The 2020 fall and winter holiday season will be different than any in our lifetimes. While asthma may have complicated holiday celebrations in the past, COVID-19 introduces a brand new set of limitations. Instead of fretting over cooking enough food for dozens of guests or planning trips to see family, many of us are preparing for small holidays at home. It’s a difficult and sometimes painful adjustment, even if we’ve been living with COVID-19 safety precautions for most of the year. Despite this year of challenges, there are steps we can take to keep ourselves safe and to find joy during the winter and holiday season.

Continue to Follow COVID-19 Guidelines

It’s important to continue following the public health guidelines for protecting ourselves and others from COVID-19. This is especially critical for individuals also managing chronic illnesses like asthma. The following precautions are crucial for limiting the spread of the virus:

• Wear a mask or face covering when in public.
• Avoid crowds.
• Keep 6 feet between yourself and those outside your household.
• Wash your hands frequently.
• Disinfect high-touch surfaces.

Depending on where you live, indoor dining, shopping malls, and other activities may be open. Be sure to follow appropriate precautions if you choose to go out to eat or shop.

Get the Flu Vaccination

There is still time to get the flu shot. Each year the flu vaccine prevents millions of illnesses and thousands of deaths. During the 2018-19 flu season, the Centers for Disease Control and Prevention (CDC) estimated that the vaccine prevented 4.4 million flu cases and 3,500 deaths in the United States.

The flu vaccine is appropriate for babies over 6 months, children, and adults. The nasal spray flu vaccine is only appropriate for people between ages 2 and 49 who are not pregnant or immunocompromised. A special flu vaccine is available for adults over 65.

Flu vaccination is generally recommended for people with asthma, and it is even more important during the COVID-19 pandemic. Be sure to let your doctor or your child’s pediatrician know if you or your child has an egg allergy.

In addition to protecting your own or your child’s health, flu vaccination helps the entire community. Flu vaccination can help maintain enough hospital capacity for people sick with COVID-19 and can ensure testing supplies and laboratory resources are available for COVID-19 testing.

Biologics and the Flu Vaccine

It is generally unsafe for people taking biologic medications like Nucala (Mepolizumab) or Cinqair (Reslizumab) to receive live vaccines. A live vaccine uses a weakened form of the illness to create immunity. Examples of live vaccines include the measles, mumps, and rubella (MMR) vaccine and the chickenpox vaccine. The flu shot uses a killed version of the flu to create immunity. The nasal spray flu vaccine is a live vaccine and is not appropriate for people taking biologic medications.

Consult your doctor with any questions about vaccinations and your medications.

The Difference Between COVID-19 and the Flu

The flu and COVID-19 share many symptoms, including fever, cough, shortness of breath, and fatigue. One symptom that seems to occur in COVID-19 but not flu is a new loss of taste or smell. Because symptoms overlap, it may not be possible to differentiate without a diagnostic test.

Contact your doctor for guidance if you have symptoms consistent with flu or COVID-19. Seek emergency care right away if you experience difficulty breathing, bluish tinge to the lips or face, chest pain or pressure, confusion, or inability to stay awake.

Connect During the Holidays

We’re all missing closeness and intimacy with our loved ones. That sense of separation can feel even more painful during holidays like Thanksgiving or Christmas when we’d normally be gathering for parties and meals. Since March, many of us have found ways to connect virtually to celebrate birthdays, new babies, and holidays. Many of us have been lucky enough to enjoy socially distant outdoor visits in backyards and parks. Here are a few more ideas to show your loved ones you care.

Send Care Packages

Putting together a care package for a family member or friend is a great way to express love and appreciation for someone. A care package can be simple and low-cost. You can pack a box with comforting items like tea or coffee, a favorite book or puzzle, and a heartfelt note.

Deliver a Meal

Sharing special foods is a part of the holidays many of us look forward to. If there’s a traditional family food you’re used to sharing, consider sending it this year. That might mean dropping off a batch of your famous cookies to a loved one across town or sending a meal from a local restaurant to a friend in another city or state.

Decorate Your Home

As lockdowns took hold this spring, signs popped up in people’s yards and windows with messages like, “Thank you front-line workers.” Parents have hung children’s drawings and placed teddy bears in windows as a way to show care and build connection with neighbors and passersby.

If you normally decorate your home, consider adding a message of care as part of your holiday decor. If decorating isn’t something you normally do, consider posting a sign on your front door or in your window sending support to your neighbors or thanking your mail carrier. These small expressions of gratitude and kindness can help us all feel more connected this year.

Set Boundaries

You may have friends or family members who aren’t taking COVID-19 precautions as seriously as you are. They may not understand that a key part of managing your or your child’s asthma is protecting yourself from COVID-19. Let your loved ones know that connecting with them over the holidays is as important as ever to you, but you can’t put your family’s health at risk.

Do your best to stay calm and focused when setting your boundaries. Here are some tips:

• Don't be afraid to say no.
• It can help to use direct "I" statements. For instance, “I am doing my best to manage my health with asthma. That means taking extra precautions around COVID-19.” Communicating in this way makes your needs clear without making others feel accused or shamed.
• Even if you usually maintain healthy boundaries, the holidays are a time when they may be tested. If a friend or family member tries to make you feel guilty for setting your boundaries, gently remind them that moderate to severe asthma may be a risk factor for COVID-19 complications.
• Offer an alternative, if possible. Instead of an indoor visit, you can offer to drive by their home to say hello or have a socially distant outdoor visit if the weather permits. If leaving your home isn’t feasible, you can offer a one-on-one phone call or video chat.

2020 has been a year of adaptation. The holiday season is no different. If we stay flexible and keep an open mind, we can find joy in this year’s celebrations.