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While it's obviously good that the government health people have decided something, they still need to learn to use proper wording because taking a steroid inhaler does not make asthma severe! Many asthmatics are on more than a steroid inhaler and are still not severe. I know that's not the point here (and, for the avoidance of doubt, I'm not saying any of these people shouldn't be in group 6) but it will only encourage the dramatic people in the world to think that being on Clenil for example (or even just on a combination inhaler) to think they have severe asthma. Sorry to derail but I wish they'd use appropriate terminology!
It was a bit sensational but I understand what the different was. Brillant news never the less.
Thanks to asthma UK and British Lung foundation.
Oh the vaccine bit is good but a lot of the issues last year were caused by them all (gov,press) using the word severe when it didn't apply, then knowledge changed and therefore so did risk and people who weren't remotely severe (not all obviously!) were all horrified because "I'm severe!" Of course there's the 'top end' who aren't CEV but definitely are not mild who may tick that box. But someone on just say Clenil is quite possibly a mild asthmatic. I just wish they'd not use the terminology they don't understand - you're right about the sensationalism. Just say all asthmatics who take a steroid inhaler. Job done.
But yes, thanks to AUK and BLF. I was confident they were doing all they could.
Completely get what you are saying, but one fight at a time. Those serious, but not on the CEV list, can at least have some hope of protection before the autumn.
Yes completely agree with that. Also I have no issue with those who aren't remotely severe (and therefore probably not hugely vulnerable) being in group 6 for vaccines - it's much easier to say steroid inhalers = group 6 for a start.
My thoughts were similar on finding out about this news this morning but went more along the lines of how one carelessly worded statement has caused a lot of stress and anxiety in a group which really doesn’t need that in times which are stressful enough. I think it also proves (yet again) how poorly understood this condition is in sections of the medical profession - shocking really, when you consider how prevalent it is.
Thanks and applause to AsthmaUK and BLF for sorting this out.
So so happy and relieved I cried. Thank you x
I would like to know more detail about this and see it in the jcvi documents, as it seems strange that it seems to contradict what AsthmaUK_Nurses posted only 2 days ago. Perhaps I'm a pessimist but we heard in December that department of health said it would be same as flu jab list and it never got officially changed. Fingers crossed this time is different!
This is great news.
However, I agree with Twinkly that it is poorly reported here and may cause confusion.
I especially raised an eyebrow at this:
As well as being an indicator of how severe someone's asthma is, steroids suppress the immune system, making it harder to fight off viruses.
A study has literally just been published (someone has already posted with a link) saying that budesonide, a common inhaled steroid, appears to significantly reduce risk of hospitalisation and reduce recovery time in patients with COVID, if given early in the disease course.
Just one inhaled steroid yes and further studies are ongoing to confirm the findings, but given this I'd be surprised if the others in the class actually increase risk in COVID. If they mean oral steroids, they should be clearer and not create potential confusion and worry for people taking these medications.
Yep. How hard is it to actually find out correct information, or ask people like AUK or BLF is something is correct?! False information frightens some people and encourages some others to be overly dramatic (sadly some people in the world love the sensational and can't disentangle it from reality!)
I think it’s best to wait for a formal statement.... it’s great to see some publicity though 😊😊
I've just looked again at the bbc article and the wording has changed since I looked a few hours ago- it no longer explicitly mentions steroid inhalers and says 'some' people who are eligible for flu vaccine . That's not promising 🙁
Sigh!!! Things were looking so positive a few hours ago. I don’t know what to think now.
I can't believe the've gone and done that, that is ridiculous.
it's pretty much invalidated all of the clarification the article had provided.
It’s usually a sign that the article was wrong or the journalist was misreading/misinterpreting things. Don’t forget the journalist writing the article usually has very little medical experience/knowledge. Here they probably decided ‘Regular/Continuous steroids’ that the JCVI mentions meant inhaled so wrote that whereas in the medical community that means oral so they’ve been corrected with the edit.
Journalists rarely actually clarify medical things 😅. And it’s frustrating for people esp when they read before the correction 🤦♀️
The first paragraph of the bbc article still says "continuous or repeated" steroid use, but I agree that with this government I'll believe it when I actually have my jab...
I think that's because they actually start talking about the CEV people being in Group 4.
Then it goes on to talk about other asthmatics. So they probably do mean that the CEV are the severe asthmatics but of course need to be very dramatic about it all - which adds to the confusion!
It would have been better to have had a factual non-sensational headline and lay out the facts in a couple of sentences!
I think if you are worried speak directly to your Dr. I spoke to mine yesterday and he confirmed to me I am to be called in group 6.
