Mask use by adults with asthma in the era of covid 19

Rationale: The evidence that wearing masks greatly reduces the chance of becoming infected with COVID-19 is strongly supported, although not all masks confer similar protection. What is unknown is to what extent adults with asthma wear masks, the type of masks worn, and discomfort/problems encountered when wearing a mask. Method: Adults with asthma who previously responded to a survey concerning the impact of COVID-19 on their lives and indicated they were willing to participate in additional studies (N=712) were asked to complete a 50-item REDCap survey concerning their mask use. Survey items included the type of mask/face covering usually worm, how long a mask was usually worn, the practice of carrying an inhaler when wearing a mask, the extent to which problems/concerns were experienced when wearing a mask/face, COVID-19 status, asthma control, and open-ended questions concerning mask wearing. Results: Respondents (N=455) were primarily female (83%), white (90%), and college educated (74%). Few (5%) had been diagnosed with COVID-19. Most participants (98.5%) indicated they wore a mask/face covering when out in public. Most respondents (63%) reported wearing a mask 2 or fewer hours/day. The most common types of masks/facial coverings used were cloth mask with at least 2 layers and a surgical mask. Over half (52%) always/most of the time carried their inhaler when wearing a mask. Respondents with uncontrolled asthma (ACT less than or equal to 19) and those with a high school education or less were significantly less likely to wear a surgical mask and more likely to wear a cloth mask with only 1 layer. Respondents with uncontrolled asthma were significantly more likely to indicate problems breathing and anxiety when wearing a mask (See Figure). Several participants commented that while they do not like wearing a mask, not contracting COVID-19 was a strong incentive to wear a mask. Several respondents who wear masks for extended periods at work indicated the importance of taking a safe break from mask wearing to relieve the discomforts experienced. Conclusions: Adults with asthma are likely to wear a mask/face covering when in public and report having some problems/concerns breathing when wearing a mask. Those with uncontrolled asthma and those with less education were more likely to wear less effective masks/face coverings. Efforts are needed to assure the knowledge and means to secure the most effective masks are available to all adults with asthma.