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| Asthma Is Absent Among Top Covid-19 Risk Factors, Early Data Shows | Asthma Is Absent Among Top Covid-19 Risk Factors, Early Data Shows |
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| For people with asthma, the outbreak of a pandemic that can lead to respiratory failure has not been a welcome event. Many health organizations have cautioned that asthmatics are most likely at higher risk for severe illness if they get the coronavirus. There’s been a run on inhalers, and coronavirus patients like the actor Idris Elba have openly worried about their asthma. | For people with asthma, the outbreak of a pandemic that can lead to respiratory failure has not been a welcome event. Many health organizations have cautioned that asthmatics are most likely at higher risk for severe illness if they get the coronavirus. There’s been a run on inhalers, and coronavirus patients like the actor Idris Elba have openly worried about their asthma. |
| But this month, when New York State, the epicenter of the outbreak in the United States, began releasing data on the top 10 chronic health problems suffered by people who died from coronavirus, asthma was notably absent from the list. State officials said only about five percent of Covid-19 deaths in New York were of people who were known to also have asthma, a relatively modest amount. | But this month, when New York State, the epicenter of the outbreak in the United States, began releasing data on the top 10 chronic health problems suffered by people who died from coronavirus, asthma was notably absent from the list. State officials said only about five percent of Covid-19 deaths in New York were of people who were known to also have asthma, a relatively modest amount. |
| The research at this early stage is minimal and not always consistent, as one would expect. A recent commentary published in Lancet by a group of European researchers called it “striking” that asthma appeared “to be underrepresented in the comorbidities reported for patients with Covid-19” — comorbidity being the term for a secondary health problem. A small study of 24 critically ill patients in Washington State noted that three had asthma. | The research at this early stage is minimal and not always consistent, as one would expect. A recent commentary published in Lancet by a group of European researchers called it “striking” that asthma appeared “to be underrepresented in the comorbidities reported for patients with Covid-19” — comorbidity being the term for a secondary health problem. A small study of 24 critically ill patients in Washington State noted that three had asthma. |
| “We’re not seeing a lot of patients with asthma,” said Dr. Bushra Mina, a pulmonary and critical care physician at Lenox Hill Hospital in New York City, which has treated more than 800 Covid cases. The more common risk factors, he added, are “morbid obesity, diabetes and chronic heart disease.” | “We’re not seeing a lot of patients with asthma,” said Dr. Bushra Mina, a pulmonary and critical care physician at Lenox Hill Hospital in New York City, which has treated more than 800 Covid cases. The more common risk factors, he added, are “morbid obesity, diabetes and chronic heart disease.” |
| The top Covid-19 comorbidities listed by New York, in order, are hypertension, diabetes, high cholesterol, coronary artery disease, dementia and atrial fibrillation, a heart condition. Chronic obstructive pulmonary disease, another respiratory ailment, but one with an older demographic than asthma, ranks seventh. Renal disease, cancer and congestive heart failure round out the list. | The top Covid-19 comorbidities listed by New York, in order, are hypertension, diabetes, high cholesterol, coronary artery disease, dementia and atrial fibrillation, a heart condition. Chronic obstructive pulmonary disease, another respiratory ailment, but one with an older demographic than asthma, ranks seventh. Renal disease, cancer and congestive heart failure round out the list. |
| Nearly eight percent of the U.S. population — close to 25 million people — has asthma, according to the Centers for Disease Control and Prevention. It is a lung disease that causes the airways to constrict and can make breathing hard work as the body fights for enough oxygen. Symptoms include wheezing and coughing. | Nearly eight percent of the U.S. population — close to 25 million people — has asthma, according to the Centers for Disease Control and Prevention. It is a lung disease that causes the airways to constrict and can make breathing hard work as the body fights for enough oxygen. Symptoms include wheezing and coughing. |
| One thing doctors agree on is that people with asthma should be taking long acting medications like steroids that keep their symptoms in check, because having your asthma under control is better than battling asthma and a virus simultaneously. | One thing doctors agree on is that people with asthma should be taking long acting medications like steroids that keep their symptoms in check, because having your asthma under control is better than battling asthma and a virus simultaneously. |
