chronic lung conditions and flu season: staying safe and avoiding serious risks
9 minute read
for people with lung conditions, catching a viral infection isn't the only factor that can cause exacerbations. cold weather and indoor air can also play a role.
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almost everyone has gotten the flu at least once in their lifetime, often leading to minor illnesses requiring little to no medical intervention. however, for people living with chronic lung conditions, catching a flu infection can be so severe that it leads to hospitalization or death. according to the canadian lung association, roughly 4,500 people in the country die from the flu each year.
people with pre-existing lung conditions such as asthma or chronic obstructive pulmonary disease (copd) need to take extra precautions during flu season, as it can literally be the difference between life and death.
understanding chronic lung disease
even on a good day, living with a chronic lung condition can be challenging. people have to contend with a decreased quality of life because of their symptoms, which often lead to difficulty breathing and reduced mobility as the disease progresses.
these conditions do not start loud in the sense that the symptoms are incredibly minor. because of that, delayed diagnosis and treatment can often occur, leading to poorer outcomes for people who develop lung disease.
dr. dawn bowdish, professor of immunology at mcmaster university’s department of medicine, executive director of the firestone institute for respiratory health, and board member and scientific advisor for the lung health foundation, researches respiratory infections and has seen firsthand how challenging it can be to experience symptoms but not get diagnosed until the condition has progressed to a more dangerous point.
“many chronic lung diseases are diseases of age where people start to feel a little breathless. they can’t do as much,” she said. “they do the stairs, and suddenly, when they didn’t used to have a problem going up a flight of stairs, suddenly there’s breathlessness.”
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she goes on to say that lung diseases also don’t typically present with pain, so it’s unlike other forms of chronic disease that alert people to something wrong by sending pain signals to the brain.
instead, people chalk non-specific lung disease symptoms like a chronic cough or breathlessness up to old age, not exercising enough, or having another chronic disease such as obesity instead of seeking the proper diagnostic tests and ensuing treatment.
“they often don’t seek treatment, and then by the time they do seek treatment, they’re a little further along than many of the respirologists would like them,” said dr. bowdish. “and once people have a chronic lung disease, there’s really very little that can be done to reverse it. it’s all about managing and caring for symptoms.”
mr. jeffrey beach, the president and ceo of asthma canada, also recognizes how difficult it can be to manage asthma as well, which is a condition much like copd that causes inflammation in the airways.
people with asthma are especially sensitive to environmental triggers, so they too are at a greater risk of severe flares if they get a respiratory infection. managing chronic lung disease can be challenging, but those challenges become amplified when flu season rolls around.
“when someone has an infection with a respiratory virus, such as influenza, that causes, or it can exacerbate or cause further inflammation of the airways in the lungs,” he said.
the impact and risks of a flu infection in vulnerable populations
when someone with a respiratory disease comes into contact with pathogens that cause respiratory infections, the level of lung damage they experience gets significantly worse. when breathing and the health of the lungs are already compromised, it can lead to severe consequences.
“(a) major challenge that people have is what we call exacerbations or infections,” said dr. bowdish. “so, this is when most commonly someone gets a viral infection, and that triggers a massive inflammatory response to the point where their lungs will up with liquid, and they can’t breathe, and they end up in the hospital.”
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after someone has an event that requires them to seek hospital care, the odds of it happening again increase significantly, leading to worsened outcomes for patients because lung function continues to decrease with all of these events.
“eventually, you either need to carry around an oxygen tank, or they can be fatal,” said dr. bowdish.
flu season typically marks an uptick in these types of events for people with chronic lung disease because of that exact reason. even with proper hospital care, the increased risk for the most dangerous of lung infections can leave these people to contend with possibly grave complications.
“there’s a higher risk for complications,” said beach. “for example, (they’re) more likely to develop pneumonia after contracting the flu compared to someone who doesn’t have asthma or another chronic health condition. so, that is something that people really need to be prepared for and take seriously as we approach this flu season in the winter months.”
for people with lung conditions, catching a viral infection isn’t the only factor that can cause exacerbations. cold weather and indoor air can also play a role.
“cold weather can sometimes send people into an asthma attack,” said dr. bowdish.
beach also finds that in addition to cold weather, people breathe more indoor air because cold weather forces people inside, which can lead to increased issues with breathing and lung disease complications in areas where air quality is low.
“looking at air quality indoors, we often think, especially during the last couple of years with the wildfire smoke and the obvious impacts that external air pollution can have on people living with lung health conditions, but indoor air is what we’re breathing in the winter, more than outdoor air.”
if indoor air quality isn’t up to par, people may require air purifiers to ensure that their lungs don’t suffer from those consequences as well.
