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Allergies and the Covid-19 pandemic

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Asthma is one of the most common chronic diseases affecting children in South Africa.
Asthma is one of the most common chronic diseases affecting children in South Africa.

The Coronavirus pandemic is a time of anxiety for most people, particularly those with existing health concerns.

Millions of South Africans live with long-term conditions, including coeliac disease and allergic disorders such as eczema (atopic dermatitis), hay fever (allergic rhinitis) and asthma, one of the most common chronic diseases affecting children.

This year’s World Allergy Week campaign, commemorated from Sunday 28 June to Saturday4 July, focuses on Covid-19 and allergies. According to Professor Michael Levin, head of allergy at Red Cross War Memorial Children’s Hospital and CEO of Allergy Foundation South Africa (Afsa), there is potentially harmful misinformation around Coronavirus and allergies circulating.

“Patients are unsure about symptoms and whether their allergies increase the risk of serious Covid-19 complications. We want to reassure people and enable them to manage their allergies as well as possible during this time. To do this, we’re providing factual, up-to-date resources and support for allergy patients and caregivers, thanks to the generous support of Sanofi,” he says.

Levin stresses that people with allergies and asthma should always take good care of themselves, whether or not there is a pandemic.

“It is conservatively estimated that 80% of asthma deaths could be prevented with better treatment and access to medication. Not managing your condition does not only negatively impact your health, it can be fatal,” Levin says.

Dr Candice Royal and Professor Claudia Gray of the KidsAllergy Paediatric and Allergy Centre in Cape Town will be available for two Facebook Live events during World Allergy Week to answer questions on allergies and Covid-19.

Royal agrees the most important message for allergy sufferers is to continue good care.

“Allergic disorders are systemic diseases and should not be looked at in isolation. They can be well-managed with education, correct medication and ongoing support from your healthcare professional. Whilst people with uncontrolled asthma may be in a high-risk group for severe illness from Covid-19, recent studies have shown this is not the case in well-controlled asthmatics,” she says.

“Do not stop taking prescribed allergy or asthma medications, including inhaled or oral corticosteroids. Find ways to access care and medication that limits potential exposure to the virus. For example, have medication delivered, or send someone to collect. A telephone appointment with your doctor may be an option rather than going to the clinic or surgery.”

Symptoms of allergies and Covid-19 can be similar, which has been a source of concern for many. Coughing, for example, is common to asthma and Coronavirus; yet fever, body aches and pains which are usually experienced during Coronavirus are rarely related to asthma.

“If you have asthma, continuing to control it could help you defend against the virus. Taking prescribed controller therapy daily, whether you have symptoms or not, helps repair swelling and inflammation in the lungs so that you’re better able to fight off viruses – including the Coronavirus,” says Royal. “There is no evidence that the use of inhaled or nasal steroids increases one’s risk of contracting Covid-19, and using them regularly might even help prevent you from getting the infection or from suffering with more severe symptoms.”

Nebulisers are not recommended, as they can increase the risk to those around you.

Levin advises using an asthma pump with a spacer, rather than a nebulizer. “Spacers deliver medication to the airways more effectively than a pump on its own,” he says.

According to Dr Motohiro Ebisawa, president of the World Allergy Foundation: “Professional help is essential to understanding what is causing symptoms such as shortness of breath, chest tightness, or difficulty breathing. Patients should not assume these symptoms are either from their asthma or Covid-19 but consult their physicians immediately in case emergency care is needed.”

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