How to control asthma in children after the COVID-19 pandemic: Tips for parents and teachers

When COVID-19 led to school closures and stay-at-home orders several years ago, it was initially unclear just how the pandemic would impact children, especially those living with chronic illness. Even before much was known about the virus, there were fears that children living with asthma might be more severely impacted by an infection. Though doctors were quickly able to determine that was unlikely to be the case, they have since noticed other impacts of the pandemic.

During the first shutdowns in Germany and in many other European countries, hospitals pushed back non-urgent appointments, including diagnostics or annual check-ups, says Prof. Dr. Christian Vogelberg, Head of Pediatric Pneumology and Allergology at Dresden’s University Hospital Carl Gustav Carus. Although necessary at the time to shore up the capacity of medical personnel, deferring these vital appointments may have had a knock-on effect, with children receiving a diagnosis or proper treatment later.

“Children who had previously managed their asthma with habits like exercise suddenly had less control due to the major lifestyle shift,” says Prof. Dr. Vogelberg.

Getting back on track with asthma check-ups

The good news is that for most children, stability can be recovered. According to Prof. Dr. Vogelberg, getting a child living with asthma back on a regular check-up schedule is a first step to managing their asthma better. Ensuring that their treatment plan and medications are up to date are the key elements of asthma care.

“During the pandemic we tried to get the message out to patients to continue their asthma medications uninterrupted,” tells Prof. Dr. Vogelberg. “But when some children returned for a check-up, we noticed that their medications had expired or not been used.”

Those expired inhalers might tell something about another pandemic-driven phenomenon: a lower need for emergency medication. There was significantly less allergy or illness-induced asthma episodes that needed attention due to the shutdowns.

“This is easily explained as there were fewer viruses circulating, less exposure to dust and mold indoors and better protection from pollens thanks to the face masks,” says Prof. Dr. Vogelberg. But he warns against allowing a false sense of stability to settle in. “As soon as lockdowns eased up, those numbers have risen again.”

Prof. Dr. Vogelberg highlights that as children have returned to school and sports activities, making sure that their medication and their management plan matches their current state of health is important. It can be useful to have a management plan in a written text, printed or in a digital format. The management plan guides the child with asthma and their carers in everyday asthma care step-by-step and encourages to monitor and act on asthma symptoms.

Supporting children and students with asthma

Although all patients might find beneficial keeping a thorough asthma diary noting symptoms and medication use, for those who have recovered from a bout of COVID-19, Prof. Dr. Vogelberg says it’s even more vital. “After infection some patients have had more unstable asthma symptoms. If they are less predictable than they might have been in the past, it’s something to keep an eye on to identify any possible triggers.”

The asthma diary and management plan can be useful not only for parents and doctors but also for school teachers or other caregivers who are supporting children with asthma. “It’s important that these children are not discriminated against,” says Prof. Dr. Vogelberg. He emphasises that clearly explaining to child’s teacher what their illness is and what their management plan looks like will help child remain an active participant in the classroom. “A kid doesn’t want to be excluded from sports just because they have asthma. A teacher who understands that a kid may need more time to warm up can help keep them in the game.”

In Saxony, where Prof. Dr. Vogelberg practices, a programme explaining how to handle common childhood illnesses has been piloted as part of standard teacher training. With proper awareness of how asthma works and how to treat it, teachers can be a good resource for helping children living with asthma to stay healthy at school. Ensuring they’re not only included but that they’re supported in keeping their asthma in check can be a real lifesaver.

By Courtney Tenz

Photo by Adobe Stock

References:

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Akelma, Z, Başkaya, N, Çetin, S, Bostancı, İ, Özmen, S.  Improvement in school-aged children with asthma during the Covid-19 pandemic. Pediatric Pulmonology. 2022; 57: 2518- 2523. doi:10.1002/ppul.26068.

Audi N., Gupta A., Cook J., Latham S., Tomlin B. Emotional impact of Covid-19 pandemic on children and parents with problematic severe asthma [preprint published online August 11, 2020]. Authorea. https://www.authorea.com/users/349820/articles/474809-emotional-impact-of-covid-19-pandemic-on-children-and-parents-with-problematic-severe-asthma

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