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Advice for people with Asthma in relation to COVID-19 April 2020

Developed using information from Asthma UK and British Thoracic Society Guidance. Correct as of 13/4/20

How can I keep healthy?

The best way of keeping healthy and recovering well if you get infected with COVID is to keep your asthma as well controlled as possible. This means taking your regular inhaled steroids and other asthma medication as prescribed and detailed in your personal asthma plan (if you have one). Make sure you have a reliever inhaler to hand. It is also important to make sure you have good inhaler technique. There is information about inhaler technique here https://www.asthma.org.uk/advice/inhaler-videos/

Ensure you have a supply of your medications. To avoid a shortage of inhalers all GP practices have been asked to only issue 30days of medications at a time. Please respect this but ensure you call for your next script in a timely way to reduce the chance of you running out.

Please do not share inhalers or spacers with others.

What about smoking?

We know from the information coming through from other countries that being a current smoker is shown to be a significant risk factor for the most severe complications from COVID-19. Please consider stopping smoking and seek help for this if needed to minimise your risk.

Does having asthma affect the risk of COVID 19 infection?

We are still learning about this new virus. Initial information suggested that asthma was not a common feature in those severely affected by COVID. However, viruses in general are common causes of asthma exacerbations and therefore it is very important that those with asthma follow social distancing precautions (and shielding if you have had a shielding letter from NHS England).

Do inhaled corticosteroids lower the immune system and put people at increased risk of COVID-19?

No. There is no evidence that inhaled steroids increase the risk so PLEASE continue taking them (and your other asthma medication) as prescribed.

What about oral steroids?

Oral steroids are not used to treat COVID 19. However, they are still appropriate for an asthma exacerbation and advice on this will be given by your doctor if needed (or via your personalised asthma plan if you have a rescue pack).

If you are on regular continuous oral steroid tablets (such as prednisolone)

  • DO NOT STOP them as stopping suddenly can be harmful
  • Remember that if you become unwell you may need to increase the steroid dose temporarily- contact us for advice

What if my asthma flares or doesn’t feel well controlled?

The treatment of asthma exacerbations is unchanged. Please continue your usual mediations and follow your asthma plan if you have one. If you have symptoms of an asthma exacerbation please contact the surgery for a telephone or video assessment. If you need general advice on your asthma or making an asthma plan please book a telephone appointment with our asthma nurse.

COVID can present with symptoms similar to an asthma attack (such as cough and shortness of breath). However, asthma attacks rarely have the other symptoms of COVID such as fever, tiredness, changes in taste or smell. If you are in doubt contact the surgery for advice (by telephone only) and follow the advice for self-isolation (https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/).

How does COVID affect those with SEVERE asthma?

Some asthmatics will have been identified as needing to follow shielding advice (https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19) . These are generally asthmatics who are on multiple different treatments for their asthma AND also have 4 or more courses of steroids (prednisolone) each year. These patients are usually already under the hospital teams and may be on other therapy. Your hospital team may be in touch with specific advice if needed. Biologic therapy does not seem to suppress the immune system and should be continued.

There is more information at https://www.asthma.org.uk/coronavirus

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