Update – May 28, 2021
We added the following updates to this blog post:
- New guidance for people who are fully vaccinated against COVID-19
- Updated information on who can get the COVID-19 vaccines
- New recommendations on cleaning and disinfecting your home
Note: Because this is a constantly changing situation, any data in this blog post may not represent the most up-to-date information. We will update this blog when possible.
The Latest COVID-19 Guidance
The Centers for Disease Control and Prevention (CDC) has updated its guidance for people who are fully vaccinated against COVID-19. You are fully vaccinated two weeks after getting your second Pfizer or Moderna shot or two weeks after getting one Johnson & Johnson shot.
What Activities Can I Do Safely If I Am Fully Vaccinated Against COVID-19?
When fully vaccinated, you can safely resume activities without wearing a mask. You no longer need to stay 6 feet (2 meters) apart. This means you can go to the grocery store, visit and hug your friends and family, and attend events.
If you have a condition or are taking medicines that weaken your immune system, talk with your doctor about which activities are safe to do.
What If I Have Been Around Someone Who Has COVID-19?
If you are fully vaccinated and have been around someone with COVID-19, you do not need to stay away from other people. You only need to get tested if you have symptoms. But, if you live or work in a correctional or detention facility or homeless shelter, you should get tested right away even if you don’t have symptoms.
Should I Still Wear a Face Mask?
Continue to wear a face mask until you are fully vaccinated. The COVID-19 pandemic is slowing, but it is not over. It is OK to continue to wear a mask if that makes you feel more comfortable. It is hard to tell who has or has not been fully vaccinated.
Wearing a face mask may have other benefits. If you have asthma or allergies, masks can help protect you from pollen and other allergens and irritants that trigger symptoms. Masks also can protect you from respiratory infections like the flu, COVID-19, and even the common cold. Masks provide protection for people who are immunocompromised.
You will still need to follow federal, state, local, tribal, or territorial laws. These jurisdictions, workplaces, and private businesses may still require that you wear masks.
Wearing a face mask is still required when traveling on planes, buses, trains, or other forms of public transportation. Masks are still required at hospitals, airports, bus, and train stations, homeless shelters, and prisons.
Does My Child Need to Wear a Mask?
COVID-19 vaccinations are now available in the U.S. for everyone 12 years old and older. Children in this age range should get vaccinated as soon as possible so they are protected from COVID-19.
Children should continue to wear a face mask and stay 6 feet apart if they are:
- 2 years old and older
- Too young to receive the COVID-19 shot
- Are not fully vaccinated
Children with a disability that keeps them from safely wearing a mask and children under 2 should not wear masks.
What Should I Do If I’m Not Fully Vaccinated Against COVID-19?
If you have not received a COVID-19 shot yet, make a plan to get vaccinated as soon as possible.
If you are not fully vaccinated, you will need to continue to take steps to slow the spread of COVID-19. This includes wearing a mask, staying 6 feet apart, avoiding crowds and poorly ventilated spaces, and washing your hands often with soap and water.
What Are the Symptoms of COVID-19 Disease Caused by the New Coronavirus?
In December 2019, a new coronavirus named SARS-CoV-2 started spreading and triggered a pandemic (worldwide outbreak). This new coronavirus causes an illness known as COVID-19.
Now, some new strains (versions) of the coronavirus are spreading. It is normal for a virus to change over time. The new versions are “variants” or “mutations.” Some information shows that the new coronavirus strains may spread more easily than the original strain of the coronavirus.
According to the CDC and the World Health Organization (WHO), COVID-19 symptoms can include:
- Shortness of breath or trouble breathing
- Feeling tired and weak
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Stuffy or runny nose
- Nausea or vomiting
Other symptoms reported are:
- Painful blue or purple lesions (such as a sore or bruise) on toes (COVID toes)
- Hives or rashes
If you or someone you know has these emergency warning signs, call 911 or go to the emergency room immediately:
- Trouble breathing or shortness of breath
- Pain or pressure in the chest that doesn’t go away
- Newly confused
- Can’t wake up or stay awake
- Pale, gray, or bluish tint on lips, face, or fingernails, depending on skin tone
According to the CDC, this list may not include all symptoms. If you have any symptoms that are severe or concerning, call your doctor.
The CDC warns that symptoms may appear two to 14 days after coming in contact with the virus. For many people, they may not have any symptoms at all but can still spread the virus.
How Can I Tell the Difference Between Asthma, COVID-19, the Flu, a Cold or Seasonal Allergies?
