Coronavirus (COVID-19) Advice

19 Mar 2020

You may be wondering what the coronavirus means for you or your child with asthma.

We are very pleased that the HSE'S National Clinical Respiratory Programme has approved the specific COVID-19 advice provided here for people with long-term respiratory illnesses. 

As a separate resource, healthcare professionals also need leadership on clinical best practice - this guidance is best provided by the HSE, ICGP , IPNA and other relevant channels.

The Asthma Society has been liaising continuously with the HSE over the past number of weeks in relation to this healthcare challenge. We are communicating to the HSE and to other government departments the needs and very acute concerns of respiratory patients. People need to know that they are doing everything in their power to manage their illness and protect themselves from coronavirus. They also need reassurance that they will receive the healthcare they need and that employers will recognise their particular vulnerability at this time. 

See below for a link to the dedicated HSE Coronavirus web page, which provides the most accurate and up-to-date information on the virus, the symptoms, the risks and protective measures. We will continue to liaise with the HSE and will link to any additional information as it is made available.

Click here for the HSE’s Coronavirus (COVID-19) webpage

As people with asthma and COPD have been classed in the at-risk group, it is important that they ensure their asthma or COPD is well managed around this time and that they do their best to avoid contracting the disease.

About Coronavirus and COPD/Asthma

1. Am I more at risk of developing complications from coronavirus because of my asthma or COPD?

The HSE has identified groups who are at high-risk of severe illness from COVID-19 (coronavirus), when the virus is circulating in their community. These include:

People (adults and children) with long-term medical conditions including people with cardiac and respiratory conditions
Patients with any condition that can compromise respiratory function

The HSE has stated that ‘protective self-separation’, is recommended for vulnerable groups. This means that you should avoid unnecessary face-to-face social interaction and avoid physical contact with others.

As someone in this vulnerable group, it is extremely important that you manage your respiratory condition as well as possible and you stay as healthy as you can. Please see the section below for advice on how best to manage your asthma/COPD.

People who are older (for example, over 65 years of age), who have weakened immune systems or those who have underlying health conditions are more at risk of severe effects from coronavirus.

2. Am I more at risk of contracting coronavirus because of my asthma or COPD?

The HSE has advised that it does not believe that those in ‘vulnerable’ or ‘high-risk’ groups have a higher risk of contracting coronavirus. But, as indicated in answer 1 above, you may, unfortunately, be at higher risk of serious illness if you do contract coronavirus. 

3. How do I know whether my shortness of breath is an exacerbation of my asthma or COPD or due to coronavirus?

The respiratory symptoms associated with COVID-19 are similar to asthma/COPD – shortness of breath, cough.

The symptom which differentiates asthma or COPD from COVID-19 is experiencing a “new” fever. Fever is the symptom that has been most common of any symptom in confirmed cases of COVID-19. The HSE are particularly focusing on any patient who is experiencing a “new” fever or a “new” cough. If you are feeling hot and cold, shivering, and achy bones, you should phone your local GP and alert them to this fact. Your GP and their staff will guide you through what happens next – you will likely be tested for the virus and be requested to self-isolate until the results come back. The healthcare professionals – GPs who will link in with any other necessary specialists – will look after you and will ensure that you have the best treatment to help you in this scenario.

4. What are the symptoms of the virus?

The symptoms of the virus are:

  • fever (high temperature)
  • a cough - this can be any kind of cough, not just dry
  • shortness of breath
  • breathing difficulties
  • Other symptoms are fatigue, headaches, sore throat, aches and pains.

5. How will the virus impact on my asthma or COPD?

If you have a long-term respiratory illness or a condition that can compromise respiratory function, it is possible that you may experience more severe symptoms if you contract coronavirus. As a number of the symptoms are respiratory, it is important that you monitor your symptoms carefully, look out for additional symptoms named above, and contact your GP by telephone if you have any concerns. It is very important that you take your medication as advised by your healthcare professional. In the meantime, make sure you are managing your asthma or COPD as well as possible.

