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Coronavirus: What Is the Risk for Asthma Patients?
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.
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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Clear-cutting a forest is relatively easy—just pick a tree and start chopping. But there are benefits to more sophisticated forest management. One technique—which involves repeatedly harvesting smaller trees every 30 or so years but leaving an upper story of larger trees for longer periods (60, 90, or 120 years)—ensures a steady supply of both firewood and construction timber.
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A Gap of 500 Years<p>The team found wood with the characteristic coppice-with-standards tree ring pattern dating to as early as the 6th century. That was a surprise, Muigg and his colleagues concluded, because the first mention of this forest management practice in historical documents occurred only roughly 500 years later, in the 13th century.</p><p>It's probable that forest management practices were not well documented prior to the High Middle Ages (1000–1250), the researchers suggested. "Forests are mainly mentioned in the context of royal hunting interests or donations," said Muigg. Dendrochronological studies are particularly important because they can reveal information not captured by a sparse historical record, he added.</p><p>These results were <a href="https://www.nature.com/articles/s41598-020-78933-8" target="_blank">published in December in <em>Scientific Reports</em></a>.</p><p>"It's nice to see the longevity and the history of coppice-with-standards," said <a href="https://www.teagasc.ie/contact/staff-directory/s/ian-short/" target="_blank">Ian Short</a>, a forestry researcher at Teagasc, the Agriculture and Food Development Authority in Ireland, not involved in the research. This technique is valuable because it promotes conservation and habitat biodiversity, Short said. "In the next 10 or 20 years, I think we'll see more coppice-with-standards coming back into production."</p><p>In the future, Muigg and his collaborators hope to analyze a larger sample of historic timbers to trace how the coppice-with-standards practice spread throughout Europe. It will be interesting to understand where this technique originated and how it propagated, said Muigg, and there are plenty of old pieces of wood waiting to be analyzed. "There [are] tons of dendrochronological data."</p><p><em><a href="mailto:email@example.com" target="_blank" rel="noopener noreferrer">Katherine Kornei</a> is a freelance science journalist covering Earth and space science. Her bylines frequently appear in Eos, Science, and The New York Times. Katherine holds a Ph.D. in astronomy from the University of California, Los Angeles.</em></p><p><em>This story originally appeared in <a href="https://eos.org/articles/tree-rings-reveal-how-ancient-forests-were-managed" target="_blank">Eos</a></em> <em>and is republished here as part of Covering Climate Now, a global journalism collaboration strengthening coverage of the climate story.</em></p>
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