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Pandemic defused asthma attacks…

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Pandemic defused asthma attacks…

Studies in USA and other countries, including England, Scotland, and South Korea, also found big drops in asthma attacks.

By Nazarul Islam

My neighbor in Asheville had spent the beginning of the pandemic incredibly worried about her daughter, who has asthma. Five-year-old Tania’s asthma attacks were already landing her in the ER or urgent care every few months. Now a scary new virus was spreading. Everyone looked up at the sky, with prayers on their lips.

Respiratory viruses are known triggers of asthma attacks, and doctors also feared at the time that asthma itself could lead to more severe coronavirus infections. So Tania’s family in North Carolina hunkered down quickly and masked up often to keep her healthy.

The ensuing months, to everyone’s surprise, turned into “this beautiful year,” Tania’s dad told me. She hasn’t had a single asthma attack. Not a single visit to the ER. Nothing – She’s breathing so much better, and all it took was a global pandemic that completely upended normal life.

All around the country, doctors have spent the pandemic wondering why their patients with asthma were suddenly doing so well. Asthma attacks have since plummeted. Pediatric ICUs have sat strangely empty. “We braced ourselves for significant problems for the millions of people living with asthma,” says Tania’s pulmonologist Dr. Sidat who works at the Children’s Hospital. “It was the complete opposite. It’s amazing.” (Fears about people with asthma getting more severe COVID-19 infections haven’t been borne out either.) Studies in other countries, including England, Scotland, and South Korea, also found big drops in hospital and doctor’s-office visits for asthma attacks.

The massive global experiment is that the pandemic is now leading doctors to rethink some long-held assumptions about the disease. Asthma is a chronic condition that occasionally flares up, leading to 3,500 deaths and 1.6 million emergency-room visits a year in the United States. These acute attacks can be triggered by a number of environmental factors: viruses, pollen, mold, dust mites, rodents, cockroaches, pet dander, smoke, air pollution, etc.

Doctors have often scrutinized allergens that patients can control at home, such as pests and secondhand smoke. But patients have stayed at home for a year and suffered dramatically fewer asthma attacks—suggesting bigger roles for other triggers, especially routine cold and flu viruses, which nearly vanished this year with social distancing and masks.

With life in the U.S. snapping back to normal, asthma doctors and patients are facing another new reality.

Masks are going away; schools will be reopening in the fall. The pandemic unexpectedly reduced asthma attacks, and now doctors and patients have to navigate between what they know is possible in extraordinary conditions and what is practical in more ordinary ones.

The most compelling evidence that asthma attacks truly did go down during the pandemic exists because of a stroke of good luck. Back in 2018, Elliot Bloom—the pulmonologist at Brigham and Women’s Hospital, in Boston, began asking Black and Hispanic or Latino adults with asthma to track their attacks at home for a study called PREPARE. (These groups have disproportionate rates of severe asthma, compared with white patients.)

Also Read: Asthma Attacks Plummeted During Pandemic

Elliot intended to compare two different ways of using long-term asthma medication, such as inhaled steroids. His team enrolled its last participant—patient No. 3468 —in March 2020. The COVID-19 shutdowns began a week later.

“We were very lucky,” Israel told me. Because of the study’s timing, his team had plenty of data from before the pandemic.

And because the participants were filling out monthly questionnaires from home, the shutdowns did not affect the data collection.

Meanwhile, the pulmonologist like his colleagues across the country was noticing an eerie lack of non-coronavirus patients. Hospital visits for heart attacks and strokes were also dropping during the pandemic. Were asthma patients just avoiding the hospital because they were afraid of catching the virus? “That was the initial thought: What if these people are suffering at home?” says Charles Brett a pulmonologist at Brigham and Women’s Hospital and a co-author with Israel on the resulting paper about asthma attacks during the pandemic.

The answer became clear as the monthly questionnaires started rolling in. The number of attacks the participants suffered at home really was dropping. It fell by 40 percent after the onset of the pandemic. “We know that this isn’t reluctance to go to the emergency room,” Israel said. “This is a true, real decrease.”

In that case – why? The pulmonologist and his team didn’t see a clear pattern connected to changes in air pollution.

(Research: NW Atlantic/Global Health)

[author title=”Nazarul Islam” image=”https://sindhcourier.com/wp-content/uploads/2021/05/Nazarul-Islam-2.png”]The Bengal-born writer Nazarul Islam is a senior educationist based in USA. He writes for Sindh Courier and the newspapers of Bangladesh, India and America. He is author of a recently published book ‘Chasing Hope’ – a compilation of his 119 articles.[/author]