| Health experts have generally seen little to no evidence that asthma increases the risk of developing Covid-19, but the question has been whether it causes worse outcomes for those who do have it. | Health experts have generally seen little to no evidence that asthma increases the risk of developing Covid-19, but the question has been whether it causes worse outcomes for those who do have it. |
| “If you have mild or moderate disease, you’re probably not going to behave much differently than someone who doesn’t have asthma, particularly if you’re a younger person,” said Dr. David Hill, a board member of the American Lung Association. But he added that those with more severe cases “may get more severity of the disease.” | “If you have mild or moderate disease, you’re probably not going to behave much differently than someone who doesn’t have asthma, particularly if you’re a younger person,” said Dr. David Hill, a board member of the American Lung Association. But he added that those with more severe cases “may get more severity of the disease.” |
| Dr. Linda Rogers, a specialist in pulmonary medicine at the Mt. Sinai Health system, which is on the front line of Covid treatment, said one would assume that patients with underlying lung diseases would be “at risk of worse outcomes.” But she said that “asthma is underrepresented” in patients that are sick enough to seek treatment. | Dr. Linda Rogers, a specialist in pulmonary medicine at the Mt. Sinai Health system, which is on the front line of Covid treatment, said one would assume that patients with underlying lung diseases would be “at risk of worse outcomes.” But she said that “asthma is underrepresented” in patients that are sick enough to seek treatment. |
| Her practice focuses on people with more serious cases of asthma, but she has been able to successfully manage many of her asthma patients through telemedicine. “These are patients who, just based on their asthma alone, are on steroids all the time. I’m just surprised some of them haven’t done worse.” | Her practice focuses on people with more serious cases of asthma, but she has been able to successfully manage many of her asthma patients through telemedicine. “These are patients who, just based on their asthma alone, are on steroids all the time. I’m just surprised some of them haven’t done worse.” |
| Updated June 22, 2020 | Updated June 22, 2020 |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| Still, the data analysis on the effects of asthma is in its infancy, and health experts cited an existing body of research that shows the flu and milder coronaviruses exacerbate asthma as worrisome indicators for those with Covid-19. Dr. Rogers said that she did not want to exclude asthma “as a potential problem as it is well known that viral infections are the No. 1 cause of asthma flares in both children and adults under normal conditions.” | |
| Dr. J. Allen Meadows, president of the American College of Allergy, Asthma and Immunology, said much the same: “Since common coronaviruses in the United States, and influenza, trigger asthma flares in well controlled patients, we might expect Covid-19 to be similar.” | |
| One doctor who has studied viruses extensively is Young J. Juhn, a clinical epidemiologist, and professor of pediatrics and medicine at the Mayo Clinic, whose laboratory research has examined the impact of asthma on the risk of infectious and inflammatory diseases. | One doctor who has studied viruses extensively is Young J. Juhn, a clinical epidemiologist, and professor of pediatrics and medicine at the Mayo Clinic, whose laboratory research has examined the impact of asthma on the risk of infectious and inflammatory diseases. |
| Dr. Juhn said the data would have to be studied and weighted in more detail, but added that, in his view, asthma put people at greater risk of poor outcomes, and potentially even more susceptible to infection, though there was limited data on the latter point. He noted that asthma disproportionately affects lower-income people who have less access to Covid testing and care. | Dr. Juhn said the data would have to be studied and weighted in more detail, but added that, in his view, asthma put people at greater risk of poor outcomes, and potentially even more susceptible to infection, though there was limited data on the latter point. He noted that asthma disproportionately affects lower-income people who have less access to Covid testing and care. |
| “It may be still fair to say that the emerging data support the current guidelines considering asthma as a high-risk condition,” he cautioned, adding that “we need more definite data.” | “It may be still fair to say that the emerging data support the current guidelines considering asthma as a high-risk condition,” he cautioned, adding that “we need more definite data.” |