Allergy season is upon us! And having to deal with the heightened symptoms while also dealing with the COVID-19 pandemic can be both daunting and anxiety-fuelling. So, it’s not weird to have a few questions about allergies right now…
Fortunately, the Allergy Foundation of South Africa recently hosted a webinar specifically dedicated to answering questions around allergies and COVID-19 with paediatrician and allergologist Dr Candice Royal. Let’s look at some of the most important take-outs from the conversation.
Q: How can I tell if my symptoms are from my allergy or a possible COVID-19 infection?
Dr Candice Royal: “Some allergy symptoms overlap with the symptoms of COVID-19. If you’ve got nasal congestion, a sore throat and a cough, you might think you have COVID-19. This is why it’s always important to make sure your rhinitis is under control and that you prioritise taking specific measures to ease your allergy symptoms so you can limit the diagnostic confusion.”
Q: My allergies make wearing a mask uncomfortable. Is there an alternative?
DCR: “Just to go over the basics – a mask is worn mostly to prevent your droplets from being spread to other people. So, the primary intention isn’t to protect you, but to protect others. It’s a very important public health measure to reduce infection.
“But should you find wearing a mask difficult, the alternative that could be considered is wearing a visor/face shield instead.
“The real question is probably why your allergic rhinitis is out of control and whether there are any simple adjustments to your treatment plan that could further ease your symptoms. I’d suggest getting in touch with your doctor and going over everything again to make sure your management treatment is as efficient as possible and to also make sure you don’t have excess allergen exposure.”
Q: I carry an EpiPen for my allergy. If I get a severe form of COVID-19 and go into respiratory distress, would the use of my EpiPen help my breathing like it would during anaphylaxis?
DCR: “An EpiPen is an adrenaline auto-injector and its role is to offer emergency treatment following exposure to an allergen that has produced a severe reaction. It works by giving you a quick dose of adrenaline, which helps to shut off that allergic reaction.
“So, this is an entirely different mechanism to the respiratory distress that’s caused by illnesses such as COVID-19. Unfortunately, an EpiPen is not going to help should you have respiratory symptoms of another cause – it is specifically for treating anaphylaxis or severe reactions.”
Q: I have eczema and sanitisers are proving to be an issue for my skin because of the frequent use. What can I do to make this better?
DCR: “Consider washing your hands with water and a glycerin soap more often than using a hand sanitiser. Of course, as you go into shopping malls or to work, you often have to use a hand sanitiser, and should that be the case – make sure to use emollient cream immediately afterward.
“Carry emollients with you everywhere you go so that you can make sure that your hands are always being moisturised after using a hand sanitiser.”
Q: My son was supposed to start peanut desensitisation just before lockdown, but we’ve put a hold on it for now. Is there a timeframe for this in terms of age?
DCR: “It does seem that the younger you are when you start that process, the more effective it is. But we don’t have an age limit per se. We have seen teenagers go through this process successfully. But the earlier you start, the better.”
Q: Is there a specific diet that can help with asthma and allergies during this time?
DCR: “In terms of asthma, there isn’t a specific diet that we recommend. Obviously, if you’ve got a food allergy then you’re going to exclude that specific food type from your diet. But in terms of a healthy diet, it’s not anything complicated. It’s about having a diet with a wide variety of good fruits and vegetables and consuming adequate sources of all the essential macro and micronutrients.
“We can’t recommend a specific diet for people with asthma and allergies – it’s just about applying general health measures that would apply to the general population.”
Q: I have idiopathic anaphylaxis [severe allergic reactions with no obvious cause] and suffer attacks three to four times a year. I’m often prescribed steroids and antihistamines for long periods after each episode – do these medicines increase my risk for COVID-19?
DCR: “It does appear to be the case that steroids can make one more vulnerable to getting infections in general. However, we don’t yet have good evidence that being on steroids makes one more vulnerable to a COVID-19 infection, or a more severe case of COVID-19. We do [however] have evidence that people on steroids may shed the virus for longer.
“Remember that it’s always better to be on your controlling medication than not, so if that’s the medication you need, it’s advised that you stay on it and not wean yourself off it.”
Q: I have allergies to paracetamol and anti-inflammatories and I’m worried that if I get COVID-19, it will be difficult to treat. What should I do?
DCR: “Having an allergy to medications doesn’t make you more vulnerable to either infection or severe COVID-19. But when you have allergies to the medications that we commonly use to treat the symptoms, I’d advise that you speak with your doctor to find an alternative.”
Q: How should I approach the treatment of my allergies, generally?
DCR: “It’s important to understand that allergic disorders don’t occur in isolation and need to be treated holistically. They have an impact on one’s entire emotional, psychological and physical wellbeing. For example, having eczema is not just having a skin disorder – it has huge implications on how one feels. Itching and scratching all the time makes one feel irritable, restless, unable to get quality sleep, exhausted and so on.
“So, it’s important – especially in these anxiety-filled times – to understand that you shouldn’t only focus on the physical management of your symptoms, but also prioritise looking after your emotional and psychological health.”