Some symptoms are similar between these respiratory illnesses. This chart can help you figure out if you may be feeling symptoms of asthma, allergies, or a respiratory illness like COVID-19, the flu, or a cold. Respiratory illnesses may worsen asthma, so it’s important to keep taking your asthma medicines. If you have a fever and a cough, call your doctor. If you have seasonal allergies, there are things you can do to treat them at home.
How Does the Coronavirus That Causes COVID-19 Spread?
The coronavirus spreads through close contact from person to person. A person with the virus can spread it to others by talking, coughing, sneezing, singing, or breathing. The virus will be in droplets that are exhaled from the mouth or nose out into the air. These droplets can vary in size from small to large. Large droplets are heavy and quickly fall to the ground/surface below. Small droplets can linger in the air longer and spread more easily. This is called airborne transmission.
People who are within 6 feet (2 meters) of someone who is ill with COVID-19 may be at greatest risk for becoming infected. But it may be possible to catch the virus even if you are more than 6 feet away from an infected person because very small droplets can linger in the air. If someone who is sick coughs on or near your face, you may get infected. People may be infected with the coronavirus and not show any symptoms. They may spread the virus without knowing it. The virus may also spread through direct contact with a person who has COVID-19.
If you are not fully vaccinated, the CDC recommends wearing a face mask in places where it’s hard to keep a 6-foot distance from others to help stop the spread of illness. If you aren’t wearing a face mask, cough/sneeze into your elbow or a tissue. If you use a tissue, throw it away. In either case, wash your hands after you cough or sneeze.
Who Is at Risk For Severe Illness From COVID-19?
Many studies to date (as of May 28, 2021) show no increased risk of COVID-19 infection or severity of COVID-19 disease in people with asthma.1,2,3 However, the CDC continues to list moderate-to-severe asthma as a chronic lung disease that can make you more likely to have severe illness from COVID-19.
Based on existing evidence, the following adults can be more likely to get severely ill from COVID-19:
- Older adults (the risk increases with age with people over age 65 at highest risk)
- People who are affected by long-standing systemic health and social inequities including:
- People who are Black, Hispanic/Latino, or American Indian/Indigenous American
- People with disabilities
- People with less access to education, income, and wealth
- People who live in rural communities
- People who live in crowded housing conditions (including prisons and jails, group homes, and long-term care facilities)
- People with chronic medical conditions, such as:
- Chronic kidney disease
- Chronic lung disease, like obstructive pulmonary disease (COPD) or cystic fibrosis (the CDC also lists moderate-to-severe asthma, but data shows asthma does not put someone at higher risk of severe illness from COVID-19)
- Dementia or other neurological conditions
- Diabetes (type 1 or type 2)
- Down syndrome
- Heart conditions such as hypertension (high blood pressure), heart failure, or coronary artery disease
- HIV infection
- Immunocompromised state (weakened immune system)
- Liver disease
- Overweight and obesity (body mass index [BMI] over 25)
- Sickle cell disease
- Smoking (now or in the past)
- Solid organ or blood stem transplant
- Substance abuse disorders
Children can be infected with the virus that causes COVID-19 and some children develop severe illness. While some children may be at increased risk due to chronic medical conditions, there are no current data that show asthma is a risk factor for severe disease in children, either.
Even though people with asthma are not at the highest risk for COVID-19, it is still important to keep your asthma under control. Common medicines you may take for asthma and related conditions do not increase your risk of getting COVID-19. They will help you keep your asthma under control. You are at greater risk for having an asthma attack if you stop taking your medicines. Take your medicines at the first sign of symptoms as listed on your Asthma Action Plan. Continue to take these medicines as prescribed:
- Quick-relief medicine (such as albuterol)
- Inhaled corticosteroids (controller medicines)
- Oral corticosteroids (such as prednisone)
- Antihistamines (allergy medicine)
- Proton pump inhibitors for acid reflux
- Nasal allergy sprays
- Allergy shots
If you have any questions about asthma medicines and the coronavirus, talk with your doctor.
If you need to take quick-relief medicine (such as albuterol) for an asthma episode, use an inhaler (with a spacer if directed by your doctor) if possible. Using a nebulizer can increase the risk of sending virus particles in the air if you are sick. But if you have a nebulizer and solution, it is OK to use it to treat an asthma episode. When using a nebulizer, limit the number of people in the room or use it in a room by yourself.
Disparities Among Black, Hispanic/Latino, and Indigenous American Communities
Black, Hispanic/Latino and American Indian/Indigenous Americans are experiencing a major impact from COVID-19. Data collected in the United States and in the United Kingdom shows that people in these groups along with lower-income groups have been disproportionately dying from COVID-19. This is likely due to long term disparities in care. Counties in the U.S. with a Black majority have six times the rates of deaths from COVID-19.4
To stay up to date on COVID-19 and asthma news, join our community so you will be alerted when new information is available.
