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Coronavirus: What Is the Risk for Asthma Patients?

Health + Wellness
A woman using an inhaler. BSIP / Universal Images Group / Getty Images

By Alexander Freund

Elderly people or people with previous illnesses are considered a special risk group in the current COVID-19 pandemic. And since the aggressive SARS-CoV-2 virus primarily affects the lungs, many asthma patients are afraid they might have an increased risk of infection and of a potentially severe course of the disease.

Additional uncertainty has been caused by indications that the immunosuppressive drugs frequently used by asthma patients, such as cortisone sprays, may further increase the risk of infection because they downregulate the body's own immune system.


Should Patients Continue to Use Cortisone Sprays?

Cortisone sprays, or cortisone tablets in severe cases, are frequently used in asthma therapy because they have an anti-inflammatory effect and reduce the asthmatic hypersensitivity of the bronchial tubes. In this way, they regulate the body's own immune defense downward, giving the active substance an immunosuppressive effect.

However, German lung physicians and experts have now issued a joint statement to reassure asthma patients on this score. They say the risk of infection for correctly adjusted asthma patients is not increased as long as they continue to take their medication regularly and do not stop taking it without consulting their doctor. Even in the event of deterioration, the cortisone dose should be adjusted only according to the instructions of the treating pulmonologist, they say.

Different Assessments

This assessment contrasts with recommendations that are critical of therapy with inhalable steroids (ICS). For example, the chief virologist of the Berlin Charite, Christian Drosten, has cautiously recommended that asthma patients should clarify with their treating physician whether their cortisone-based asthma medication should be replaced by one that does not interfere as much with the immune system.

However, since a connection between such cortisone-based medications and increased infection risk has not yet been scientifically proven, the experts of the German Society for Pneumology and Respiratory Medicine (DGP) continue to support inhalation therapy.

They say that a sudden discontinuation of the medication or a change in therapy could be considerably more dangerous than any increased risk of infection with SARS-CoV-2.

The DGP specialists regard older people with severe asthma and patients who regularly take cortisone tablets as being more at risk. Asthma patients who have so far used cortisone sprays only occasionally should now take them more regularly, they say, so that the airways remain open and patients do not have to struggle with coughing or shortness of breath. If the cortisone spray does not help, the doctor treating the patient should be consulted.

Are Additional Protective Measures Useful?

It can be true that people with chronic respiratory diseases are less able to fight viruses themselves because the lung mucosa is weakened. However, according to the lung specialist Rainald Fischer, asthma patients are not as severely endangered as some because their bronchial mucosa usually shows only allergic inflammation and does not develop pneumonia, as a rule.

Fischer also pointed out, however, that wearing a mask, such as one of the more effective FFP3 masks with filter function, can be unpleasant for lung patients in particular, as it makes breathing somewhat more difficult.

Since other viruses and bacteria can also inflame the lungs and bronchial tubes independently of the new coronavirus SARS-CoV-2, many doctors also consider influenza and pneumococcal vaccinations to be useful for asthmatics.

In general, asthmatics and other people with respiratory diseases should pay particular attention to recommended hygiene measures and maintain a sufficient safety distance of at least 1.5 meters (5 feet) from other people.

Reposted with permission from Deutsche Welle.

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In early October, Britain's Prince William teamed up with conservationist David Attenborough to launch the Earthshot Prize, a new award for environmentalist innovation. The Earthshot brands itself the "most prestigious global environment prize in history."

The world-famous wildlife broadcaster and his royal sidekick appear to have played an active role in the prize's inception, and media coverage has focused largely on them as the faces of the campaign.

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With more and more global attention on the climate crisis, celebrity endorsement of environmental causes has become more common. But why do environmental causes recruit famous faces for their campaigns? And what difference can it make?

'Count Me In'

"We need celebrities to reach those people who we cannot reach ourselves," says Sarah Marchildon from the United Nations Climate Change secretariat (UNFCCC) in Bonn, Germany.

Marchildon is a proponent of the use of celebrities to raise awareness of environmental causes. In addition to promoting a selection of climate ambassadors who represent the UN on sustainability issues, Marchildon's team has produced videos with well-known narrators from the entertainment world: among them, Morgan Freeman and Mark Ruffalo.

"We choose celebrities who have a lifestyle where they are already talking about these issues," Marchildon explains.

