among children. One is that children are getting protection from masks. The masks provide protection from all respiratory viruses, which in turn, help prevent asthma attacks. Social distancing also helps reduce exposure to viruses of all sorts. There are also many additional theories including less air pollution, reduced travel, less stress due to slower daily schedules, fewer exposures to school toxins/triggers, and fewer sports/exercise-induced triggers. It may also be that there is more of an infectious component to asthma than previously thought.

Whatever the reason, experts are looking into how to maintain this positive downward trend. There is some concern that as COVID-19 levels improve, other viruses will come back and the number of severe asthma attacks will increase.

Graphic: Three steps to help manage your child’s asthma: • Understand asthma triggers • Continue mask-wearing • Continue daily controller medication, regardless of symptoms

Managing Asthma Triggers

With more time spent at home this past year, the concern of asthma triggers shifted from the school environment to the child’s home environment. Although there are many asthma triggers in schools, there are also an equal number of asthma triggers at home, including pets, seasonal pollen, animal dander, cigarette smoke, cleaning products, air pollution, mold, pests (such as mice and cockroaches), and dust mites.

There are ways to help reduce your child’s asthma triggers at home. An air filter is a simple and cost-effective way to reduce environmental triggers and improve the air your child breathes. Home repairs and pest control can also help reduce your child’s asthma triggers. If you need help making repairs, there are programs in Philadelphia, for example, Rebuilding Together Philadelphia and Habitat for Humanity, that may be able to help.

Now that more schools have re-opened, it is important to keep up with maintenance medications, continue mask-wearing, and practice good hand hygiene.

Return to School

As children return to school, and they spend more time outside in the spring, they should be aware of their triggers and asthma action plan. Caregivers, friends, and family should also know the child’s triggers and action plan. Of course, the child’s school/school nurse should have a copy of the child’s asthma action plan on file as well.

Your child should also have their rescue medication and inhaler with them in case of an emergency. Families and their children should familiarize themselves with the correct way to use an inhaler including how to use a spacer for medications that require it.

Health Maintenance and Preventive Medicine

One of the most important aspects of managing asthma is regular, everyday control of the condition. Making sure your child/teen takes their everyday controller medication — even if they don’t have symptoms — is critical. One known barrier to asthma control is that people don’t take their control medications if they don’t have symptoms. Those with asthma should keep up with their prescribed controller medications regardless of symptoms. Children should also still be seeing their pediatrician/specialist for regular asthma check-ups.

There are ways to help your child/teen stay on track with their asthma action plan. Mail-order pharmacies allow you to easily order prescriptions ahead of time so that you can have a three-month supply on hand.

Resources

There are numerous resources available for families of children with asthma:

  • The Children’s Hospital of Philadelphia’s Community Asthma Prevention Program offers free asthma education in schools, churches, and community centers throughout Philadelphia. They may also offer asthma prevention home visits for eligible children.
  • As part of the Independence Blue Cross Asthma Case Management Program, members can call 1-833-444-6428 and connect directly with a pediatric nurse Health Coach who can help them manage their child’s asthma. The Health Coach can provide support and education, collaborate directly with a child’s pediatrician/specialist, and point members to additional resources.
  • The National Institutes of Health recently released new guidelines intended to help manage and treat asthma. Check with your child’s doctor to see if the new guidelines impact your child’s asthma action plan.
  • The American Lung Association has an online library of asthma education videos, articles, and other resources available for those with asthma.

Looking Ahead

As the COVID-19 pandemic continues, it’s important to be educated about the impact of COVID-19 on those with asthma. As the vaccine becomes more widely available, those with asthma should get the COVID-19 vaccine as soon as they become eligible. Although children under the age of 12 aren’t yet eligible for a COVID-19 vaccine, trials are underway. Until then, children and their families should continue wearing masks and practicing social distancing.

The Importance of Mask-wearing

It is a myth that masks exacerbate asthma. Masks are safe to wear for those with asthma, and they are safe for children with asthma (over age 2). Children with asthma should wear a mask.

The Asthma and Allergy Foundation of America will provide masks for free for those with allergies and asthma.

Stephen Higgins MD, FAAP

About Stephen Higgins MD, FAAP

Dr Higgins graduated from Hahnemann Medical School (now Drexel University College of Medicine) in 1989 and went on to train as a Pediatrician and Neonatologist at DuPont Hospital for Children/Thomas Jefferson University Hospital. He spent most of his career as a Neonatologist at Crozer Chester Medical Center where he worked clinically in neonatal intensive care. He was actively involved in medical education rising to the level of Associate Dean at Crozer for Temple Medical School and more recently as the Associate Dean for Drexel’s Clinical Campus at Crozer. In addition to his role as Associate Dean, was the Chief Academic Officer and Pediatric Residency Director at Crozer before joining the Independence Blue Cross family in April of 2019.

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