The trees are once again dusting everything with powdery yellow pollen, but it’s hardly allergy season as usual.
Allergy sufferers may be wondering about their symptoms while the the new coronavirus spreads. Meanwhile, doctors and nurses at Allergy Partners of Richmond are screening and spacing out patients to help with social distancing while re-examining the best treatments.
Dr. Michael Blumberg and Becky Collie, practice ambassador at Allergy Partners of Richmond, answered questions related to spring allergies and asthma versus the coronavirus in this Q&A, which has been edited for length and clarity:
QUESTION: How do the symptoms of seasonal allergies and COVID-19 overlap and how do they differ, and what is your advice to people?
BLUMBERG: People who have allergies almost never have a fever with it, so if you’re running 100 degrees or above temperature, that usually is not an allergy. The people with allergies also don’t get the flu or COVID-19-type aches and pains, where their whole body hurts. And although they might cough, it’s not the severe, painful coughing that you get with the flu or COVID-19.
People who have allergies, they obviously have respiratory symptoms. But their symptoms are more sneezing and itchy eyes, they have a lot of other symptoms with that. ... That’s pretty easy to differentiate from people who have COVID-19 or even the flu, where it doesn’t matter whether they’re inside or outside. They have the same symptoms and they’re not being triggered by outdoor exposure.
QUESTION: How can people suffering from spring allergy symptoms take care of themselves?
BLUMBERG: There are a variety of allergy medicines. The newer generation antihistamines, the topical intranasal steroid sprays are all very safe to use this time of year and are not going to put people at additional risk if they come down with a viral illness, so the antihistamines and the topical steroid nose sprays are very good preventive medications.
QUESTION: How is the medical advice changing because of the coronavirus?
BLUMBERG: We frequently use prednisone, which is a potent anti-inflammatory but can also be an immunosuppressant. We have a lot of people in our group who require immunosuppressing medicines for a variety of illnesses. And most of these people are not youngsters, they’re people in their 60s, 70s and 80s who are typically on these kinds of medicines.
We are trying to safely lower the dose of those medications, or when that’s not feasible, switch them to something else that seems to have a better safety profile especially when you’re at risk from a virus. We also have many patients who are on the new biologix; these are monoclonal antibodies that block certain chemicals, usually cytokines or chemokines, and to be honest we’ve never had a pandemic so we don’t have a good idea what these drugs do to people who are at risk, so it’s a worry.
I think that people who are concerned about their medicines or their allergy health should at least be calling us, that’s what we’re here for. And I would not want my patients to be taking medicine that they happen to have leftover in their cabinets and think that because they were given it in the past, it’s the right thing to take now. Some of these medicines are not the right thing to be taking now and that’s why we’ve got phones. We work from 8 to 5, but there are people who are on call 24 hours a day, seven days a week. They can contact us and talk to us, and we can give them better advice than they are giving themselves.
QUESTION: If somebody is in distress with their existing asthma, is it a good idea for them to be going to the ER in this situation?
BLUMBERG: If people are having problems with their asthma and we screen them and we think that’s actually what’s going on, I would much prefer them to come to my office and not show up at an emergency room.
In the 2020s, most people who have asthma who are patients of ours do not go to the emergency room. We are somewhat circumscribed I think in using certain medicine like prednisone because we don’t want to make these people potentially higher risk if they do come down with COVID-19. I think most of these people who have moderate or even severe asthma we can handle over the phone or in the office, so if it’s weekends or nights we can make a decision on what’s best for them considering the fact that there are other illnesses out there that they can be exposed to that would not be good.
QUESTION: Have you seen any questionable information going around about drugs and the virus?
BLUMBERG: I did have a patient, she gave me an article on plaquenil. ... There are actually people who die from taking that drug, and I suspect that the risk of taking plaquenil when you don’t have any idea what you’re treating or what your underlying disease might be is a very, very high-risk scenario. So we are trying to tell people that these possible cures are out there, but they shouldn’t be the first people who get involved in their own little study and take medicine that they don’t know what it might do.
QUESTION: What’s been going on with the tree pollen?
BLUMBERG: We’ve already seen high counts. Friday, the count was 1,100. Today [Tuesday] it’s 4. So we’re seeing quite variable counts.
COLLIE: As the weather gets warmer later in the week, I’m anticipating numbers should go up with that.
BLUMBERG: So even though we’re seeing a goodly amount of it in March, I suspect we’ll see a lot higher counts in April, especially with the warm winter that we had.
QUESTION: When will we see that big peak of oak pollen numbers?
COLLIE: It’ll be the first couple of weeks in April, again, somewhat weather-dependent. The sooner it gets warmer and sustains some days with warmer temperatures, it’s going to come out.
BLUMBERG: So it kind of is not the best of timing to have people getting sick from this virus and also more likely to show up in urgent care centers with respiratory problems.