6. Vaccinations – when will there be one for COVID-19?

Coronavirus (COVID-19) is a new virus. Scientists and healthcare professionals from all over the world are working together to learn more about how it works and they are sharing what they have learned to develop medications to treat the virus and vaccines to protect people from developing it. This kind of process traditionally takes a long time but many people are currently working together on these two aspects – treatment and prevention – and it may be the case that treatments and a vaccine get developed quickly, with important drug approval processes to follow, all of which will be fast-tracked.

7. I am pregnant and also have asthma? Do I need to be concerned for my baby and is there anything else I need to do to protect myself?

If you are pregnant, The National Maternity Hospital has published document offering on coronavirus and maternity advice that you may find useful. You can find it here.  If you are concerned about your health in pregnancy, please contact your midwife or maternity consultant.

It is essential that you continue to manage your asthma as well as possible during your pregnancy. Please see below for our tips on how to manage your asthma well.

8. Should I/my child get flu jab?

The flu is a different illness to coronavirus. The flu vaccine helps your body to create antibodies so that it is prepared to fight off the flu virus, in the event of contracting it. The flu vaccine has not been shown to have any impact in reducing the likelihood of contracting coronavirus or in reducing the severity of the symptoms.

We strongly recommend that all patients with a respiratory illness get the flu vaccine every year. It will not, however, help with coronavirus specifically.

9. Should I self-isolate and, if so, what does that involve?

People are now being asked to self-isolate if they have ‘flu-like symptoms’ (for example, fever, cough, generalised aches and pains or breathing difficulty) regardless of travel or contact history. It involves staying indoors and completely avoiding all contact with other people. This is to stop other people from getting it.

A doctor will also ask you to self-isolate if they think your flu-like symptoms could be due to coronavirus.

This could be:

  • before you get tested for coronavirus
  • while you wait for test results
  • if you have had a positive test result for coronavirus

People in vulnerable groups, such as those with chronic respiratory conditions or any condition that can compromise respiratory function, are being advised by the HSE to practice ‘protective self-separation’, i.e. to avoid unnecessary face-to-face social interaction and avoid physical contact with others.

10. Should I self-quarantine and what does it involve?

Quarantine is used to restrict the movement of people who might have been exposed to an infection, but who aren’t yet sick. Self-quarantine is avoiding contact with other people and social situations as much as possible. You will need to do this if you are a close contact of a confirmed case of coronavirus and you are still well.

Quarantine is used to restrict the movement of people who might have been exposed to an infection but who aren’t yet sick (some of whom will never get sick while some will go on to develop COVID-19 symptoms in the following days).

People in vulnerable groups, such as those with chronic respiratory conditions or any condition that can compromise respiratory function, are being advised by the HSE to practice ‘protective self-separation’, i.e. to avoid unnecessary face-to-face social interaction and avoid physical contact with others.

11. Should I practice self-separation and what does it involve?

People in vulnerable groups, such as those with chronic respiratory conditions or any condition that can compromise respiratory function, are being advised by the HSE to practice ‘protective self-separation’, i.e. to avoid unnecessary face-to-face social interaction and avoid physical contact with others.

12. Should I practice social distancing and what does it involve?

All residents are being advised to practice social distancing to decrease or interrupt the spread of coronavirus. Social distancing aims, through a variety of means, to decrease or interrupt the spread of COVID-19. It does this by minimising contact between potentially infected individuals and healthy individuals. Social distancing involves keeping a 2m (6ft) space between you and other people. You should not shake hands or avoid close contact where possible.

All Irish residents are now required to:

  • avoid crowded places
  • increase interpersonal distance (ideally separation of at least 2 metres, not shaking hands, avoiding communal sleeping areas)
  • when in crowded settings, practice personal protective measures as they usually do (for example, frequent hand hygiene, avoid touching eyes/nose/mouth)

13. From an 85 year old COPD patient - "is it safe to go out"?

It is safe to go out, as exercise is so important to our health and well-being, and particularly so for those with chronic respiratory conditions once you wrap up well for the weather. However, you should not spend time in close contact with other people. It is sensible to continue to practise social distancing while outdoors (avoid crowds in particular) and make sure to wash your hands after you return from being out.

