
Support for Caregivers Means Better Care for Loved Ones with COPD
Providing care for a loved one is an important role, but also comes with challenges. Respiratory Health Association (RHA) created the COPD Caregiver’s Toolkit in 2017 to support informal caregivers of people living with COPD. This educational resource provides caregivers the tools and guidance they need in their role as caregiver, while also protecting their own health. Early support from the National Heart, Lung, and Blood Institute’s (NHLBI) Learn More Breathe Better® program enabled RHA to study the acceptability and usability of this tool. Findings from this study showed that caregivers found the Toolkit to be useful in navigating the multiple roles of caring for someone living with COPD.
Because of this positive response to Toolkit, NHLBI recently partnered with RHA to create a digital form of the Toolkit in hopes of providing greater support to caregivers across the country. The digital form of the Toolkit contains the same information provided in the hard copy resource, separated into online modules on an NHLBI webpage. These modules cover a variety of topics such as how to prepare for doctors’ appointments, navigate changes in home life, provide help after a COPD flare-up or hospital stay, and more. Medication and vaccination tracking sheets and a list of questions to ask doctors are also available for download on the webpage.
Click here to read a brief message from NHLBI’s Dr. James Kiley and RHA’s Joel Africk about the COPD Caregiver’s Toolkit.

Novavax COVID-19 Vaccine
The U.S. Centers for Disease Control & Prevention (CDC) has endorsed the Advisory Committee on Immunization Practices’ (ACIP) recommendation that Novavax’s COVID-19 vaccine be used as another primary series option for adults ages 18 years and older.
Novavax is a protein subunit vaccine. These vaccines package harmless proteins of the COVID-19 virus alongside another ingredient called an adjuvant that helps the immune system respond to the virus in the future.
Vaccines using protein subunits have been used for more than 30 years in the United States, beginning with the first licensed hepatitis B vaccine. Other protein subunit vaccines used in the United States today include those to protect against influenza and whooping cough.
Two doses of Novavax are given in the primary series, 3–8 weeks apart. People who are moderately or severely immunocompromised should also receive 2 doses, given 3 weeks apart (a 3rd primary dose is not currently authorized). Novavax COVID-19 vaccine is not authorized for use as a booster dose.

COPD Caregiver’s Toolkit now available online
Providing care for a loved one living with COPD can be hard, but Respiratory Health Association’s Caregiver’s Toolkit has information and resources to help you along the way. Thanks to our partnership with the National Heart, Lung, and Blood Institute’s (NHLBI) Learn More Breathe Better® program, the toolkit is now available online! Learn more at https://bit.ly/copd-digital-toolkit.

The Relaxation Response Can Help You Fight Stress
The following is reprinted from the NIH’s National Center for Complimentary and Integrative Health (NCCIH)

When you’re under stress, your body reacts by releasing hormones that produce the “fight-or-flight” response. Your heart rate, breathing rate, and blood pressure go up, your muscles tense, and you sweat more. If this happens often, over a long period of time, it can worsen many health problems.
There is no drug to cure stress. But we do have access to a built-in “stress reset button.” It’s called the relaxation response. It slows the heart rate, lowers blood pressure, and decreases oxygen consumption and levels of stress hormones.
Some complementary health approaches, such as yoga, meditation and mindfulness practices, and relaxation techniques, may help to produce the relaxation response and counteract the ill effects of stress. Find out more in the NCCIH’s recently updated stress fact sheet.

Is It Asthma or COPD? Know the Difference
By Gary Fitzgerald – Allery & Asthma Network*
People with chronic cough, wheeze and shortness of breath may wonder if their symptoms are asthma or chronic obstructive pulmonary disease (COPD). The difference between the two diseases is not always clear.

