Childhood asthma is one of the most prevalent chronic conditions affecting children. Given its impact on lung health, both adults and children with asthma have had to exercise greater caution due to the pandemic. However, a recent study published in the Annals of the American Thoracic Society highlights a significant change: after Massachusetts shut down schools and childcare facilities in March 2020, there was an 80% reduction in asthma-related emergency room visits at Boston Children’s Hospital compared to the previous two months. By the end of May, as stay-at-home orders began to relax, the emergency room still recorded 82% and 87% fewer visits for asthma compared to the same months in 2018 and 2019.
Dr. Tregony Simoneau, the lead author of the study and a pediatric pulmonologist, noted that while she expected a decline similar to that seen during summer breaks, the extent and duration of this drop were unexpected.
It’s easy to assume that this decrease could be attributed to parents avoiding emergency rooms out of fear of COVID-19, or better discernment regarding what constitutes an emergency. For instance, when my five-year-old daughter experienced difficulty breathing after a late-night episode, I hesitated to take her to the ER, weighing the risks of infection against her symptoms. Parents of asthmatic children likely faced similar dilemmas.
Surprisingly, the study authors suggested that avoidance of the ER wasn’t the sole reason for the decline. They pointed to pandemic-induced changes in individual, community, and environmental factors. The study found that asthma-related emergencies saw a sharper decline compared to other pediatric ER visits, consistent across different ethnic groups.
Moreover, since hospitalization rates for asthma emergencies did not increase during this period, the authors concluded that most cases that did make it to the ER were not worse than those before the pandemic.
Reasons for the Decrease in ER Visits for Asthma
So, if parents aren’t simply avoiding hospitals or making better emergency decisions, what other factors are contributing to this trend? A study from the Children’s Hospital of Philadelphia (CHOP) and the Hospital of the University of Pennsylvania published in August 2020 supports the findings from Boston Children’s Hospital regarding the factors leading to fewer ER visits.
- Improved Medication Adherence
Proper use of daily controller medications became crucial during the pandemic, as these medications can lead to better health outcomes and fewer respiratory issues. However, the CDC estimates that only about 54% of children take their medications as prescribed, which can worsen asthma attacks. Dr. Simoneau noted that many families became more proactive, refilling inhalers earlier and using their medications more regularly. - Better Preventive Measures
Common colds can trigger asthma attacks, but due to pandemic-related public health measures, there have been fewer cases of rhinovirus and other cold viruses. Increased hygiene practices, such as frequent handwashing and surface disinfecting, along with adherence to CDC guidelines, have likely reduced viral infections that trigger asthma. - Telemedicine Access
The fear of COVID-19 led to a rise in telemedicine use, allowing families to seek help without visiting an ER. This shift could enable patients to receive care earlier and manage symptoms before they escalate into emergencies. - Enhanced Environmental Conditions
Social distancing, remote schooling, and shelter-in-place orders have reduced children’s exposure to asthma triggers like viruses, pollen, and pollution. Continued practices such as mask-wearing and better adherence to medication could help maintain low ER visit rates even after the pandemic.
By exploring these factors, healthcare professionals may identify strategies to keep asthma-related ER visits low even as we move beyond the pandemic.
For further reading on related topics, check out this post on home insemination or explore resources from Make a Mom and UCSF’s Center for Reproductive Health.
Potential Search Queries:
- Why are asthma ER visits decreasing during COVID-19?
- How can parents manage asthma in children during a pandemic?
- What are the benefits of telemedicine for asthma patients?
- How to improve asthma medication adherence in children?
- What environmental factors influence childhood asthma?
Summary
During the pandemic, a remarkable decrease in asthma-related ER visits among children has been observed, attributed to improved medication adherence, better preventive hygiene measures, and increased use of telemedicine. This trend suggests that factors beyond just fear of hospitals are at play, including changes in the environment and healthcare access. By understanding these elements, healthcare providers can develop strategies to maintain lower asthma emergency rates even post-pandemic.