14. Should I use my nebuliser or spacer for relief if I am worried I might have coronavirus and my asthma is bad?

In the first instance, always use your reliever inhalers through a spacer. However, if using a nebuliser, do so alone in a well-aerated room and take care when cleaning the device.
15. Should my family, friends and carer(s) take additional steps to protect me from coronavirus because of my asthma or COPD?

According to the Chief Medical Officer in the Department of Health, people with underlying health problems should distance themselves from others as much as possible.

Your family, friends and carers need to be extra vigilant in the event that it is necessary to have face-to-face contact with you. They should follow all HSE advice to reduce the spread of the virus including frequent hand washing, coughing and sneezing into a tissue or their elbow, avoiding touching their face and disinfecting surfaces you may touch regularly. See below for additional home measures they should follow.

All Irish residents are now required to:

  • avoid crowded places
  • increase interpersonal distance (ideally separation of at least 2 metres, not shaking hands, avoiding communal sleeping areas)
  • when in crowded settings, practice personal protective measures as they usually do (for example, frequent hand hygiene, avoid touching eyes/nose/mouth)

16. Should I keep my child at home from school? Should we still bring my child to training/play dates/to visit their grandparents?

As with adults, children who are considered ‘vulnerable’, such as those with chronic respiratory conditions or any condition that can compromise respiratory function, are advised by the HSE to practice ‘protective self-separation’, i.e. to avoid unnecessary face-to-face social interaction and avoid physical contact with others. We recognise that this is likely to be very difficult for children and their families.

If a child is displaying any flu-like symptoms (for example, fever, cough and so on), regardless of travel or contact history, they should be isolated and you should contact your GP by phone.

An Taoiseach Leo Varadkar has announced that all schools and childcare facilities are to close until 29 March 2020. He has also stated that this decision will be kept under review, which suggests that the closures could be extended at a later time, if circumstances require it.

Many sports organisations have officially cancelled alltraining sessions for the coming weeks. Check with your local club or branch to confirm their arrangements.

Dr Sarah Doyle from the HSE advised that, in order for the school closures to have their intended outcome – to reduce the spread of coronavirus – parents are to limit playdate and limit the number of children involved in play dates.

Deputy Chief Medical Officer in the Department of Health Dr Ronan Glynn has advised that, even if children and their grandparents are deemed healthy, social distancing should be practiced in particular with vulnerable groups, which includes people over 60 years. Children who are sick should not visit anybody.

Dr Glynn has also strongly recommended, while recognising the childcare difficulties many parents will be facing in the coming weeks, that those who are asked to mind children during this time should NOT be older than age 75, or have a chronic disease, or be in an immunosuppressed state.

Is my child more vulnerable if they are mixing with peers who have travelled to affected areas?

As of 16th March 2020, on the advice of the National Public Health Emergency Team, the government is advising against all non-essential travel overseas including to the UK (excluding Northern Ireland). 

As with adults, children who are considered ‘vulnerable’, such as those with chronic respiratory conditions or any condition that can compromise respiratory function, are advised by the HSE to practice ‘protective self-separation’, i.e. to avoid unnecessary face-to-face social interaction and avoid physical contact with others. We recognise that this is likely to be very difficult for children and their families.

If any adult or child is displaying any flu-like symptoms (for example, fever, cough, generalised aches and pains, breathing difficulties and so on), regardless of travel or contact history, they should be isolated and you should contact your GP by phone.

Managing my Underlying Respiratory Illness

17. Are there any changes to how I should be managing my asthma at the moment?

There current COVID-19 outbreak does not require any change to what is normal good asthma management. People with asthma should be on daily preventer/controller medication, so that they need less and less of their reliever medication in the future. All people with asthma should have a written Asthma Action Plan and know how to use their medications accordingly.