May is Asthma Awareness Month, and Allergy & Asthma Network joins with the US COPD Coalition in raising awareness of these life-threatening lung diseases. More than 24 million people live with asthma, while approximately 16 million are diagnosed with COPD, according to the U.S. Centers for Disease Control and Prevention (CDC). Woman are more than two times as likely to get COPD as men.
Apart from prevalence data, what are the differences between the two diseases?
Asthma is usually diagnosed early in life. Symptoms include:
- Coughing
- Wheezing
- chest tightness
- Shortness of breath
Asthma flares are often triggered by allergies (pollen, mold, pet dander, dust mites) and irritants (air pollution, chemicals in cleaning products). Respiratory infections like the cold or flu are also common triggers.
Asthma results in approximately 3,600 deaths per year, or 1 in 10 people with the disease.
COPD tends to occur in people after the age of 40. The two diseases that make up COPD are emphysema and chronic bronchitis. Symptoms are the same as asthma but may also involve:
- Increased mucus or phlegm with cough
- Frequent colds
- Nasal and throat infections
- Fatigue
- Blue lips or fingernails – a symptom you may not have enough oxygen in your blood
COPD is considered more serious than asthma and tends to get worse over time. Approximately 120,000 people die of COPD each year, making it the third leading cause of death in the United States, according to CDC. It can lead to permanent lung damage.
Many people develop COPD after years of exposure to something that irritates the lungs. For most, it’s cigarette smoking. For others, it could be long-term exposure to air pollution or fumes in the workplace.
Can asthma lead to COPD? Not necessarily. A person whose lungs are damaged due to poorly controlled asthma and exposure to irritants such as tobacco smoke is at increased risk of COPD.
Given the similarity of symptoms between the two diseases, it’s perhaps not surprising the COPD is sometimes misdiagnosed as asthma. It’s also possible for people to have both diseases at the same time – this is called Asthma-COPD Overlap, or ACO. People with ACO tend to have frequent exacerbations and a more rapid decline in lung function.
Treatments for these conditions are similar – but with one notable difference.
Asthma, COPD and ACO patients are prescribed quick-relief albuterol inhalers to treat symptoms that arise suddenly. Each group uses inhaled corticosteroids (ICS), long-acting beta-agonists (LABA), long-acting muscarinic antagonists (LAMA), or a combination medication of the three to control airway inflammation daily.
In recent years, biologics have emerged as a revolutionary treatment for asthma. These medications target specific cells and pathways that cause airway inflammation, stopping symptoms before they can start.
Biologics are not available for COPD, although recent research shows promise in finding a precision biomarker that could target the disease. Doctors may recommend oxygen therapy for severe cases of asthma and COPD.
Pulmonary rehab has also been shown to benefit severe asthma and COPD patients as well. Pulmonary rehab is a whole-body approach to treatment that involves patient education, exercise, nutrition, and more. The program can shorten hospital stays and increase participation in daily activities.
Asthma and COPD can change over time, which means medication needs may change, too. Patients should work closely with their doctor to evaluate which medications work best at any given point in time.
Lifestyle changes to avoid triggers are also key to successfully managing both conditions. For starters, it’s critical that asthma and COPD patients not smoke. It’s the single most important thing to do to slow the rate of lung function decline, regardless of disease severity. If stopping is too hard, talk with a doctor about smoking cessation programs.
It’s also important to get annual pneumonia and flu vaccinations to ward off viruses. CDC recommends both vaccines for asthma and COPD patients.
The COVID-19 pandemic provided both good and bad news for people with asthma and COPD.
First, the good news: asthma and COPD patients are not at an increased risk for contracting COVID-19. And now the bad news: patients with moderate-to-severe asthma and COPD patients are at risk for severe COVID-19 if they do contract the virus.
A recent study revealed that 83% of people with COPD say that COVID-19 has served as a wake-up call to realize their disease puts them at risk. And 98% say they want to be as healthy as they can to fight off COVID-19.
Asthma and COPD patients can take steps to protect themselves. Practicing the three Ws – wear a mask, wash your hands, and watch your distance from other people. If you don’t feel you can wear a mask due to severe asthma and COPD, it may be best to stay home and avoid public places. Ask family and friends to run errands for you. If you must go out, avoid large crowds, and practice social distancing.
Allergy & Asthma Network has placed an urgent priority on addressing asthma, COPD and COVID-19 disparities. These conditions disproportionately affect Black, Hispanic/Latino and Native American communities, especially those in urban areas. They face higher rates of emergency department, hospitalization and deaths due to asthma, COPD and COVID-19.
Allergy & Asthma Network’s Not One More Life Trusted Messengers saw an opportunity to engage those impacted by health disparities by going where they gather: churches, faith-based settings and other community venues. Starting in September 2020, the Network has hosted more than 20 Not One More Life events.
Attendees received free asthma and COPD screenings and COVID-19 education and vaccinations. They were given referrals and patient education to make informed, evidence-based decisions about their health. Furthermore, uncontrolled high-risk patients were enrolled in a digital health/telehealth coaching program free of charge for six weeks. To date, over 5000 patients have been screened and more than 500 received coaching to improve lung function and quality of life.
Expanding access to care and encouraging underserved communities to participate in research are key in achieving health equity. Allergy & Asthma Network is excited to be a part of the US COPD Coalition as we work together to address the needless death and burden caused by asthma and COPD.
*The Allergy & Asthma network is a valued member of the US COPD Coalition. The mission of Allergy & Asthma Network is to end the needless death and suffering due to asthma, allergies and related conditions through outreach, education, advocacy and research.