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care guidelines and access during flu season
treating flu season as any other season isn’t a luxury that people living with chronic lung diseases can afford. they have to approach the entire flu season in a way that helps provide them with further protection from developing a dangerous or potentially life-threatening illness.
according to beach, people should consult with their healthcare provider before flu season starts every year to ensure that all their medications are up to date and that they have the proper dose and frequency outlined.
“asthma sometimes is a disease that people, especially if they don’t have severe asthma, people will just sort of settle into a routine,” he said.
this routine often makes people more vulnerable because extra measures are rarely included.
unfortunately, many people with chronic lung diseases do not have access to a family physician, making accessing care during flu season much more difficult.
“there’s a shocking number of people that don’t have a primary care provider, family physician, or family health team,” said beach.
he recommends that in those cases where accessing care to create a flu season plan isn’t as easy, people can turn to other resources for help to stay on top of their health.
“we (asthma canada) have a helpline that’s available by phone or by email that people can call or email into. that helpline is staffed by certified respiratory educators who are professionals. they’re nurses, they’re respiratory therapists, some are pharmacists trained in asthma and copd disease management strategies,” he said.
these people cannot provide prescriptions, but they can answer questions to help someone determine what course of action they should take.
asthma canada also provides asthma control test questionaries that people can access to learn how well their disease is managed. if they find out it’s not, they can seek medical assistance to get it back on track.
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this questionnaire also comes in handy when people go to their doctors to create a flu-season care plan (or all year round) because it can outline what a patient is experiencing in a straightforward way for the healthcare provider.
“having that information going into the doctor or the nurse practitioner, whoever you’re seeing, and say, ‘look, you know, i’ve gone through this. i’ve checked out the information on asthma canada’s website. i’ve talked to one of their certified respiratory educators. here’s what’s happening. i really think we need to take a look at what my medication is or how i’m managing my disease, and i need your help to do that,’” said beach.
he also goes on to say that it’s crucial for patients to be their own advocates and be ready with questions and concerns when they see the doctor because, in today’s healthcare system, it’s not always easy.
dr. bowdish agrees with the need to see a healthcare provider for lung conditions during flu season, especially if symptoms are worsening.
“oftentimes, especially around the christmas holidays, but thanksgiving holidays (as well), and sometimes people don’t want to go to the hospital,” she said. “they’ve heard about the burdened healthcare system, and they feel like they might be able to wait this one out, and every respirologist i know and work with would much rather see you before things get bad than have to fix it when things get bad.”
it’s all about being proactive, according to dr. bowdish.
“i know we’re living in a time with incredibly strained healthcare resources, but your doctors want to give you the best quality of life for as long as possible, and it’s much easier to do that preventatively than after the fact.”
caring for yourself during flu season
when it comes to ensuring that you’re well taken care of during flu season, the first and foremost best thing you can do is get vaccinated against the flu. this vaccination is an added layer of protection for those with chronic lung conditions.
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the canadian government has established a flu vaccine program that provides people with free vaccines in convenient locations, such as pharmacies. this makes it that much easier to get the flu shot, especially if you already have pre-existing conditions that would greatly benefit from the protective measure.
“we’re fortunate in canada that we have a good vaccination program that’s available, including flu vaccines that are widely available,” said beach. “so, it is really important that people keep up to date with their respiratory illness vaccines, and we want to ensure that people who have asthma and other lung health conditions really see that as part of managing their condition.”
it isn’t just people living with chronic diseases that should get the flu vaccine, but also those who are around those people. because while a healthy person won’t suffer from a severe adverse event, those who they love with chronic lung diseases may not be so lucky.
“the more people in the circle of those people living with chronic lung disease who are vaccinated, the more protection they get, and even if it’s a minor infection in a child or a healthy adult, that can be a pretty major event for older adults living with these conditions,” said dr. bowdish. “so, ideally, everyone who cares for someone who’s living with chronic lung disease, which is, by the way, just about everyone since one in five canadians have chronic lung disease (should get vaccinated).”
asthma canada also has a downloadable document that people can use to help manage their appointments, medications, and symptoms. it can also be used to develop an action plan if someone experiences an exacerbation of their disease.
other ways people can help protect themselves this flu season are to know the risks and practice other prevention measures besides vaccination.
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“things that we did learn during that period (covid-19) that can be applied to managing flu as well, especially for someone living with asthma, is washing hands frequently can help and of course after coughing, sneezing, and so forth, just paying attention to that and trying to avoid situations where you’re exposed or exposing others if you happen to be sick yourself,” said beach.
whether you live with a lung condition or just love someone who does, taking actionable steps to prevent infection can save a life.
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