RAMP

JAMA Internal Medicine released a research letter in August 2020 examining emergency visits for thunderstorm-related respiratory illnesses among older adults. The study was designed to determine whether increases in emergency department (ED) visits for acute respiratory illnesses occur among Medicare beneficiaries in the days surrounding thunderstorms across the continental US. The researchers note this is particularly important because thunderstorm-related atmospheric changes are expected to increase in severity with rising global temperatures. To view the letter’s abstract, click here: https://bit.ly/3lDY6nN

Earlier this year, authors Lidia Morawska and Donald K. Milton published, It is Time to Address Airborne Transmission of COVID-19. Signed by 239 scientists, the stated purpose of the publication is: We appeal to the medical community and to the relevant national and international bodies to recognize the potential for airborne spread of COVID-19. There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to... medium distances (up to several meters, or room scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission. The authors explain that multiple studies have demonstrated that viruses are released during exhalation, talking, and coughing in microdroplets small enough to remain aloft in air and pose a risk of exposure at distances beyond 1 to 2 m from an infected individual. This poses the risk that people sharing environments can potentially inhale these viruses, resulting in infection and disease. This problem is especially acute in indoor or enclosed environments, particularly those that are crowded and have inadequate ventilation relative to the number of occupants and extended exposure periods. The main purpose of the publication was to ask the World Health Organization to acknowledge the role of aerosol transmission in the spread of COVID-19. Following this publication, the World Health Organization released a brief in which they maintain that the virus is mostly spread through close contact with infected people but call for more research into the matter of transmission by aerosolized particles. While the relevance of this exchange is not directly tied to asthma, it has direct impacts on policies and practices related to indoor air quality, which do have a direct impact on asthma. Read more here: https://bit.ly/3hY3wqC

On July 1, 2020, the American Academy of Allergy, Asthma, and Immunology updated its information sheet on Caring for Pregnant Patients with Asthma During the COVID-19 Pandemic. The authors explain that Few data exist to indicate that having asthma is associated with an increased risk of becoming infected with COVID-19 or a more severe course in the non-pregnant infected patient. Recent reassuring data show that having asthma was not associated with an increased risk of hospi...talization or even mortality in COVID-19 hospitalized patients. There are even fewer data for pregnant asthmatic women with COVID-19. Current recommendations emphasize the need to maintain asthma control during pregnancy. Reducing controller therapy could put pregnant women with asthma at increased risk of an asthma exacerbation necessitating medical care, which could then put them at an increased risk of being exposed to COVID-19. See more

The U.S. Environmental Protection Agency's Indoor Air Quality Tools for Schools Program is hosting a webinar titled, Indoor Air Quality in K-12 Schools: Addressing the Concept of Layered Risk Amidst COVID-19. The webinar will focus on how proper indoor air quality management can lead to fewer health risks and explore the basis for the indoor air quality guidance issued by the government and public health organizations. The webinar will feature panelists from the EPA, as well as the International Society of Indoor Air Quality and Climate and the American Industrial Hygiene Association. It will take place Thursday, November 19th, from 9:00am 10:30am Pacific Time. For more information and to register, click https://bit.ly/3kt3Y1a.

Researchers published an article in the October edition of European Review of Medical and Pharmacological Sciences, looking at the impact of wildfire smoke on COVID-19 in San Francisco. The researchers looked at daily COVID-19 cases, deaths, particulate matter (PM-2.5 m) and carbon monoxide from March 20, 2020 to Sept 16, 2020. They found that a one micrometer (g/m3) increase in PM2.5 were associated with an increase in the daily COVID-19 cases, cumulative cases and cumula...tive deaths by 0.5%, 0.9% and 0.6%, respectively. Additionally, with a 1 part per million (ppm) increase in carbon monoxide level, the number of daily COVID-19 cases, cumulative cases and cumulative deaths increased by 5%, 9.3% and 5.3%, respectively. They concluded that, "The wildfire allied pollutants, particulate matter PM-2.5m and CO have a positive association with an increased number of SARS-COV-2 daily cases, cumulative cases and cumulative deaths in San Francisco." https://pubmed.ncbi.nlm.nih.gov/33090440/

