USAsthma Summit 2021 Looks to the Future in Asthma and COVID-19 Care

Allergy & Asthma Network hosted its 7th annual USAsthma Summit on Nov. 5 in New Orleans.
Approximately 50 people attended in person and more than 700 watched via an interactive livestream during the day-long Summit.

More than 24 million people live with asthma in the United States. But there is relatively little public understanding about its impact, especially on quality of life. The USAsthma Summit is designed to bring together healthcare professionals – asthma coalitions, state asthma programs, doctors, school nurses, community health workers, patients and other key stakeholders – to advance Guidelines-based asthma care.

In addition, the Summit focused on the future of asthma treatment alongside COVID-19, including a look at “long haul COVID” and the continued growth of telemedicine.

The USAsthma Summit is held in conjunction with the American College of Allergy, Asthma & Immunology (ACAAI) and with the support of the U.S. Centers for Disease Control and Prevention (CDC).

Patient Testimony: Melody Papazis 

(Starts at 11:00 in video)

Allergy & Asthma Network President and CEO Tonya Winders opened the USAsthma Summit with the story of severe asthma patient Melody Papazis.

Melody was diagnosed with asthma at age 14. Her asthma worsened to the point where she was hospitalized more than 15 times. After years of breathing difficulty, she eventually found treatment in bronchial thermoplasty, a medical procedure that uses a catheter to heat the lining of the airways. “My lungs opened up like never before. I could finally breathe freely,” Melody says.

Asthma treatment has allowed her to live a full life. “It’s amazing how breathing freely has raised my spirits and quality of life,” she says. “With a lot of help, I chose not to let asthma define me.”

Global Initiative for Asthma (GINA) – 2021 Updates

(Starts at 19:25 in video)

Tonya Winders serves on a GINA expert panel that provides feedback on global asthma care guidelines. She detailed the 2021 updates during the USAsthma Summit.

GINA guidance for COVID-19 reinforced that people with asthma are not at increased risk of getting COVID-19. However, people with severe asthma who recently were treated with oral corticosteroids or were recently hospitalized were at increased risk of death. GINA also recommends people with asthma get the COVID-19 vaccine.

In its 2021 update, GINA clarified its guidance for adults and adolescents regarding regular use of short-acting bronchodilators (SABA) to control asthma flares. This has been associated with adverse effects.

The preferred approach, according to GINA, is to now use a low-dose inhaled corticosteroid (ICS) of formoterol. This can help reduce the risk of an asthma flare. If ICS-formoterol is not available, then the alternative is to use the short-acting bronchodilator.

The State of Asthma in the Age of COVID-19

(Starts at 56:51 in video)

Luz Fonacier, MD, ACAAI President, joined the USAsthma Summit to discuss the state of asthma in the United States. She addressed recent innovations in asthma care. Researchers continue to identify asthma and allergy phenotypes that allow work on precision medicine treatments.

Dr. Fonacier cited several studies addressing asthma and COVID-19. One study presented at the ACAAI annual meeting Nov. 4-8 revealed that Latinos are significantly more likely to experience an asthma flare after having COVID-19.

With cases of asthma hospitalizations declining during the pandemic, more research is needed to learn how interventions could contribute to fewer asthma flares.

Eosinophilic Asthma: Signs, Symptoms and Treatment

(Starts at 1:15:00 in video)

Bradley Chipps, MD, ACAAI Past President and Medical Director of Capital Allergy & Respiratory Disease Center in Sacramento, California, discussed “care pathways” for eosinophilic asthma.

Eosinophilic asthma is a subtype of asthma that is difficult to control with traditional asthma medications. With this type of asthma, the numbers of eosinophils – a type of white blood cell – are increased in blood, lung tissue, and mucus. The entire respiratory tract becomes involved in airflow obstruction, from the sinuses to the small airways.

Dr. Chipps reviewed the latest on biologics as a primary treatment for eosinophilic asthma. He noted that benralizumab is effective in suppressing eosinophils and reducing asthma flares. Omalizumab was helpful in children at all eosinophilic levels.

Learn more about eosinophilic asthma at eosasthma.org.

Building an Asthma Lifestyle Plan: The Total Lung Connection to Improve Asthma Outcomes

(Starts at 2:10:27 in video)

Don Bukstein, MD, Medical Director at Allergy & Asthma Network, discussed the importance of lifestyle changes to manage asthma. He encourages patients to develop a Lifestyle Action Plan that, in addition to medications, addresses sleep, exercise, nutrition, stress and environmental factors.

“On balance, an investment in wellness promotes enhanced disease control, greater productivity at work or school, and improved quality of life,” Dr. Bukstein says.

Wellness programs can be part of Shared Decision Making, he adds. Shared Decision Making involves the doctor and patient working together to come to a decision on the best course of treatment using the best available evidence. Studies show Shared Decision Making improves patient satisfaction and adherence to treatment plans.

Latest Updates on COVID-19: Asthma, Allergies and the Long Haul

(Starts at 2:52:45 in video)

Purvi Parikh, MD, a board-certified allergist and immunologist in New York City and COVID-19 vaccine researcher zeroed in on “long haul COVID symptoms.” Many long-haul patients have recovered from COVID-19 and have negative tests but continue to experience debilitating symptoms. It has forced many out of work and impacted quality of life.