It has been very stressful for many of us, who last year fell out of CEV criteria, but were thankful they would be vaccinated in group 6. To be removed with no explanation other than, well you won’t die is cruel. We all know our asthma and what triggers make us more uncontrolled.
Labels are dangerous, but I guess for mathematical modelling essential to make complex issues more statistically simplistic and predictable. But the don’t tell the more complex story. At least people have stood up and spoken out with the issue being made aware to a wider audience.
The chances of my surgery responding are negligible to say the least, the doctors themselves are fine but getting to speak to them at the moment is next to impossible. I have written to them suggesting they tell people, or at least tell them if they request it, which group they are in but I’m not hopeful.
This whole shenanigans seems to have a base in politics to me. All along, every article on the gov website, the BBC and even on asthma UK a has either explicitly stated or implied the flu vaccine list would be used. There is no logical reason to change that, the fact less asthmatics are being admitted seems a good thing but a lot of that is down to the fact we’re choosing to isolate more, choosing to work from home more or employers are making allowances. Even if you drill down into the data about asthma and covid, you do admittedly find that an asthmatic with covid tends to be no worse off than their non asthma equivalent BUT that is surely because the worse off asthmatics are taking precautions and avoiding contact even more than the average person. I’m being much more cautious than my 50 year old sister without asthma.
As far as the data goes, an asthmatic is an asthmatic. The young 20 year old with a ventolin inhaler and nothing else is, for the statistics, the same as a 50 year old with montelukast and high dose Fostair.
I've always been concerned that the number of asthmatics who have a daily steroid inhaler , which must be a big number, if all pushed into group 6, would create frustration amongst those in groups 7, 8 and 9 being delayed and that the government fear the potential bad press and potential lost votes which, let's be honest, is all they care about.
Absolutely and this news about the asthma steroids helping covid will probably have been a gift to the government.
I would also add that the number of children I’ve taught over recent years with a diagnosis of asthma seems to be rocketing year on year. I’m not a doctor but I do know asthma and the number of those children without an inhaler and no apparent symptoms is relatively large.
Having had asthma for all my large number of years I never play down asthma but I do sometimes wonder if there is an increasing number of asthmatics like the ones I mention that are exceptionally mild - and they may start to influence government policy about the broader group of asthmatics? Not just for vaccines but issues like free prescription campaigns once they realise how much asthmatics would cost.
The data isn't about who actually gets covid though (which would I'm sure have a link to people being at home working and so on). It's to do with what happens to those who do have covid.
It is - but in my example of a 20 year old asthmatic who is very mild and going about their business relatively normally (because they’re not too concerned) opposed to a 50 year old taking Fostair. They catch covid but aren’t badly affected, at least no worse than someone ‘healthy’ of their age.
The 50 year old might be very concerned and would potentially be more adversely impacted by covid but they don’t catch it because they stay at home or work in isolation.
As far as these stats are concerned, the only point of reference they have is the 20 year old. They cannot say how the 50 year old would be affected because he never caught it. I think that’s my point, using just asthmatics who caught covid as a basis for government policy is not a fair test scientifically.
I know this is only one hospital's experience too but my hospital has not seen respiratory patients (asthma, COPD, all ages but particularly over 50s) coming in because of their respiratory issues if they have covid. If they have been admitted it's only been for the same covid issues as non-resp patients (no extra wheezing or shortness of breath linked to pre-existing conditions) and they haven't needed high-level care.
That’s good news
The senior respiratory nurses at the hospital said it to me in the autumn and it's still the case now.
I suspect there's something in the budesonide study that's maybe to do with it (assuming all ICS do similar). It would make sense to me if they help given that oral and IV steroids seem to help. And if people with covid can be prescribed a steroid inhaler for a month or something and they stay home and recover well then that would be brilliant.
This is really the problem. You mention quite rightly that this was only one hospital. It really needs a large scale study to establish the risk, and those take time. There are variables in asthma (huge numbers of them) and variables in the severity of covid too.
I'm not claiming it's fact everywhere or anything. There are huge unknowns all over the place but some people are determined to find the negative in everything and sometimes others feel reassured by a real example that it's not always as horrendous as is being painted. That's not to say it's all positive, of course it's not, but even if one person gets some much needed mental relief from worry for a while then I think that's good.
Have I read that correctly? ‘but some people are determined to find the negative in everything ‘ Are you suggesting those of us who are worried and scared by this hash up, are getting upset just because we are determined to find a negative? Really? Apologies if I have read that wrong or you didn’t mean it in that way, but I find that statement very insensitive!