With the expansion of telemedicine during the COVID-19 pandemic, public health leaders have hoped that this method of care would increase the ability to reach vulnerable populations. However, a number of challenges have arisen. On October 2, 2020, researchers Thromson et al published an invited commentary titled, The Pandemic of Health Care Inequity in the Open Network of the JAMA. The authors explain, local patterns suggest a story of differential access to virtual care. ...During the second quarter of 2020, we saw low rates of telemedicine (i.e., audiovisual visits) adoption in clinics primarily dedicated to the care of patients who are unhoused (11 of 2632 visits [0.4%]), patients with limited English proficiency (69 of 2617 visits [2.6%]), and a racially diverse safety-net population (329 of 4477 visits [7.3%]). They noted that the most common barrier they encounter is lack of access to the necessary technology. They shared, Our observations are not unique; Nouri et al recently found that patients with socioeconomic disadvantage were significantly underserved by telemedicine visits in March 2020. Citing poor access to technology as a major factor, they described lower rates of telemedicine uptake among patients who were non-White individuals, were older, had low English proficiency, and lacked commercial insurance. The authors explain that while these challenges are significant, they are not insurmountable. Cross-sector collaboration among health care systems, local governments, telecommunication companies, schools, community-based organizations, and philanthropic organizations is needed to address inequitable access to critical resources and provide assistance for the members of our communities with the most risk. We must advocate for broadband infrastructure and internet-capable devices for underserved patients. The comments in this article are noteworthy for health professionals serving patients with asthma. While a lot of asthma care can be successfully conducted through telemedicine, we need to ensure access to those services for the most vulnerable patients. Asthma home visiting programs across California are exploring ways to address the digital gap and identify best practices for providing virtual asthma services during, and possibly beyond, the pandemic. Read more here: https://bit.ly/3e3zkKB

Researchers from the Harvard T.H. Chan School of Public Health and Massachusetts General Hospital analyzed data from 492,768 participants in the UK Biobank, which stores biologic samples from participants and is linked to their medical records. The researchers found 65,677 participants had asthma and 641 patients had severe COVID-19. After adjusting for age, sex, body mass index, and other factors, the researchers found that having non-allergic asthma increased the risk of ...severe COVID-19 by as much as 48%. They also found that the risk of severe COVID-19 increased by as much as 82% among people with asthma and chronic obstructive pulmonary disease. Importantly, however, the study showed that people with allergic asthma had no statistically significant association with severe COVID-19. The researchers published their results in the Journal of Allergy and Clinical Immunology in June. Read the article here: bit.ly/35YFF80 See more

The U.S. Environmental Protection Agency and the North American Development Bank are sponsoring an webinar titled Ask the Experts: Wildfire Smoke, Mental Health, and Green Cleaning-Sanitizing-Disinfecting. The webinar will feature speakers from the Western States Pediatric Environmental Health Specialty Unit and is designed for both parents and caregivers. The webinar features children’s health experts, and is tailored to those looking to protect their kids from wildfire sm...oke, those looking for how to safely clean and disinfect their homes, and those trying to support their family’s mental health during these times. The webinar will take place today, October 20th, from 2:00pm 3:30pm Pacific Time. Simultaneous interpretation into Spanish will be provided during the program. To register, and for more information, click here: https://bit.ly/3dGSCFj

The American Lung Association has launched a new podcast with their Chief Medical Officer, Dr. Albert Rizzo. Lungcast spotlights conversations with researchers, physicians, patients, and advocates about hot topics impacting lung health. The first episode featured Dr. David Ho, a disease expert helping to solve the COVID-19 pandemic. For more information and to listen to the episodes, click https://www.lung.org/professional-education/lungcast.

The UC Davis' Western Cooling Efficiency Center has released a video on the importance of ventilation in schools. Ventilation in Schools is a six minute video that helps show why schools being ventilated and having good indoor air quality is critical to protecting the health and well-bring of those in the schools. It also details why COVID-19 has made it even more important schools have good ventilation to reduce airborne exposures. To watch the video, click here: https://youtu.be/F9hB9BgonHs.

