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A consistent increase in the intensity and length of allergy season in regions of the United States signals a difficult season in 2020 for patients with allergic rhinitis, at the same time as the COVID-19 pandemic affects communities.
“We are seeing quite a bit of concern and confusion because allergy season is early this year due to warmer temperatures and symptoms can come on suddenly,” said Lakiea Wright, MD, from Brigham and Women’s Hospital in Boston, who was scheduled to speak at the recently cancelled American Academy of Allergy, Asthma and Immunology (AAAAI) 2020 Meeting.
“Everyone is on edge, so if they start to have a cough or feel congested, they might have a moment of panic. That’s why it’s up to us to pinpoint what’s really going on,” she told Medscape Medical News.
Both allergies and COVID-19 can involve congestion, a run-down feeling, coughing, and a running nose, explained Jeffrey Factor, MD, from the Connecticut Asthma & Allergy Center in West Hartford.
Itching, watery eyes, and sneezing, though, are symptoms of allergies and are not associated with the virus, he added.
“It is difficult to protect patients from outdoor molds and pollens,” said Sanjiv Sur, MD, from the Baylor College of Medicine in Houston.
Although allergies can be treated with over-the-counter or prescription medications, right now “there is a lack of availability of over-the-counter medications because people have stocked up,” he told Medscape Medical News. “Patients should not wait until the last minute to ascertain whether they have enough supplies.”
Allergies vs Coronavirus
It’s important that patients know the difference between allergies and COVID-19, and understand when they should be concerned. That point, Sur explained, is when they develop shortness of breath in addition to flu-like aches and pains.
Although fever is a common symptom of COVID-19, it’s helpful to let patients know that people can have the virus without ever developing a fever, he pointed out.
If a patient’s symptoms improve with medication or when they stay inside, it’s likely they’re dealing with allergies.
Wright said she is advising patients to keep a journal of symptoms, possible triggers, and details such as whether windows are open when symptoms start, the time of day when symptoms are worst, the daily weather, and the length of time between when they take an allergy medication and when they feel relief.
“This gives patients a greater feeling of control, and that’s important because, often, fear comes from a sense of uncertainty and lack of control,” she explained. “Sometimes, just sitting down to document symptoms brings comfort because they feel like they’re doing something to take charge of their health.”
It’s especially important that patients with both allergies and asthma have enough controller medication to last beyond a stay-at-home order, and that they have access to their albuterol inhaler. In some parts of the country, there have been reports of shortages of rescue medication, Wright reported.
Healthcare providers should tell patients to check that their inhalers are not expired and that they have enough inhalations left for several potential rescue situations, Wright advised. This can help determine prescription priority.
Like other specialists, many allergists are using telehealth to check in with patients. This can help assuage worries significantly, Factor pointed out.
“Obviously, this is not as ideal as being able to see someone in person, but it’s the next best thing,” he said. “It’s helpful to both me and my patients, and it’s reassuring, especially as allergy season starts in earnest.”
The National Allergy Bureau is a network certified by the AAAAI that counts pollen and mold, compiles allergen levels from certified stations across the country, and tracks regional counts.
American Academy of Allergy, Asthma and Immunology (AAAAI) 2020 Meeting.