How Can I Avoid Getting COVID-19 (and Other Respiratory Infections)?
The following eight steps will help you avoid COVID-19, the flu, and other respiratory infections:
1. Get your vaccines.
Vaccines can help protect you, your loved ones, older adults near you, teachers, and essential workers from getting a respiratory infection. They can also cut down your symptom severity if you do get sick. Vaccines reduce the burden on our health care system by reducing the number of people who get COVID-19 or the flu.
COVID-19 vaccines are now available. Experts expect the Food and Drug Administration (FDA) to authorize more COVID-19 vaccines as they complete clinical trials. Everyone who 12 years and older can get the vaccine at no cost. Visit vaccines.gov to find out where you can get the COVID-19 vaccine near you. Most people can get the COVID-19 vaccine with no issues. Allergic and adverse reactions are rare.
Talk with your doctor before you get a COVID-19 vaccine if you have a:
- Moderate or acute (short-term) illness
- Current case of COVID-19
- History of severe allergic reactions (anaphylaxis) to a vaccine (not including mRNA COVID-19 vaccines) or injectable medicine
- History of an allergic reaction to PEG or polysorbate
You should not get the COVID-19 mRNA vaccine if you have:
- Had a severe or immediate allergic reaction to a previous dose of an mRNA COVID-19 vaccine
- A history of an allergy to any of the COVID-19 vaccine ingredients
Getting a flu shot every year is recommended for everyone, especially people who are at high risk for both complications from the flu and COVID-19.
People with asthma should take precautions when any type of respiratory illness is spreading in their community. During flu season (usually October through May) it’s important that people with asthma get the flu shot. It is possible to get COVID-19 and the flu at the same time. Once you get a flu shot, it takes about two weeks for your body to build the immunity to the flu. The flu shot will not protect you from getting COVID-19.
People who have certain medical conditions, are age 65 and older, or are under 6 should get the pneumococcal vaccine, if they haven’t gotten it in the past. If you have asthma, talk with your doctor to see if you should get the vaccine. The pneumococcal vaccine protects against a bacterial pneumonia (from streptococcus pneumonia), but it will not protect against the pneumonia that COVID-19 causes. You do not have to get it every year like the flu shot.
Even if you are fully vaccinated against the coronavirus, flu, and pneumococcal disease, you can continue to protect yourself from respiratory infections by following the tips below.
2. Wear a mask.
A face mask needs to fit snug on your face, and cover your nose, mouth, and beard completely. Wear a mask when you leave your home, if you are caring for someone at home who is sick or have been exposed to someone with COVID-19. People with asthma should be able to wear face masks. If you adjust your mask often, then it probably doesn’t fit well. You may have to try different styles before you find one that fits best and is most comfortable.
The WHO recommends three layers:
- An outer water-resistant layer (such as polyester or polyester blend)
- A middle layer of non-woven fabric (such as polypropylene)
- An inner layer of cotton
Ask people who are not fully vaccinated to wear a mask when they are around you or in your home.
3. Keep a physical distance from other people.
Even though the vaccines have reduced the spread, the COVID-19 pandemic is still not over. In general, the more closely you interact with other people and the longer that interaction, the higher the risk of coronavirus or flu spread. Try to stay home when possible. Avoid large crowds of people, especially in indoor locations. When in public, keep at least 6 feet apart. Stay away from people who are sick or have been in contact with someone who is sick. Even when you’re at home with family, don’t share makeup, food, dishes, or eating utensils.
Other tips to help you stay home more often and help reduce the spread of respiratory infections like coronavirus:
- Stock up on 14 to 30 days’ worth of supplies (such as medicines)
- Use online ordering for food deliveries
- Switch to mail-order pharmacy if your insurance plan covers it
- Avoid non-essential travel
- Skip indoor parties and gatherings with people who don’t live with you if there isn’t a way to maintain physical distancing of at least 6 feet
See the CDC’s guidelines on how to protect yourself at specific locations and in certain situations, such as shops, public places, gatherings, and more.
4. Ventilate indoor air.
Being outdoors is generally safer than indoors because there is better air circulation outside. Keep your indoor spaces well-ventilated by opening windows or doors, using fans, running air cleaners, or using air filters in your HVAC system.
Current evidence shows the risk of the coronavirus spreading is much lower outdoors than indoors. Good ventilation in your indoor environment may help reduce the spread of the new coronavirus. It may also affect the risk of transmission (how fast it spreads). To help reduce the spread of the virus that causes COVID-19 in your home or business, consider these steps:
On days when pollen is low and air quality is good, open your windows to let in fresh air. Run your HVAC system as much as possible (especially when windows are closed). Use high efficiency air filters in your HVAC system and replace them at least every three months.
