Managing Asthma During Cold and Flu Season

Why a simple cold can knock your asthma sideways

For most people, a winter cold means a sore throat, a box of tissues and a few groggy days. If you have asthma, the same virus can travel straight down into your airways, causing them to swell, tighten and produce more mucus. That combination is one of the most common reasons people with asthma end up needing urgent care between October and March.

Cold and flu viruses are also a leading trigger for asthma attacks. The good news is that a lot of the protection is in your own hands. Vaccination, good hand hygiene, keeping your preventer inhaler top of the agenda and acting quickly when symptoms start can all make a real difference to how you get through the season.

Vaccination is your best-value protection

Respiratory infections are far more likely to cause a flare-up than most other triggers, so reducing your chance of catching them in the first place is worth real effort. In the UK, the flu vaccine is offered free on the NHS to adults with asthma who use a preventer inhaler, have needed steroid tablets for their asthma, or have had an asthma attack bad enough to need hospital care in the past year. If you are not sure whether you qualify, ask your GP surgery or pharmacist — they will check for you.

• Book your flu jab early, ideally in the autumn before viruses start circulating widely.
• Check your COVID-19 vaccine eligibility each year — the groups offered it do change, and asthma is sometimes included depending on your treatment.
• Ask about other vaccines you may be due, such as pneumococcal, if you have other health conditions alongside your asthma.
• Children with asthma can usually have the nasal spray flu vaccine at school or at their GP surgery — it is quick and painless.

Vaccines are not a guarantee you will avoid every infection, but they substantially cut your risk of serious illness and hospital admission.

Hand hygiene and everyday habits that genuinely help

Cold and flu viruses spread through droplets in the air and on surfaces you touch. Small, unglamorous habits add up.

• Wash your hands with soap and water for around 20 seconds when you get home, before eating and after using public transport.
• Use hand sanitiser when soap is not available, and try not to touch your eyes, nose or mouth with unwashed hands.
• Catch coughs and sneezes in a tissue, bin it straight away, then wash your hands.
• Air rooms regularly and consider opening windows on buses or trains where you can.
• If flu or COVID-19 is circulating heavily and you are in a crowded indoor space, a well-fitted mask is a reasonable extra layer of protection.
• Keep your distance from anyone who is clearly unwell, and ask visitors who are coughing to postpone if possible.

Sleep, regular meals and staying active within your limits also help your immune system do its job.

Use your asthma action plan before things escalate

Everyone with asthma should have a written action plan agreed with their GP or asthma nurse. It tells you exactly what to do when your symptoms change — and this is the single most useful document you own during cold and flu season.

Typical plans work in zones based on your peak flow and symptoms. If you are coughing more, waking at night, or using your reliever inhaler more than usual, that usually means you are moving out of your green zone. Follow the steps in your plan rather than waiting to see whether it settles by itself.

• Know your personal best peak flow and check it if you feel your breathing changing.
• Keep your reliever inhaler with you at all times, and make sure it is in date.
• If your plan includes a standby course of steroid tablets, use it as instructed and contact your GP or asthma nurse the same day.
• Book your annual asthma review — it is a good moment to update your plan and check your inhaler technique.

Keep your inhalers working properly

Preventer inhalers reduce the inflammation in your airways, but they only work if you take them every day, even when you feel well. A cold virus finds it much easier to trigger an attack in airways that are already inflamed.

• Take your preventer as prescribed, morning and evening, and rinse your mouth afterwards if it contains a steroid.
• Ask your pharmacist or nurse to watch you use your inhaler — small errors are very common and easy to fix.
• Use a spacer with a metered-dose inhaler if you have been advised to; it gets far more medicine into your lungs.
• Check your inhaler counter so you never run out, and order repeat prescriptions in good time.
• Be cautious with over-the-counter cold and flu remedies. Some contain ingredients that can worsen asthma, and painkillers such as ibuprofen or aspirin can trigger symptoms in a minority of people. Ask your pharmacist what is suitable for you.

Spotting the warning signs and getting help fast

Most flare-ups settle with early treatment, but some become emergencies. Seek urgent help by calling 999 if:

• Your reliever inhaler is not helping, or is needed every few hours.
• You are too breathless to speak in full sentences, eat or sleep.
• Your peak flow drops below half of your personal best.
• You have chest pain, blue lips or fingertips, or feel exhausted and confused.

For less severe concerns, call 111 or contact your GP. Never put off asking for help because you do not want to be a nuisance — asthma attacks can develop quickly, and treating them early is far easier than treating them late. With a vaccine, sensible hygiene and a plan you actually follow, you can go into winter feeling far more in control of your breathing.