"Sometimes they reach out to us themselves, as David Attenborough did recently. And then they can promote the videos on their own social channels which reach more people than we do — for example, if they have 20 million followers and we have 750,000."

Environmental groups focused on their own domestic markets are also taking this approach. One Germany-based organization that uses celebrities in campaigns is the German Zero NGO. Set up in 2019, it advocates for a climate-neutral Germany by 2035.

German Zero produced a video in March 2020 introducing the campaign with "66 celebrities" that supported the campaign, among them Deutschland 83 actor Jonas Nay and former professional footballer Andre Schürrle. They solicit support as well as financial contributions from viewers.

"Count me in," they say, pointing toward the camera. "You too?"

"We are incredibly grateful for the VIPs in our videos," says German Zero spokeswoman Eva-Maria McCormack.

Assessing Success Is Complex

But quantifying the effectiveness of celebrity endorsement of campaigns is not a straightforward process.

"In order to measure effectiveness, first of all you need to define what is meant by success," says Alegria Olmedo, a researcher at the Zoology Department at the University of Oxford.

Olmedo is the author of a study looking at a range of campaigns concerning pangolin consumption, fronted by local and Western celebrities, in Vietnam and China. But she says her biggest stumbling block was knowing how to measure a campaign's success.

"You need a clear theory of change," explains Olmedo. "Have the celebrities actually helped in achieving the campaign's goals? And how do you quantify these goals? Maybe it is increased donations or higher engagement with a cause."

A popular campaign in China in recent years saw famous chefs Zhao Danian and Shu Yi pledge to abstain from cooking endangered wildlife. While the pledge achieved widespread recognition, both Olmedo and Marchildon say it's difficult to know whether it made any difference to people's actions.

"In life we see a thousand messages every day, and it is very hard to pinpoint whether one campaign has actually made a difference in people's behavior," she explains.

Awareness Is Not Enough

Many campaigns that feature celebrities focus on raising awareness rather than on concrete action — which, for researcher Olmedo, raises a further problem in identifying effectiveness.

"Reach should never be a success outcome," she says. "Many campaigns say they reached a certain number of people on social media. But there has been a lot of research that shows that simply giving people information does not mean they are actually going to remember it or act upon it."

But anecdotal evidence from campaigns may suggest reach can make an active difference.

"Our VIP video is by far the most watched on our social media channels," McCormack from German Zero says. "People respond to it very directly. A lot of volunteers of all ages heard about us through that video."

However, some marketing studies have shown that celebrity endorsement of a cause or product can distract from the issue itself, as people only remember the person, not the content of what they were saying.

Choosing the Right Celebrity

Celebrity choice is also very important. Campaigns that use famous faces are often aiming to appeal to members of the public who do not necessarily follow green issues.

For certain campaigns with clear target audiences, choosing a climate scientist or well-known environmentalist rather than a celebrity could be more appealing — Attenborough is a classic example. For others, images and videos involving cute animals may be more likely to get a message heard than attaching a famous face.

"We choose celebrities who have a lifestyle where they are already talking about these issues," says Marchildon from the UN. "You need figures with credibility."

McCormack cites the example of Katharine Hayhoe, an environmental scientist who is also an evangelical Christian. In the southern United States, Hayhoe has become a celebrity in her own right, appealing to an audience that might not normally be interested in the messages of climate scientists.

But as soon as you get a celebrity involved, campaigns also put themselves at risk of the whims of that celebrity. Prince William and younger members of the royal family have come under fire in recent years for alleged hypocrisy for their backing of environmental campaigns while simultaneously using private jets to fly around the world.

But Does It Really Work?

While environmental campaigns hope that endorsement from well-known figures can boost a campaign, there is little research to back this up.

"The biggest finding [from my study] was that we were unable to produce any evidence that shows that celebrity endorsement of environmental causes makes any difference," says Olmedo.

This will come as a blow to many campaigns that have invested time and effort into relationships with celebrity ambassadors. But for many, the personal message that many celebrities offer in videos like that produced by German Zero and campaigns like the Earthshot Prize are what counts.

The research may not prove this conclusively — but if the public believes a person they respect deeply personally cares about an important issue, they are perhaps more likely to care too.

"I personally believe in the power this can have," says Marchildon. "And if having a celebrity involved can get a single 16-year-old future leader thinking about environmentalist issues — that is enough."

Reposted with permission from DW.