18. If I feel short of breath, should I increase the number of times I take my preventer inhaler?

You should only follow the written instructions contained in your Asthma Action Plan. Different preventer inhalers have special limits on doses that can be safely taken, so you should not experiment with your inhalers, but only follow written instructions that clearly tell you which inhaler to use, when and how much.

19. From my Asthma Action Plan, I think I’m in the orange zone (where it says ''I feel like I have a cold or flu'') - should I go onto 4 hourly reliever inhaler?

If you are experiencing a “new” fever – sudden onset of typical fever symptoms – contact your local GP office and they will advise you on how to proceed. At this point, the HSE is expanding testing. It is likely you may be tested which will be key to identifying COVID-19 so you can be properly treated or to eliminating COVID-19 so that you do not have to worry about it.

The instructions in an Asthma Action Plan are specific to the patient who owns that plan and should not be copied by other asthma patients unless it is written in their own plan. If you do not have your own tailored asthma action plan, discuss this with your asthma doctor or nurse or phone the free Asthma Society Asthma and COPD Adviceline on 1800 44 54 64 where a nurse can help you develop one.

20. Will there be a shortage of medication and should I stock up on my medication?

No, we have been liaising with the IPU and they have assured us that that there is no need for patients to order extra quantities of medicines - we have sufficient stock of asthma and COPD medications in the country.

The Department of Health and Irish Pharmacy Union wants us to reassure patients that there will be a continuity of supply of medicines and should be encouraged not to seek supplies of medicines over and above their normal requirements.

It is, of course, prudent to have a one month supply of your asthma or COPD medications, as is always the case.

21. Will my pharmacy remain open?

We have been reassured by the Irish Pharmacy Union that that there is extensive contingency planning to ensure pharmacies remain open in every locality in Ireland to serve patients. You may be requested to use hand sanitiser when you enter your local pharmacy. Please do co-operate with any requests like this for everyone’s health and well-being.

22. Should I attend my scheduled GP or hospital appointments?

The HSE has advised that you continue to attend for any planned treatment, unless you have been told not to. If you have flu-like symptoms or have been in close contact with someone with coronavirus, phone the hospital before your appointment.

If you believe you may have coronavirus and need advice from a medical professional, call your GP surgery. Do not attend the surgery unannounced.

23. If I think I have coronavirus, what should I do?

If you are experiencing any flu-like symptoms, you should self-isolate. You should not visit your doctor without first calling beforehand. Your GP will make arrangements with you.

It is likely you will be asked if you have been in contact with someone who has been diagnosed with coronavirus or if you have been abroad in the last 14 days  You should answer all these questions honestly.

At the moment, many people are experiencing long delays when contacting their GPs. If you are unable to get through to your GP you can call the HSE’s dedicated Coronavirus Helpline on 1850-24-1850 for any additional support required or visit their website (www.HSE.ie) where they have a wealth of information on the virus.

24. Should I wear a mask to protect me from contracting coronavirus?

Using masks is unlikely to be of any benefit if you are not sick, and masks used incorrectly may not protect you from contamination with coronavirus. Sick people will be advised by their doctor when and how to use a mask correctly.

Healthcare workers need masks and other personal protective equipment to protect them from infection during their work with infected patients, and they do not wear masks in the course of their work when they are treating other patients who have no COVID-19 symptoms.

25. How long will this last? Will it get worse?

We know that COVID-19 (coronavirus) is contagious and many people will catch it. Because it is a new virus for humans, we have not developed immunity to it and so it is spreading more widely than the usual viruses we see each year. Because it is new, experts are still learning about it and the information and advice is being improved and updated regularly.

 It is not known exactly how long coronavirus outbreak will take to get under control or how long the newly introduced measures will be in place. However, Ireland is looking to countries, like China, where coronavirus has been widespread and is applying measures that have proven to slow the spread of the virus.

Ireland is currently in what it deems the second phase of tackling the outbreak of coronavirus, referred to as the Delay Phase.

The government’s delay strategy is planned to slow down the spread of the virus. This means that for example, if 1,000 people are going to catch the virus, the delay initiatives should result in 200 people per week catching the virus over five weeks, rather than 500 people per week catching the virus over 2 weeks. That way we will be able to reduce the burden on our GPs and hospitals.