5. Avoid unnecessary travel.
The CDC recommends avoiding domestic and international travel until you are fully vaccinated against COVID-19. You will still have to wear a mask when you travel on planes, buses, trains, and other forms of public transportation. If you absolutely must travel and you aren’t fully vaccinated, traveling in your personal car is probably safest because it’s easier to limit the number of people you are exposed to. If you plan to travel, check CDC travel precautions.
Remember that the biggest risk of getting any illness on a plane, train, or bus comes from the people in the row in front and behind you and those right beside you. Sit in a window seat with an empty middle seat if possible. Ask to be reseated if someone in the row in front or behind or next to you appears ill. Think about bringing antiseptic wipes to wipe down your armrests, tray table, headrest, and other areas you will be touching.
6. Wash your hands often.
Use soap and warm water to wash your hands for 20 to 30 seconds. Always wash your hands before and after eating and after coughing or sneezing. If you don’t have access to running water, use an alcohol-based hand sanitizer that is at least 60% ethyl alcohol (ethanol) or 70% isopropyl alcohol (isopropanol). Don’t touch your eyes, nose, or mouth.
Before using your hand sanitizer, make sure it hasn’t been recalled for containing harmful ingredients by checking the FDA’s recall list. The FDA has recalled several hand sanitizers because they have methanol. Methanol is toxic and can make you sick if you put it on your skin. Some hand sanitizers have even been mislabeled as containing ethanol, but really contain methanol.
Not all hand sanitizers are effective at killing germs. To sanitize your hands for the new coronavirus, look for a hand sanitizer that contains:
- At least 60% ethyl alcohol (ethanol), or
- At least 70% isopropyl alcohol (isopropanol)
7. Regularly disinfect commonly touched surfaces.
Surfaces can contain viruses and bacteria that can make you sick if you touch the surface and then touch your mouth, nose, or eyes. Using a household cleaner that contains soap reduces the number of germs on surfaces. In most situations, cleaning alone with remove most virus particles on surfaces. According to the CDC, you probably don’t need to disinfect to reduce the transmission of COVID-19 at home.
Use a disinfectant cleaner to clean commonly touched surfaces like door handles/knobs, remote controls, cell phones, steering wheels, tabletops, light switches, etc. if someone in your home has been sick within the last 24 hours.
Products that clean, sanitize, or disinfect may trigger asthma. When using these products, open windows, run exhaust fans, avoid spraying them into the air, and wear gloves and a mask to protect yourself. If you can, have someone else do the cleaning while you are in another room or outside of the home. The Environmental Protection Agency (EPA) recommends the use of EPA-registered household disinfectants. When choosing a disinfectant, look for products that are non-scented. Also look for asthma-safer ingredients like hydrogen peroxide, lactic acid, citric acid, and alcohol-ethyl or isopropyl alcohol.
According to the CDC’s How to Clean and Disinfect, clean surfaces first with soap and water to reduce the number of germs, then use a disinfectant to kill the germs. The things you touch a lot should be cleaned often, like tables, doorknobs, countertops, handles, toilets, etc. Follow manufacturer’s instructions for cleaning keyboards, phones, and touch screens.
You can buy many cleaning supplies that disinfect. If you want to use products you may already have at home, try these:
- Use hydrogen peroxide (3%) full strength to kill the new coronavirus. Leave it on surfaces for 1 minute before wiping.5
- You can make your own disinfectant with bleach. Add 1/3 cup of household bleach to one gallon of cold water in a well-ventilated area or outside. Wear gloves and a mask, and do not mix other cleaning products (especially ammonia) with bleach. Mix small batches and throw away after 24 hours. Bleach can trigger asthma and is harsh on the skin, so use with caution. Wash your hands after using the bleach solution.
Vinegar and essential oils (like tea tree oil) are not EPA-registered disinfectants and will not kill COVID-19.
8. Take care of your health.
Take your daily asthma medicines to keep your asthma under control. Eat well and get enough sleep.
Pollen (such as grass or ragweed pollen) may impact people across the U.S. too. Seasonal allergies can affect people with allergic asthma. If pollen allergies trigger asthma symptoms for you, be sure to follow your allergy treatment plan to keep your allergies under control to prevent asthma episodes or attacks.
The CDC is recommending that people see their health care providers again. If you stopped seeing your allergist or getting allergy shots (immunotherapy) during the COVID-19 pandemic, consider making an appointment soon. Keeping up with your regular allergist visits is an important part of keeping your asthma controlled.