Portable Oxygen Needs Assessment Form Available for Download
There are many types of oxygen equipment used in the home, with each device having advantages and disadvantages. An assessment of a patient’s needs is crucial to matching oxygen patients with the right equipment. The United States COPD Coalition (USCC) Portable Oxygen Task Force has developed the accompanying Portable Oxygen Needs Assessment form for completion by patients, which may save time during their appointment, while providing more insight concerning the most appropriate oxygen equipment to meet their individual needs.
The form was created with input and participation by a broad committee of people from all over the US, including patients, providers, and oxygen equipment vendors. It is designed to be completed by the patient (or their caregiver) while the patient is waiting to see the their healthcare provider who will be prescribing oxygen. The completed form will help provide more information for staff to match the prescription for oxygen equipment with the patient’s needs. Ideally, the patient will get the most suitable oxygen system that optimizes health, keeps the patient actively engaged, and saves time, energy and frustration for all.
Whether you are a patient, a healthcare provider, or a home oxygen supplier, USCC encourages you to download the attached form and use it to help match the individual’s needs with the appropriate device. Click on the link below to download the form.

Health consequences of secondhand smoke

There is no risk-free level of exposure to secondhand smoke.
- Secondhand smoke causes numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome (SIDS).
- Smoking during pregnancy results in more than 1,000 infant deaths annually.
- Some of the health conditions caused by secondhand smoke in adults include coronary heart disease, stroke, and lung cancer.
Secondhand smoke is a mixture of the smoke that comes from the burning end of a cigarette, cigar, or pipe, and the smoke breathed out by the smoker. It contains more than 7,000 chemicals. Hundreds of those chemicals are toxic and about 70 can cause cancer.
There is no safe amount of secondhand smoke. Even low levels of it can be harmful. The only way to fully protect nonsmokers from secondhand smoke is not to allow smoking indoors. Click on the link below for an excellent list of resources related to secondhand smoke.

5 Questions To Ask About a Health Website
The following is a bulletin from the NIH’s National Center for Complementary and Integrative Health
Some online sources of information on integrative health are useful, but others may be inaccurate or misleading. If you’re visiting a health website for the first time, ask yourself these questions. The answers may help you judge whether the site is trustworthy.
- Who runs or created the site? Can you trust them?
- What is the site promising or offering? Do its claims seem too good to be true?
- When was the information written or reviewed? Is it up to date?
- Where does the information come from? Is it based on scientific research?
- Why does the site exist? Is it selling something?

Isolation and Quarantine

The Centers for Disease Control & Prevention (CDC) has updated isolation and quarantine recommendations for the public. These recommendations do not apply to healthcare personnel and do not supersede state, local, tribal, of territorial laws, rules, and regulations.
People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by 5 days of wearing a mask when around others.
Recommendations for people who are exposed to COVID-19 are also updated. If you are unvaccinated or more than 6 months out from your second mRNA dose (or more than 2 months after the J&J vaccine) and you are not yet boosted, CDC recommends a quarantine for 5 days followed by strict mask use for an additional 5 days. If a 5-day quarantine is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure.
People who have received their booster shot do not need to quarantine following an exposure but should wear a mask for 10 days after the exposure. For all those exposed, best practice would also include a test for COVID-19 at day 5 after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19.

Is It Flu, COVID-19, Allergies, or a Cold?
The following article is reprinted from the January 2022 issue of the National Institutes of Health’s NIH News In Health.