I don't mean it quite as you have expressed, no. I completely understand that people are concerned and I understand why. People need clarification and I've always says I wish those in power writing these documents actually consulted people with the knowledge in the first place (eg terminology and descriptions for levels of asthma and so on).
What I meant is that it feels like everything at the moment is about the negative aspects - ok there are a lot of them (and again I understand people are worried and angry and confused) but when that's all there is to read, sometimes it helps some people to also be able to see a possible reason for something or a glimmer of hope.
I certainly agree with your wish that those in power consulted with people with appropriate knowledge. One of the statements made in one of the later BBC reports yesterday commented that the government had made their decision based on independent expert advice. I would very much like to know who those independent experts were though I don’t suppose for a moment we’ll ever find out. Given that both BLF and AsthmaUK are calling for clarification I think it’s reasonably safe to assume it wasn’t them.
Twinkley I have to be honest but I too have felt offended by some of the language you have used further up thread like 'dramatics of the world'. May I ask have you personally been guaranteed the vaccine in group 4/6?
Firstly I can't find where I used the phrase you have quoted - so to put it in quotation marks is rather unfair.
I'm not sure therefore if you mean this: "Then it goes on to talk about other asthmatics. So they probably do mean that the CEV are the severe asthmatics but of course need to be very dramatic about it all - which adds to the confusion!" - here I was referring to the media being dramatic, alluding to non-CEV asthmatics but actually talking about the CEV and so hyping up issues that are already understandably a concern to the non-CEV which is very unfair of them (the media)
Or this: "False information frightens some people and encourages some others to be overly dramatic (sadly some people in the world love the sensational and can't disentangle it from reality!)" I wasn't actually referring to anyone on here with that phrase so apologies if it came across that way. I have seen (largely on social media) many many times since March people who seem to really want a label when it's really not warranted (eg. They take a steroid inhaler (and only that) so therefore their asthma is severe and it means they will die). It's not just an asthma thing, it happens all over all the time - the person who coughs so they have a chest infection, the sneeze is definitely flu, the child who doesn't want to do what they're told has ASD (probably a contentious example but such things make it harder for those who genuinely have ASD). Anyway my point was false information in the media only concerns people or angers them (as will have understandably happened yesterday) or is jumped on by those who can't see through the sensational headlines - eg with yesterday's awful initial BBC article, people here are not reading it and deciding 'omg we're all severe' in some dramatic way - they just desperately want the clarification and further detail to break stuff down. So I'm not saying people wanting the clarification are being dramatic - I was saying that dramatic people feed off false info in the media.
Sorry that's so long.
If it helps I’ve also heard that’s asthmatics are underrepresented directly from 3 different hosps (2 tertiary resp centres, 1 local) as anecdotal. Also heard from multiple others that their hosps have said the same (different hosps - local and tertiary).
The lack of asthmatics (and apparently COPD) requiring hospital is a recognised phenomenon across the country (and internationally) I think, hence them investigating why - what’s the reason that asthmatics are capable of managing COVID at home, when everyone assumed they would be over represented. The fact that a known treatment now for COVID is an OCS, it kinda makes sense that having ICS would help prevent things escalating to hosp levels, which is what people were worried about back at the start of the pandemic. As much as it sucks for anyone with long covid etc, the main aim of shielding/being cautious was to prevent death/hosp admissions, so the groups most likely to have either are the CEV/CV people. We’re a year on now, so anecdotal has more sway, even tho research has only just started to investigate why. That’s why they did the study to start with - had asthmatics been turning up to hosp like they first expected no one would have thought to work out why they weren’t 😅
The only ‘young’ asthmatics that I know of that have been in hosp have been shielders (severe/uncontrolled asthma under tertiary hospitals) and have had a multitude of comorbidities and risk factors for admission, and even then not every young shielding asthmatic that I know who has had covid required hospital.
I know true research is still in the works and yes I want to know more about long covid risks, but there are a lot of places suggesting that for some reason asthmatics aren’t doing as badly as first predicted a year ago, and that I view as a good thing!
Thanks Emma:-). That’s more helpful. One of the problems with something so widespread is that it can take so long to assemble data and then analyse it. The numbers involved will be huge!
I know of one ‘young’ asthmatic who has had covid, but he got it mildly (as did his parents who are not asthmatic but are over sixty and one of whom has other health issues - they all got it at the same time). So none of them needed additional medical help.
I totally agree with this statement and personal glad, I’m cev with copd bad asthma so very happy, more importantly tho is my dad who’s worse than me ‘maybe’ will not be as much risk as first thought, so I’m taking this as a very big positive because as I’m not to concerned about myself I always put family first, take care everyone
Very good point I’m not severe but was texted last year to say I was more vulnerable, so I have more or less shielded anyway, they need to take this into consideration. How many asthmatics have maybe been extra careful compared with the general population, so their hospitalisation numbers might be lower from this.