The most important thing you can do is to keep your asthma under control. If your asthma is not under control, call your doctor right away.
During the COVID-19 pandemic, many people with asthma have wondered if they should monitor the amount of oxygen in their blood. COVID-19 has been known to sometimes reduce blood oxygen levels. But monitoring your blood oxygen levels is not a recommended part of home management of asthma.
Pulse oximeters (or “pulse ox”) are used by doctors to measure how much oxygen your blood is carrying. Some people with COVID-19 experience a drop in their oxygen saturation in their blood. Many people with COVID-19 are using pulse oximeters at home to watch their oxygen levels even though they are not as accurate as medical grade devices.
In general, peak flow readings or keeping a symptoms diary are the most common ways to manage your asthma (along with an Asthma Action Plan). A pulse ox may be added to this, but it is important to discuss this with your doctor. There are many ways home pulse oximeters can provide inaccurate readings. Normal pulse oximeter readings range from 92 to 100%, with 90% or below usually considered low, although some people have lower oxygenation levels normally. It is important to remember that the symptoms you feel should always come before pulse ox and peak flow numbers.
There are no data demonstrating that monitoring your pulse ox through an oximeter or smartphone app will help manage your asthma. As always, talk to your doctor about the best ways to monitor your symptoms and asthma control.6
Similarly, there is no recommendation to use an at-home pulse oximeter to determine if you have COVID-19. Doctors may recommend using a pulse oximeter to keep an eye on oxygen levels for people with confirmed COVID-19 and high risk factors. Some people with mild to moderate COVID-19 may need to use supplemental oxygen at home.
If I Think I Have COVID-19, What Should I Do?
If you start having symptoms of COVID-19, call your doctor or your local health department within 24 hours. Many states have various testing options, and your doctor or department of health can tell you what to do.
Many doctors have been offering telehealth (video or virtual appointments). If that is an option, ask your insurance company if telehealth is covered under your plan. And if you have Medicare, you might be able to have a virtual visit with your doctor. The government has expanded the coverage of telehealth services during the COVID-19 crisis.
How Can I Deal With Stress During the COVID-19 Pandemic?
Even though the number of COVID-19 cases have gone down, nearly everyone is still experiencing stress because of the pandemic. Some also are concerned as more activities return and businesses increase capacity and relax mask mandates. Stress can affect your well-being and quality of life. It can be an asthma trigger. It’s important that you continue to take care of yourself during this time.
Find some self-care practices that work for you. Some examples are:
- Try a hobby
- Take breaks from the news and social media
- Take care of your body through exercise, healthy eating, and good sleep habits
- Practice deep breathing and stretching
- Keep in touch with friends and family
The CDC also offers more information on coping with stress.
When you have a chronic disease like asthma, taking part in a support group can have many benefits. AAFA has free online support groups for people with asthma and allergies. For support and encouragement through the COVID-19 pandemic, join the AAFA community.
Medical Review, Mitchell Grayson, MD, May 2021.
1. Chhiba, K.D., Patel, G.B., Vu, T.H.T, Chen, M.M., Guo, A., Kudlaty, E., Mai, Q., Yeh, C., Muhammad, L.N., Harris, K.E., Bochner, B.S., Grammar, L.C., Greenberger, P.A., Kalhan, R., Kuang, F.L., Saltoun, C.A., Schleimer, R.P., Stevens, W.W., & Peters, A.T. (2020). Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19, Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.06.010.
2. Butler, M. W., O’Reilly, A., Dunican, E. M., Mallon, P., Feeney, E. R., Keane, M. P., & McCarthy, C. (2020). Prevalence of comorbid asthma in COVID-19 patients. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2020.04.061
3. Lieberman-Cribbin, W., Rapp, J., Alpert, N., Tuminello, S., & Taioli, E. (2020). The Impact of Asthma on Mortality in Patients With COVID-19. Chest. https://doi.org/10.1016/j.chest.2020.0air pol.575
4. Thebault, R., Tran, A. B., & Williams, V. (2020, April 7). The coronavirus is infecting and killing black Americans at an alarmingly high rate. Retrieved from https://www.washingtonpost.com…post-analysis-shows/
5. Kampf, G., Todt, D., Pfaender, S., & Steinmann, E. (2020). Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection, 104(3), 246–251. doi: 10.1016/j.jhin.2020.01.022
6. Heneghan, C. (2018, January 30). Self-management of asthma – is there an app or pulse oximeter for that? Retrieved from https://blogs.bmj.com/bmjebmsp…-app-pulse-oximeter/