Feeling sick can be especially concerning these days. Could your sniffles be caused by COVID-19? Or the flu? A cold? Or maybe allergies?
Determining the cause of an illness can be tricky because many share some symptoms. They can leave you sniffling, coughing, and feeling tired. But there are important differences.
Figuring out what’s making you sick can help you recover and prevent spreading sickness to others.
Flu vs COVID-19
“Distinguishing COVID from flu can be difficult because the symptoms overlap so much,” explains Dr. Brooke Bozick, an NIH expert on respiratory diseases that affect the lungs.
Flu and COVID-19 are caused by different viruses that can be spread among people. Flu is caused by the influenza virus. COVID-19 is caused by SARS-CoV-2. Both can give you a fever, cough, headaches, and body aches.
Flu and COVID-19 also spread similarly. They’re transmitted by small particles that come from your nose and mouth when you sneeze, cough, sing, or talk, raising the possibility of infecting people who are nearby. Infected people may not have symptoms, but can still pass along either virus.
“Both influenza and COVID can be spread to other people before individuals develop symptoms,” notes Dr. Aubree Gordon, an infectious disease expert at the University of Michigan.
COVID-19 symptoms can take longer than flu symptoms to develop, she explains. Someone with flu usually has symptoms 1 to 4 days after being infected. A person with COVID-19 typically shows symptoms about 5 days after infection, although this can range from 2 to 14 days.
One telling sign of COVID-19 in some cases is loss of smell or taste. But because of other similar symptoms, there’s really only one way to be certain if you have COVID-19 or flu: Get tested.
“You can go and get a COVID test at many pharmacies, and your doctor can administer tests for flu,” Bozick says. COVID-19 tests are also available at many health centers. And you can buy testing kits approved for use at home.
Could It Be a Cold? Or Allergies?
Like flu and COVID-19, colds are also caused by viruses and can be passed to others.
Symptoms of a cold tend to be mild. You may have a runny nose, cough, congestion, and sore throat. But you won’t usually have the aches and fever that are common with COVID-19 and flu. Often, you’ll feel better in a couple of days.
There’s no cure for the common cold. Typical treatments include rest, fluids, and over-the-counter medicines. Some complementary treatments may help with cold symptoms, too. Taking honey may help with nighttime cough for children over 1 year old. Rinsing your nose and sinuses can help with congestion. You can use a neti pot or other nasal rinsing device. Be sure to only use water that’s been properly processed, such as distilled or boiled water, not tap water. Nasal rinses can bring relief for both cold and allergies.
Allergies can cause a runny nose and sneezing. But they’re not contagious. If your eyes, nose, or ears itch, that also could be an allergy.
Exposure to things like dust, pets, and tree or grass pollen can trigger allergies, which are caused by the immune system overreacting.
Allergy symptoms tend to stop when you’re no longer exposed to the cause. Unless you have asthma, allergies typically do not cause breathing problems. Allergies can be treated with drugs like antihistamines, decongestants, and nasal steroids.
Wintery Mix of Viruses
Winter is the prime cold and flu season. You’re more likely to be indoors and closer to others when it’s colder outside. Weather also plays a role in the spread of viruses.
“Cold and flu viruses survive better and are more transmissible if it’s cooler and if there’s lower humidity,” Gordon explains.
Experts are concerned that flu and COVID-19 cases may increase and overlap in the winter. Flu cases usually start to increase around October and peak between December and February. Being infected with flu and SARS-CoV-2 at the same time is possible, as is showing symptoms of both.
If you’re sick with the flu, your doctor may prescribe antiviral drugs. Such drugs can make your flu milder and shorten the time you are sick. They work best if they’re used early in your illness.
The FDA has also approved one antiviral drug, called remdesivir, to treat COVID-19. Other treatments are in development and under review. No complementary approaches have been shown to be helpful for fighting off flu or COVID-19.
Fortunately, strategies to prevent the spread of COVID-19 also prevent the spread of flu and cold. “Measures like masking and social distancing work for other respiratory viruses, as well as COVID-19,” says Dr. Chip Walter, who studies vaccine development at Duke University.
Staying Well
There’s another really important way to fight viruses. “Get your flu shot and COVID-19 vaccine,” Walter advises. They are safe and effective ways to protect yourself and those around you.
Don’t forget to vaccinate your children, too. That is the best way to protect their health. COVID-19 vaccines are now recommended for everyone age 5 years and older.
Flu vaccines are recommended for everyone 6 months and older. Flu vaccines are designed to protect against the four types of flu viruses that scientists expect to circulate that year.
Researchers like Walter and others are working to develop flu vaccines that last longer and offer broader protection against many flu strains.
Masks continue to be an important tool for stopping the spread of respiratory viruses, such as COVID-19. “With the pandemic still ongoing, it’s going to be really important that people wear masks,” Gordon says. Try to avoid crowded indoor situations when possible, too.
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