To help slow the spread of coronavirus: anyone who has symptoms should self-isolate for 14 days, everyone should limit unnecessary social contact as much as possible and at-risk groups should avoid close contact with people outside the home.

26. There is so much information out there about coronavirus? What should I believe? What sources can I trust?

The most up-to-date and accurate advice is available on the HSE website. You can also call the HSE’s dedicated helpline on 1850-24-1850.

The Department of Foreign Affairs and Trade regularly updates its travel advice for over 200 countries. In the rapidly evolving situation relating to the COVID-19 virus, they are working to provide accurate and up-to-date information for each country. As of 16th March 2020, on the advice of the National Public Health Emergency Team, the government is advising against all non-essential travel overseas including to the UK (excluding Northern Ireland). 

Further information on travel related queries can be found on the DFA website.  https://www.dfa.ie/travel/travel-advice/ . If you have a COVID-19 related travel query, you can call their dedicated advice centre on (01)613 1733.

The Asthma Society of Ireland is in constant communication with the HSE and are updating the information provided by our Adviceline nurses, on our social media channels and on our website as needed. We are also urging the HSE to provide specific advice for people with respiratory illnesses.

Finally, the Asthma Society has arranged additional hours and extra staff to be able to respond to your queries about coronavirus and your asthma or COPD. You can phone to make an appointment for a free call back from our Asthma /COPD Adviceline nurses on 1800 44 54 64, who are available to talk to you from Monday to Friday. If you are worried at all, please phone us. We are endeavouring to respond to all calls as quickly as possible. However, please note, we are receiving unprecedented numbers of calls at this time and ask you to bear with us should you experience some delay. 

Important Home Measures to Promote Health and Well-being: 

  • Hand washing frequently, cough / sneeze into your elbow, tissues into the bin immediately, wipe surfaces with alcohol / bleach wipe.
  • Good nutrition with hot home-cooked dinner every day based around soups, stews, casseroles, spaghetti bolognaise, Shepard’s pie etc. with onions, leeks and garlic. Onions/leeks and garlic are from the ‘allium’ family and these foods contain natural antiseptic qualities (antimicrobial) just used as normal in cooking, absolutely no need for eating this raw or in large quantities. Also take a bit more Vitamin C – found in oranges, kiwi, lemon, strawberries, papaya, guava and grapefruit, also in vegetables such as broccoli, cauliflower, Brussels sprouts and peppers. If you have a child that is a really fussy picky eater, get them a multivitamin, be guided by your pharmacist.
  • Stay well hydrated, drink plenty – little and often and not icy cold!
  • Dress appropriately for the weather – hats, scarf over nose and mouth, etc. Fresh air is good for mental health and for patients with respiratory illness, though follow the guidance about self-distancing provided above. If you get drenched, home as quick as you can and get out of wet clothes.
  • All normal parenting skills.
  • Keeping calm and anxiety free is good for your health. When we are stressed our immune system switches off, so it is best if we keep the scary social media stuff away – switch it off.  Since we may be spending long days at home, try doing creative stuff like baking, jigsaws, colouring, write a song or a poem, plan a garden, paint something - all of these have been shown to reduce fear and worry.
  • We in the Asthma Society have put on extra hours and extra staff and you can phone to make an appointment to speak to an Asthma /COPD Nurse at 1800 44 54 64. We are happy to talk to you and please, if you are worried at all, phone us. We are trying to manage a high volume of calls, so if we are unable to immediately answer your call, leave a voicemail and we are returning every single call in due course.

Cocooning and Severe Asthma

The Government of Ireland has recommended that certain groups of people must continue to ‘cocoon’ themselves throughout Phase One, which commences May 18. it is likely that this will continue through Phase Two. This restriction applies to people who are considered extremely medically vulnerable if they contract coronavirus. (It does not mean you are prone to contracting it, but that the symptoms may be more severe if you do)*