What’s more, people with COPD are actually more likely to catch viral respiratory infections in the first place. “Their lung immune cells are a bit suppressed,” says Frank Sciurba, MD, associate professor of medicine at the University of Pittsburgh School of Medicine and medical director of the Pulmonary Physiology Laboratory at University of Pittsburgh Medical Center. That means their lungs tend to be less effective at fighting off the germs they’re exposed to. Here’s what you need to know to stay healthy during cold and flu season if you have COPD, along with what to do if you do think you’re getting sick.
Why Colds and the Flu Are More Serious in People With COPD
The cold and flu viruses are much more serious for people with COPD because they can trigger COPD symptoms to get worse. In fact, most COPD flare-ups are triggered by upper respiratory infections like the common cold and the flu, according to the American Thoracic Society. Dr. Sciurba says that approximately a third of COPD exacerbations are related to viruses, a third are related to bacteria, and a third are related to irritants or allergies — but the balance tips toward viruses in winter. Breathing is already difficult if you have COPD because the condition causes your airways to swell and become blocked with fluid, according to the Centers for Disease Control and Prevention (CDC). Cold and flu viruses can make it even more difficult because they cause fatigue and congestion and may increase swelling in your airways. Since people with COPD have a lower lung capacity to begin with, says Sciurba, if they lose some lung function because they’re sick, it can lead to more wheezing, coughing, and shortness of breath to the point where they don’t have enough capacity to breathe. A study published in March 2017 in the International Journal of Chronic Obstructive Pulmonary Disease suggests that the risk of COPD symptom exacerbation is 30 times greater in people who catch a cold. People who have COPD also have a greater risk of developing serious and potentially deadly complications of the flu, like pneumonia, requiring hospitalization. “They have less ability to tolerate it, which can result in more symptoms while fighting the virus off,” says Sciurba. “The big problem is not the virus itself, but that it exposes patients to post-flu pneumonia, which can be devastating.”
Get your flu shot. The CDC recommends that everyone 6 months of age and older get the flu shot — especially those with risk factors like COPD. The flu can be deadly in people with COPD, and the flu shot is your best protection, according to the American Thoracic Society. Keep in mind that flu strains change from year to year, which is why it’s important to get your shot every year. In fact, getting your shot consistently boosts protection. “The viruses will be a different pattern than what we expected, and those may overlap with vaccines from previous years,” says Sciurba. “By getting vaccinated every year, you might be more protected against more strains than if you just got vaccinated that year.”Ask your family to get the flu shot. A study published in July 2014 in Clinical and Experimental Vaccine Research suggests that it’s important for people who are at high risk of flu complications — which includes those with COPD — to be surrounded by others who’ve gotten their shots. This provides a cocoon effect, decreasing the odds that you’ll be exposed to the flu virus. It’s called herd immunity, where if a certain number of people are immunized in a community, an outbreak of a virus or infectious disease is much less likely, says Sciurba. Ask your housemates and those you regularly see, like your children or parents, to get their seasonal flu shot.Get the pneumonia vaccine. If you haven’t already gotten it, the pneumonia shot helps people with COPD to avoid potentially dangerous complications.Avoid touching your nose or mouth. Many people get sick after coming into contact with a cold or flu virus and then touching their face.Stay away from people with colds and the flu. Cold and flu viruses spread easily. Steering clear of people who are ill — including large crowds of people — as much as possible can increase the odds you won’t be exposed to the viruses and bacteria that can make you sick. “It’s a balance between getting in exercise and trying to stay fit while minimizing exposure to sick people. Because depression is problem in our patients, isolating yourself in the bedroom is not the best thing either,” says Sciurba. “But you’re more likely to catch a virus in large groups of people. Try to be wise and cautious as much you can.”Wash your hands frequently and thoroughly. Wash your hands before eating or preparing food and anytime you’ve been outside or touched door handles or subway poles. Scrub all over your hands and between your fingers with soap and warm water for at least 20 seconds (two rounds of “Happy Birthday” in your head).Prioritize your health. Eating a well-balanced diet with plenty of fresh fruits and vegetables, staying physically active, and getting a full night’s sleep are all habits that will help keep you healthy and less vulnerable to infections.Get a personalized COPD plan. Ask your doctor to write down exactly what you should do if you have a flare-up. Your plan can include the medications to take and symptoms that always warrant a call to the doctor or visit the emergency room.Make sure your medications are stocked and up to date. Check your cupboards to make sure all of your prescription medications, including any emergency meds for COPD, are up-to-date in case you get sick or have a flare-up. Sciurba often prescribes an antibiotic and steroid to his patients to fill and stock at home so they don’t have to haul themselves to the pharmacy if they’re feeling sick or having a COPD exacerbation. He adds that it’s important to check with your doctor before taking these medications.Don’t smoke. This one might seem obvious, but it bears repeating. Stopping smoking is the best way to avoid further damaging your lungs. What’s more, smoking makes you more likely to catch respiratory illnesses and can makes cold and flu symptoms worse.
Managing COPD in Cold Weather Keep in mind that even if you manage to avoid getting sick, the colder air in fall and winter can also irritate your airways and lead to more wheezing, coughing, and shortness of breath. “Our metabolism in cold weather is increased, so you have to burn more oxygen and therefore have to breathe more,” says Sciurba. “It can be irritating and result in bronchospasm. It doesn’t necessarily predispose a person to getting flu, but it can be challenging.” The following tips can help keep COPD symptoms in check when temperatures drop:
Check air quality forecasts. Pollution tends to be higher in winter, and it can be dangerous for people with COPD symptoms. Keep an eye on air pollution and try to stay inside as much as possible on days when it’s elevated.Avoid wood-burning fires. While a fire in the fireplace might be your idea of a cozy winter evening, the smoke and fumes can aggravate your lungs, especially if you have a lung disease like COPD. Warm up under a pile of blankets instead.Preempt symptoms with your reliever medication. Use your reliever inhaler, if you have one, about 30 minutes before you’re going outside, and keep it with you.Cover your nose and mouth with a scarf when you head outside. This helps keep the air you breathe warmer, so you’re less likely to aggravate your lungs. Breathe in through your nose and out through your mouth. Also avoid exercising outside when it’s cold.Warm up your home. Even if you thrive in cooler temperatures, now’s not the time to turn down the thermostat. The British Lung Foundation recommends setting it to at least 64 degrees Fahrenheit and layering up on clothes.
What Should You Do if You Think You’re Getting Sick?
If you get sick, stick to your prescribed COPD plan, drink plenty of fluids, and rest to help your body heal. If you feel safe and it seems your COPD is under control, it’s usually okay to see if you can improve on your own before calling your doctor. You should always ask your doctor, however, before taking any medications, including over-the-counter cold or flu medications. If you sense that your COPD is getting worse, don’t wait until your symptoms are severe to call your healthcare provider. Your doctor can offer medications to ease your symptoms, such as increased bronchodilator therapy, antibiotics, or oral steroid medication, to reduce the likelihood that you’ll need emergency care. Symptoms that always warrant a call to your practitioner include:
Fever, especially if you have cold or flu symptomsShortness of breath that’s worse than usual or happens more often (you need more frequent treatments or can’t walk as far as usual, for example)Increased coughing or wheezingChanges in mucus color (including blood), thickness, amount, or odorExtreme fatigue, headaches, dizziness, confusion, or irritabilityUnexplained weight loss or sudden weight gain
