Lockdowns and masks good for childhood asthma, Australian study finds

Lockdowns and mask mandates led to dramatic reductions in paediatric hospital presentations for asthma, Australian-first research has found.

Based on figures from two major hospitals in Sydney, the 50-70% falls were likely linked to the overall reduction in viral respiratory infections, the researchers say.

There was also evidence that general outdoor air quality in NSW improved during the lockdown period thanks to the reduction in car traffic, say the team led by Dr Nusrat Homaira (PhD) of the University of NSW.

They compared presentations in patients aged 2-17 for the five years preceding the pandemic with those in the following 18 months, using ED and hospital admission data from Sydney Children’s Hospital at Randwick and the Children’s Hospital at Westmead.

The hospitals received 13,160 patients seeking treatment for asthma over the pre-pandemic years (2015-2019), making up 2.67% of all paediatric presentations in that time.

Based on these numbers, the expected number of paediatric asthma presentations from January 2020 to August 2021 would have been above 4,300, the authors calculated.

Instead, just 1912 children and adolescents presented with asthma in 2020 and 1452 in 2021, they found.

Notably, the biggest falls coincided with times when the city entered lockdown, particularly April and May 2020, when asthma presentations were just 31% of pre-pandemic levels.

They dropped again as Sydney entered lockdown in December 2020, hitting half of pre-pandemic levels, and again in August 2021 as the Delta variant sparked another wave of restrictions.

Writing in the journal Allergy, Asthma & Clinical Immunology, the researchers acknowledged it was possible at least some of the decline in asthma presentations was simply a reflection of the overall reduction in health service utilisation and the uptake of telehealth.

“It is also possible that general fear within community residents about contracting COVID-19 which may have led to reduced physical visits to hospitals and opting for telehealth services,” they wrote.

“We could not look into adherence to asthma medications during lockdown periods.”

“There are reports of increased purchase of asthma inhaler medications during lockdown period which may lead to improved self-management of asthma symptoms.”

Nevertheless, they also emphasised that although lockdowns and mask mandates seemed to have a positive impact when it came to asthma, they were not necessarily advocating for their imposition more broadly.

“While this decline has been associated with lockdowns, such an approach is not feasible or sustainable in the absence of an infectious disease outbreak,” the researchers added.

“Therefore further research to determine the positive factors associated with this observed pattern could help develop strategies to mitigate the burden of chronic conditions such as asthma on the health system.”

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