Asthma in the New World

I don't know much about asthma, so I was surprised to learn that quite a few children need to visit the ER often enough that, when the number of these visits decreases, it's very noticeable.  Those visits decreased a lot recently:

Just one week after Massachusetts closed schools and day cares in March, Boston Children's Hospital saw a drastic change in asthma-related visits to the emergency room:  They were down 80% from the prior two months.

ER visits continued at about the same low rate as long as the shutdown continued.  Other pediatric ER visits didn't follow the pattern, it was just the case with asthma.  And "most cases that made it to the ER weren't any worse than usual."

OK, fine.  Elements of the pandemic environment and the shutdown and quarantine life have led to innumerable impacts on nearly all areas of our lives.  Here at "The New World," we're not interested in those changes that will dial themselves back to normal once everything else is back to normal, but only those impacts which will create some interesting changes in the new world.

It turns out that the folks from Boston Children's have found some factors that might have been responsible for reducing pediatric asthma ER visits to nearly zero.  Most of them were factors which won't last:  masks/distancing/handwashing (which are reducing a whole host of common respiratory ailments), a lot less contact with outdoor allergens, and the elimination of school sports, which trigger a lot of "exercise-induced asthma."

But there are two effects which may last in the new world.  Not knowing much about asthma, I certainly didn't know that, according to the CDC, "only 54% of children who take asthma medications use them as prescribed, which can lead to more frequent and severe, asthma attacks."  54%, indeed.

The Boston Children's researchers report a great improvement in proper use of prescribed medications during the few months that they studied, the first few months of the pandemic.  They speculate that the high profile of distressing health news, and the fear of encountering COVID in the hospital, may have focused these patients (and, perhaps more important, their parents) on better medication cooperation.

Still, this is certainly an effect that will fade when our attention returns back to life in general, and hospitals are no longer COVID hotspots, right?  Right, except for one more thing I didn't know about asthma: "...medications are able to maintain better control of symptoms over time."  

I read that to mean that the longer you take your medications properly, the better your asthma becomes, overall.  Instead of asthma being something that makes life difficult and requires constant ER visits, it becomes a less-salient difficulty, when you take your medication regularly, and the ER can become a not-so-fond memory.

The other factor that researchers suggest has an impact on ER visits, and that I think might have an impact on the new world, is telemedicine.  Once you get over the novelty, and learn how to do it, telemedicine is way easier than actual doctor visits, and much cheaper and more efficient than ER visits.  And - as an added bonus - it tends to improve medication adherence, at least in adolescents.  Win-win.  

So - maybe some hope for children who suffer from asthma in the new world?  Healthier kids emerging from the pandemic, with the understanding that it is medication adherence that has made life better?  Kids who are used to telemedicine and therefore more likely to maintain a positive relationship with healthcare providers?  Kids who grow up and pass these habits and attitudes on to their children?  Wouldn't that be a breath of fresh air.