Published on July 8, 2020, in the journal Nature, authors Elizabeth J. Williamson et al, reviewed results of the largest cohort study conducted by any country to date. They looked at risk factors connected to 10,926 COVID-19 deaths in the UK. They found that COVID-19-related death was associated with: being male; older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. As explained by the COVID-19 Response Task... Force of the American Academy of Allergy, Asthma, and Immunology, the study results suggested that asthma patients who had received oral steroids (OCS) in the past year also had increased mortality. They state, However, when the data were limited to those in whom BMI, smoking history, and ethnicity were known (and, thus, could be controlled for), asthma with or without OCS use did not demonstrate a significant increased risk for death from COVID-19. Therefore, even with this paper, the preponderance of published data continues to demonstrate no increased severity or mortality with COVID-19 in asthma patients. Read more here: https://go.nature.com/3kD1KNq

In September 2020, the Asthma and Allergy Foundation of America (AAFA) released COVID-19 and Asthma Toolkit for Schools designed to address the major challenges schools are facing in the 2020-2021 school year. School administrators, nurses and staff can use this toolkit to create an environment that can help protect students and staff with asthma, while preventing the spread the new coronavirus. The free, downloadable toolkit includes easy-to-use checklists, recommendations on ventilation, cleaning and disinfecting, and guidance on face coverings, physical distancing and other measures. Check out the toolkit here: https://bit.ly/3hNv41W

The California School-Based Health Alliance is hosting its 2020 California School-Based Health Conference: School Health on the Frontlines -- Navigating Pandemics and Building Equity. Taking place from October 6th 8th, the conference is an opportunity to learn, grow and connect with fellow providers, educators and advocates. School-based health centers are critical partners for managing asthma among vulnerable youth, and RAMP has been partnering with school-based health leaders in addressing the burden of asthma in California. For more information and to register, click here: https://bit.ly/2ROSYzv

Lead and Healthy Housing Conferences has announced it will host a 2020 Virtual Conference on Lead and Healthy Housing from August 31st through September 11th, 2020. The online event will include more than 30 conference sessions and can provide up to 28 CEUs by the National Environmental Health Association. In addition, all presentations will be available on demand through October 31st, 2020. For full information and to register, click here: https://bit.ly/39AfIeu

The American Lung Association is hosting a virtual Asthma Educator Institute from August 31st to September 2nd, 2020 from 12:00pm 5:30pm Central Time (CDT). The Asthma Educator Institute is a professional education course that targets frontline healthcare professionals with over 1000 direct hours of asthma education, and aims to prepare them for the national asthma certification exam. The curriculum covers content outlined in the NAECB Candidate Handbook and includes case studies, skills demonstration and more. Registration is open now and costs $300. Registration covers materials, continuing education credits, a demo device toolkit, and access to resources. For more information, click https://bit.ly/2Fklh5Z

The National Institute for Health Care Management (NIHCM) Foundation is hosting a webinar titled Environmental Health: Air Pollution, COVID-19 & Health Disparities on Friday, August 21st, from 9:00am 10:00pm Pacific Time. The webinar will explore what contributes to air pollution and how COVID-19 has highlighted environmental injustice and inequity. The webinar will also discuss how neighborhoods with poorer air quality and extreme heat are bearing the brunt of the pandemic and will describe strategies to improve air quality and combat asthma. Registration for the webinar is open now. For more information, and to register, click https://bit.ly/2XUd6Ui

The Environmental Protection Agency is hosting a webinar series discussing how to create and maintain healthy learning environments in schools. These webinars will discuss plans, practices, and principles from experts put in place to sustain indoor air quality management programs. All webinars will feature question and answer following the presentation. What Schools Need to Know: Practices and Principles for Healthy IAQ and Reducing the Spread of Viruses will take place Thursday, August 13th, 2020, from 12:00pm 1:30pm Pacific Time. The webinar focuses on strategies to develop a comprehensive indoor air quality management plan with guidance specific to schools to help prevent the spread of viruses and bacteria. For more information and to register, click https://bit.ly/3ajPTQh.

JAMA Network Open features an article in its June 2020 edition estimating asthma prevalence by various disability categories and developmental delays in a diverse sample of the US pediatric population. In order to do so, researchers collected data from a population-based cross-sectional study of 71,811 families with children. They found that U.S. children with various developmental disabilities or delay may have higher odds for developing asthma. To view the full article, click https://bit.ly/3f704sg