News of the novel coronavirus is traveling, pardon the pun, virally. This article breaks down important information that people with asthma need to know about symptoms of coronavirus, what to do if you have it, and what are things you can do to reduce your chances of catching it.
UPDATE: March 16, 2020
Updated with new symptoms
I think I have Coronavirus. What should I do?
If you are experiencing breathing problems like shortness of breath, coughing, asthma attacks, and have a fever, call your local hospital immediately for their recommendation.
If you are experiencing any flu-like symptoms, you should immediately self-quarantine. First call your Primary Care Physician (PCP) and ask what they would recommend you do. If it is after hours, call your local urgent care or hospital and ask what they would recommend you do.
Your risk for the coronavirus increases if you have traveled to any of the following countries, or have been in close contact with anyone who has recently traveled to these countries: China, Italy, Spain, Iran, or anywhere in Europe which is the new epicenter of the disease.
Symptoms of Coronavirus
- Fever, > 37.5C and 99.5F
- Shortness of Breath
- Sore throat
- General malaise
- Gastrointestinal upset, including vomiting and diarrhea (one of first symptoms)
Symptoms of coronavirus start out as fevers, shortness of breath, and coughs. Some people experience a sore throat. Other people experience a general malaise or extreme tiredness. Some people experience gastrointestinal upset, including vomiting and diarrhea, a few days before shortness of breath and coughing occurs.
For asthmatics and others with chronic lung diseases, these symptoms can sound very vague, and often sound like an asthma attack or cold or seasonal allergies. It can be confusing trying to differentiate between them.
New reports coming out of China show that the gastrointestinal upset occur days before the respiratory distress. Things like nausea, vomiting, diarrhea, and abdominal discomfort are all early signs of possible infection. Doctors are now using these to distinguish between the flu (an upper respiratory infection and not the stomach flu) and the novel coronavirus. (10)
Additionally, stool samples are testing positive for the SARV-CoV-2. It is important to note that 23% tested positive in a stool sample and negative in a respiratory sample. Endoscopy is showing extensive damage in the GI system. If you are suspicious of having this virus, it is even more important to wash your hands with this new information.
For more information on the coronavirus in general and what people with asthma should know, make sure to read Asthma and COVID-19: What To Do.
Am I at Greater Risk for Developing Coronavirus with Asthma?
According to international data, you will not be at a greater risk of getting infected, ie, you are not more likely than another person without asthma to catch it. (1) (2) However, if you are infected with the coronavirus, you are more likely to suffer a more severe case of it, due to your asthma.
Should I practice Social Distancing?
Yes. Most countries are now advising that you practice social distancing when possible. This means minimizing contact with other people, avoiding crowded areas, limiting the number of people into your home, limiting the number of times you leave your home. It also advises maintaining a distance of 6 ft / 2 meters around yourself so as to avoid the water vapors of others. You should not shake hands and should generally avoid people whenever possible.
For those with asthma and other chronic lung conditions, this is the most important thing you can do to minimize the risk of contracting the novel coronavirus.
Think of it this way: If I have a giant bowl of Skittles with 100 pieces in it, but 3 of them will kill you immediately if you eat one, would you take a handful? This is why we need to social distance, to help out those who are most vulnerable.
Should I Stay Home from Work or School?
If you have the means to do so, yes. This is not just for your safety, but for helping to control the disease at large for the safety of everyone. Working from home and attending school online is the safest thing to do at this moment.
I understand that there are some people who are the support for their family and work a job that won’t allow for time off. First, check with your local, state, or national government to see if there are any grants or unemployment measures in place to help you through this period.
If not, and you must go to work, then practice the safety protocols issued by WHO (9):
- Wash your hands frequently.
- Avoid close proximity with others.
- Wipe down surfaces with anti-bacterial wipes when possible.
- Ask for meetings to be held remotely when possible.
- Retain the names and contact for all members of the meeting for 30 after in case of an outbreak.
- Avoid travel when possible.
Should I Stop Using My Asthma Medicines Because They Lower My Immune System?
No. If you use corticosteroids to control your asthma, there is a slight decrease in the immune system. However, it is more important to keep taking your medicine so that your asthma is well controlled. This way, if infection does occur, your asthma is already under control and you do not have to add that to the mix, so to speak.
Dr. Juanita Mora of the Chicago Allergy Center and a National Spokesperson for the American Lung Association says that the novel coronavirus has shown to cause asthma attacks. It is most important that your asthma is well controlled.
Again, the most important thing is to have your asthma well controlled so that if infection does occur, your lungs are in a better position to ward off the virus. Do not stop any asthma medications at this time in the hopes of having a greater immunity to prevent the virus. Having well controlled asthma is the more important of the two and there are other things to do to improve immunity (addressed further in this article).
Is there any medicine I can take to help?
