Over 380,000 people in Ireland have suffered with asthma in the past 12 months - that means almost 8pc of the population have had difficulty breathing and needed assistance or medication to relieve their symptoms.
This week is Asthma Awareness Week, an annual event where the Asthma Society of Ireland aims to highlight the tell-tale signs of the condition, educate people on how to manage their asthma correctly, make the public aware of what it is like to have asthma and raise much-needed funds for the society.
But this year the society is even more concerned about getting the message across as people with asthma are considered more at risk if they contract Covid-19, so it is of the utmost importance that they are effectively managing their condition.
"There is conflicting evidence so far as to the extent to which asthma may be set off by Covid-19, and so the official advice is to be especially cautious and rigorously follow the same public health advice as everyone else," says Dr Marcus Butler, medical director of the Asthma Society.
"It is very important to continue taking your regular maintenance treatments, and to ensure you have and understand your written asthma action plan.
"A minority of patients, believed to be between 3-5pc, have what is termed severe asthma and are among the groups that have been singled out as being extremely medically vulnerable to severe illness from Covid-19, and for whom cocooning is recommended.
This approach is being taken in most developed countries, not just in Ireland."
But while long-term maintenance is the best treatment, many people are not using their inhalers correctly - this could cause acute attacks.
"Inhaled steroids are not a quick fix, and therefore patients often and understandably resort to their preferred fix, which is a blue-coloured reliever inhaler (salbutamol or terbutaline)," says Dr Butler, a respiratory specialist consultant. "But while blue inhalers give quick relief in minutes, they do not alter asthma inflammation in any way whatsoever, but rather stimulate a muscle layer in the airways to widen the airway passages.
"The best treatment is long-term maintenance medication, usually in the form of an inhaler containing a safe form of mild steroid which prevents asthma inflammation from developing. When a patient has stayed the course and remained on maintenance treatment for months, the benefits start to slowly kick in, with a lesser likelihood of such symptoms in the future, even when exposed to the classic asthma triggers.
"If anyone has concerns about their breathing, they should telephone their GP, who can advise on the next step."
For many sufferers, asthma begins in childhood and can last a lifetime, but some don't develop the condition until adulthood, so it is vital that everyone understands what to look out for.
"There are substantial geographical differences in the prevalence of adult asthma," says Dr Butler.
"And for adults aged 20-44, data from the European Community Respiratory Health Survey has broadly shown higher prevalence of asthma symptoms in Ireland, the UK, New Zealand, Australia and the US versus northern, central and southern Europe.
"The main symptoms are a cough, wheeze, chest tightness and shortness of breath, but different exposures can set off asthma in different people, and it can develop at any age for reasons we don't fully understand, relating to the interaction between our genetic make-up and the world or environment around us.
"Common environmental triggers include viruses such as the common cold (and perhaps Covid-19), allergens such as house dust mite, pet dander, pollen and mould, as well as exercise-induced asthma."
Prof Brian Harvey (63) developed asthma when he was 50 and took early retirement (he was director of research at the Royal College of Surgeons and professor of molecular medicine at RCSI Beaumont Hospital) after suffering several severe asthma attacks.
"My asthma started in 2007 with an occasional morning wheeze and cough, which I put down to stress," he says. "A year later, I had a sudden attack and my GP diagnosed late-onset asthma and I started taking medication - Ventolin and a steroid inhaler. My condition remained stable until May 2012, when I suffered a near-fatal asthma attack (NFA) and respiratory arrest while at work.
"I was rushed to A&E and spent six weeks in a high-dependency ward and underwent a full battery of examinations, where it was discovered that the most likely trigger for my NFA was an acute lung infection.
"I was diagnosed with severe brittle asthma and placed on a regime of preventative and rescue inhalers as well as oral medication. And for the following nine months I had to self-isolate and work from home, so it was good training for Covid-19."
The father of five says his asthma came as a complete surprise as he didn't have the condition in childhood and had been an athlete until he was 40, when he stopped due to work pressures.
"I noticed over the following decade that my breathing was becoming more laboured when hiking and doing other forms of heavy exercise but paid little attention to these early warning signs," he says. "Since then I did a lot of research and found that the disease was prevalent in high-performance athletes who abruptly stopped practising their sport.
"The underlying patho-physiological cause is thought to be an over-active lung going into hypertrophy, and thickened airways making the lungs less efficient for oxygen uptake and more susceptible to acute infections and inflammation. Stress has also been implicated in late onset asthma."
Despite strict adhering to daily medication, Prof Harvey suffered a second near-fatal asthma attack and respiratory arrest in November 2015 and spent six weeks in the high-dependency ward in Beaumont hospital.
"This attack scared the living daylights out of me as I was told that I would have been dead within 15 minutes if I had not been at work in the hospital when the attack occurred," he says. "My respiratory consultants gave me strong medical advice to ease off my work-load and take life a bit easier and avoid stress - so I heeded that advice and took early retirement in 2018 after two subsequent severe asthma attacks requiring hospitalisation.
"My condition severely restricts my day-to-day living as I get out of breath easily and find it difficult to breathe, especially with night-time asthma, which affects my sleep pattern.
"I am super-careful in taking my daily preventive medication and am reliant on rescue medication to mitigate the effects of a severe asthma attack if I am not near a hospital. I always carry my rescue inhalers wherever I go, monitor my lung function daily and watch for signs of decreased lung function and early signs of lung infection.
"I haven't had an NFA since 2015 and think I have it under control through a mix of strict discipline in compliance with medication and doctor's orders, healthy Mediterranean diet, regular aerobic exercise, relaxation and breathing techniques, keeping my professional interests alive, and spending more time with my family."
Throughout the current pandemic Prof Harvey is making sure to be socially distanced from others and avoid any chance of developing Covid-19.
"Developing Covid-19 could be a death sentence for me," he says.
"So I will continue my own high level of infection risk avoidance and social distancing, no matter what government decides in relaxing the measures, until a safe and effective vaccine becomes available."
Health & Living