One theory about long haul COVID, Dr. Parikh says, is the virus may remain the body in some small form. Another theory suggests the immune system may continue to overreach even though the infection has passed. Research is ongoing.

Approximately 10-30% of COVID-19 patients experience long haul COVID symptoms. “Current numbers and trends indicate that this could be our next health disaster in the making,” Dr. Parikh says.

Is As-Needed Use of Controlled Inhalers OK in Mild Asthma?

(Starts at 3:25:05 in video)

Kaharu Sumino, MD, Associate Professor in Medicine at Washington University in St. Louis and clinician investigator in pulmonary medicine discussed the results of the ASIST Study examining mild asthma. The study was funded by the Patient-Centered Outcomes Research Institute (PCORI).

The study of children and teens with mild persistent asthma found that using a controller inhaler as needed worked the same as daily use by improving…

• asthma control
• number of asthma flares
• how well the lungs work
• quality of life

Parents should consult with their doctor and discuss whether this asthma treatment approach is appropriate for their child. Any change in treatment should be added to the child’s Asthma Action Plan.

Learn more about the ASIST Study with these free resources:

• Treating Mild Persistent Asthma In Children – for healthcare professionals
• Managing Mild Asthma in Children Age Six and Older – for parents

Telemedicine and Digital Health Post COVID: Where Do We Go From Here?

(Starts at 5:06:27 in video)

Jacqueline Eghrari-Sabet, MD, Medical Director of Telehealth for Allergy & Asthma Network, spoke about the emerging role of telemedicine in healthcare. She noted that 92% of adults now own a cellphone and 70% of patients search the Internet for healthcare answers.

Dr. Eghrari-Sabet discussed benefits of telehealth for patients (convenient access), physicians (extends geographic barriers) and payers (low-cost care). Some concerns included quality of care over telehealth, security of their health data and lack of personal interaction.

What types of visits work best for telehealth? Dr. Eghrari-Sabet says…

• new health concerns that can be assessed without an in-person physical exam
• follow-up visits for newly prescribed medications and/or chronic conditions that require education or counseling

The CDC EXHALE Technical Package to Control Asthma: What it Looks Like In the Community

(Starts at 5:49:50 in video)

John Dowling, Program Manager for the Michigan Asthma Prevention and Control Program, talked about how to implement the CDC’s EXHALE strategies.

EXHALE consists of six patient-centered strategies that reinforce:

Patient Testimonial: Laonis Gooden, RN

(Starts at 6:31:45 in video)

Laonis Gooden, RN, from Detroit joined the Summit virtually to share the story of her son Anthony, who passed away due to an asthma attack in 2007. Laonis founded the Breathe Anthony J. Chapman Foundation to raise awareness and educate people on the impact of asthma.

“There’s so much work to be done,” Leonis says. “The disparities that African Americans face, that Anthony faced daily since he was 21 years old – we did not have access to quality care. We had to use the emergency room as our doctor’s office. When you have to go to the emergency room as much as my son did, your asthma is not under control.

“Asthma is controllable and there’s no reason anyone should die of an asthma attack. All of us together, we can do better.”

Not One More Life Trusted Messengers Program: Lessons Learned from Engaging Communities of Color During COVID-19

(Starts at 6:42:10 in video)

Allergy & Asthma Network’s Not One More Life Trusted Messengers program expands access to care in communities of color across the United States. The program was created to partner with churches in primarily African American neighborhoods and offer free asthma and COPD screenings, COVID-19 testing and vaccinations, and patient education.

Patients identified with uncontrolled asthma or COPD were enrolled in a 6-week digital telehealth coaching program.

African Americans continue to face high asthma rates, hospitalizations and deaths. These disparities have been apparent again since the start of the COVID-19 pandemic: African Americans experienced 20.8% of all COVID-19 deaths despite representing 12.4% of the population.

“Something within us must say this is wrong and it must stop,” Tonya Winders says.

Learn more about our Trusted Messengers program.

2021 EPA Award Winners: Addressing Asthma Disparities and Health Inequities in Communities

(Starts at 7:09:07 in video)

The U.S. Environmental Protection Agency (EPA) introduced its two winners of the 2021 National Environmental Leadership Award in Asthma Management.

The Central California Asthma Collaborative in Fresno, California implemented an Asthma Impact Model Program to improve the lives of low-income, predominantly Hispanic and African American asthma patients. They conducted in-home interventions to reduce environmental triggers, ensure proper use of medications, and improve access to care.

Rady Children’s Hospital-San Diego established a Community Approach to Severe Asthma Program. It used community health workers to improve asthma management for children, conduct home visits for environmental assessments and reinforce treatment plans. Due to COVID-19 in 2020, the hospital moved the program to a virtual format with great success.

The Future of Asthma Care in 2030

(Starts at 7:59:34 in video)

Tonya Winders concluded the USAsthma Summit with a compelling glimpse of what the future may hold for asthma management and treatment.

Asthma prevalence may double in the next decade due to effects of climate change, worsening air pollution and rising urban obesity. Long haul COVID could cause more people to be diagnosed with asthma and/or COPD. This could lead to a greater demand for more effective treatments.

Personalized treatment options are in the pipeline already. Improved inhaler design and access to affordable biologics are seen as key advances in asthma medications, Winders says.

Finally, in 2030 people with asthma will refuse to be defined by their disease. Patients will feel empowered to self-manage. And asthma will be regarded NOT as a determining factor of life, but a part of life.

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