Some Western, traditional, or home remedies may provide relief from the symptoms, however there is currently no known cure or medicine for the novel coronavirus. (4) There are several ongoing trials that hope to provide answers soon.
In 2018 there was a meta study performed that looked at the role of vitamin D and the flu. It concluded that there is a relationship between low levels of vitamin D in the body and the chance and severity of respiratory infections. (5) Those who had low levels often experienced more frequent and more severe infections, with those having levels below 10 NG/MLs most affected.
To combat this, first check with your doctor to see if you have low levels. If you do, then supplementation through the diet is the easiest way to increase your levels. You want your number to be between 20 and 30 NG/MLs and NEVER above 39 NG/MLs. Vitamin D is a fat-soluble vitamin which means that the body will store the excess in your fat. This means that storing in the body can lead to toxic effects.
The role that vitamin D plays in increasing our immunity to respiratory infections is not well studied. However, you cannot just take a huge dose of vitamin D and expect to be safe. You need to have vitamin D be a regular occurrence in your diet for it to be effective.
Zinc has gotten a lot of press lately as being a substance that can help combat the novel coronavirus, and while there are not any studies on this strain of coronavirus in particular, there are some that support this. Zinc has been shown to inhibit the growth of other coronaviruses in labs. However, the type of zinc you take plays a role in this. (6)
Zinc gluconate lozenges that provide 13 mg of zinc were found to have lessened the duration of illness. Zinc acetate lozenges that provided 5 or 11 mg of zinc did not.
There is no current evidence to show that zinc will stop this novel coronavirus. Excess zinc can have super harmful effects on your body, including permanent loss of smell. If you wish to supplement with zinc, never take more than 8mg/day for women and 11mg/day for men.
What Doctors are Saying In Europe
Infectious disease specialist Dr. Giovanni Guaraldi discussed lessons being learned by Italian doctors about the new virus with Canadian CTV News. (8) He had the following to say.
First, the virus causes the alveoli and the lung vascular to have difficulties of getting oxygen from the air into the blood stream. This causes most of the distress in patients as there is little oxygen in the blood.
This is further compounded with the rise of secondary infections. In Asia, they saw a rise of viral pneumonia and in Italy they are seeing a rise of bacterial pneumonia. This makes management very difficult as it is hard to forecast patient’s prognosis. Dr. Guaraldi says, “We admit patients who seem to be quite stable, but in very few hours they may develop respiratory insufficiencies.”
In Italy, they are testing the use of antiviral medications, specifically HIV inhibitors with a protease inhibitor. However, there is still no vaccine or cure for this virus.
The death rate is hovering around 2% of all known infected cases. That is not a huge number but the burden it is placing on Italian hospitals is overwhelming. Hospitals are needed to determine patient forecasts for who gets a bed, and as stated, that can change in only a few hours. They now prioritize those with a greater risk.
What People with Coronavirus Have Said:
There are many people who are in the process of recovering from the coronavirus and have uploaded their stories to places like YouTube. (7) In general, what they have described is that the coronavirus in and of itself is not deadly, what is dangerous is that it opens the path for secondary viral infections to arise. Things like viral bronchitis and viral pneumonia are the most common secondary infections. These are the dangerous infections that are causing mass hospitalizations.
Why America Can Be (Slightly) Optimistic
I’ve been writing about the coronavirus for the past week, tweeting about it as news breaks, and updating you with information as it arises. It’s easy to feel overwhelmed and scared. I know that I am anxious and overwhelmed. Now I’d like to offer you a little glimmer of hope.
First, we need to have every American pull together and fight this virus. We can still, as of writing this on March 15th, minimize the number of Americans (and consequently other North and South American countries as well) who contract the virus.
One thing we have going for us is that Americans are generally loners. We stand farther apart than other cultures. Americans don’t kiss and hug anyone who isn’t a family or friend. We have huge stores with aisles that are wide enough for two shopping carts, two sets of parents, and multiple kids to all be throwing extra items in the cart all at the same time. Our homes are often single-family homes with self-contained ventilation systems. And we have cars and don’t rely on mass transit.
Normally, I would be saying how these things are bad for the planet and contribute to climate change. But right now? These might just be the things that save us.
Finally, our healthcare system, broken as it is, has an advantage over other countries: We have a huge number of ICU beds available. We also have a huge private sector of labs waiting to join in testing for the coronavirus.
This doesn’t mean that we can walk around as if “everything is fine”. We still need to mobilize for one of the greatest fights that Americans have ever faced. This time, our enemy isn’t the face of another human, but one of epically small proportions that will require an equally and epically large resistance.
We are fighters. We get knocked down and we stand back up ready to swing again. Sure, we might have been slow to start this fight against the coronavirus, but we sure as heck are not going to let it have the last word.
For more information on the coronavirus, please check out these articles
3 Interview with Dr. Mora conducted March 6, 2020