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When we went into shutdown mode, asthma visits at Children's Hospital dropped 80 percent

NPR reports doctors are looking at why and have several possible explanations: Less exposure to other infectious diseases - due to isolation and better hygiene - better adherence to medical advice on inhalers and less air pollution.

Impact of the COVID-19 Pandemic on Pediatric Emergency Department Utilization for Asthma - the report by Children's Hospital.

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Good News: Environmental policies such as decreasing pollution have immediate, positive benefits. Substantial changes are possible and can be done quickly when demanded.

Bad News: If America is sucking so hard at COVID -- something comparably easy to control -- we're completely fucked when it comes to climate change.

Environmental destruction and forced changes make COVID look like a paper cut.

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I'm hoping COVID will teach society at large that a lot of the things environmental folks and disability advocates and others have been promoting for years are possible and don't result in the sky falling. We don't in fact need most of our workforce commuting every day. Most workplaces don't need every single person in the office M-F 9-5 and can function just fine with people coming in a few days a week and doing things remotely the rest of the time. We can then have smaller workspaces and less travel happening. We also have shown that a lot of things work just fine over video and people don't need to be traveling for things like quick checkins with medical providers, social service agencies, etc.

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My hope is the lesson would be less about telecommuting and more about public transportation. There's been plenty of articles about people living in cities suddenly buying cars.

City living is environmentally preferable. It shouldn't matter if you work from home or not if you don't drive daily. And it's better to heat/cool a single office building than the single-family suburban/rural homes of the employees. Having the population spread out is not a net win.

Sadly, it seems the last few months of the pandemic have only reinforced the worse: Driving is near what it once was, delivery waste is massive, and public transportation has permanently been reduced. April and May showed what was possible and November & December showed it isn't going to last.

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The study authors identify several other potential reasons for the drop which aren't all good -- like avoidance of the hospital and reduced participation in sports and exercise. Unsurprisingly, the incidence of other communicable diseases is also way down and that would reduce the likelihood of kids getting asthma. But we do want kids to be able to go to school for more effective learning and socialization.

It might be reduced pollution. But it might be a lot of other factors, too. There isn't enough evidence to support a conclusion apart from ED visits going down. The study authors even point out that the decline seems more consistent with seasonal declines during the summer months which are likely connected with kids being out of school.

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It could be lots of things together, sure, but my understanding of the etiology of childhood asthma exacerbations would make the reduced pollution and not being in school buildings a big part of the reduction in visits.

School buildings in this state can be pretty nasty with mold, cleaning products, pesticides, etc. Parents are now trained to reduce problems at home and most do a very good job of keeping their homes clear of triggers.

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I'll add personal experience to this hypothesis. As a senior with substantial lung disease (chronic asthma) the shut down and staying close to home and away from outside pollutants has seen me greatly reduce my need for bronchodilators (inhalers). The reduction has been more than 50%. So this needs to be looked at, if for nothing else as an indicator.

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