They didn’t look at ‘how many asthmatics have COVID and went to hospital’ they looked at ‘how many asthmatics got covid and needed hospital, compared to the overall number of asthmatics who had COVID’
So if 50 asthmatics went to hosp with covid and only 50 asthmatics caught it that’s 100% so really bad, but if 50 went to hosp when 500000 caught it thats 0.0001 percent then actually they are under represented (numbers made up for ease!!!). At the beginning there was a concern asthma would be like the former, but a year on they can see that anecdotally it’s more like the latter.
Asthmatics weren’t ever seen to be at increased risk of catching covid, it was an increased risk of ITU/death they were worried about.
Hope this helps explain what they mean.
Yes it does thank you for clarifying it, that’s really good to hear.
The unanswered issue is how many asthmatics are either shielding on instruction from govt or effectively shielding because their doctors have said it would be a good idea. Those doing that are more likely to avoid the virus but the milder asthmatics will probably be those carrying on relatively normally. If those milder asthmatics catch it they are more likely to avoid hospital than if a shielded person caught it.
In essence, and I know this isn’t scientific or even proven, the more severe asthmatics are less likely to catch the virus because they’re locking themselves away.
Well i'm effectively shielding, have Asthma (Symbicort 2 times, twice a day, montelukast every night) and was not asked to shield.
I also work remotely 100% of the time since lockdown 1.
Anecdotal but we are part of the equation.
should add that I've always taken either more precautions or the strictest precautions when more lax ones were given by government. examples being:
- I locked down a week before national lockdown 1
- I wore masks on the couple of times I had to go out before it was law
- I stayed inside and distant for the majority of the summer when the restrictions were loosened (i've only visited parents for a very brief time in summer and only went out for medical appointments)
Not sure how many people with asthma have done this, but i'm certainly a good example of someone who's asthmatic and has avoided covid by being more stringent because of my condition.
I’m not shielding because I can’t in my job but I have Fostair at least twice daily and montelukast. Having said that, my employer has been as good as they can in keeping me away from danger but that’s hard working in a school - primary school children aren’t renowned for being hygienic 😄 I also haven’t been in a shop or anywhere for almost a year, all I do is walk to school and back every day. I’m fortunately (?) over 50 so any jab won’t be too long delayed but this whole thin* doesn’t seem fair at all, if only because of raised expectations now not being met. Sounds familiar for this government.
I was not asked to shield or had any communication throughtout the whole pandemic and I am not sure if I should have or not, as it seems to be mainly older people and I am only 20. But I have been shielding (left uni for the year and moved home) apart from my support bubble with my Gran (she lives alone). I do not know what asthma level I have or therefore when I will get the vaccine 🤞for soon (but not terribly convinced).
I agree that most asthmatics are being super careful and that is probably a large reason for not many asthmatics going to hospitals with covid.
Welcome asthma UK. Thank you
The BBC have now backtracked on the above article and have said they are awaiting further clairification. Someone from the Govt/DHSC clearly told the person writing the article that inhaled steroids/moderate asthmatics would be included in group 6 (which is irrelevant as GPs will mostly be following JCVI guidance), and it sounds as if they were mistaken.
From reading tweets and updates from Asthma UK and others, it looks likely that those on inhaled steroids will be left out and will fall into groups by their age. I am 25, take inhaled steroids once a day (moderate asthma), and had email confirmation from my local CCG that I will be in group 6 (I initially rang my GP for confirmation, but they said they didn’t know).
However, I am not holding out for anything, as I think when the time comes for group 6 to be vaccinated, I will not be on any lists for invites as I do not fall under any JCVI criteria. Looks like is moderate asthmatics, who were told and are STILL told we are clinically vulnerable, will be unprotected for a while longer yet.
Do you mind me asking which inhaler you’re on?
Hi, no not at all. I was on Seretide twice a day until just before the first lockdown, when my GP recommended I change to Relvar ellipta once a day (the reason was that it was cheaper to make and does the same job), which I have been using since.
I discussed Relvar Ellipta with my then GP a few years ago. At the time we were discussing whether it would be a good idea for me to switch Inhalers because I had been found to have oesophageal thrush and my steroid inhaler was being blamed for it. I have a feeling we dismissed it because it was probably surfeit to what my asthma required at that time. I was (actually still am) on Flixotide 250 (same steroid as Seretide but without the LABA). At the moment I’m on the maximum amount of that and, very unusually, have been so for the vast majority of the past eighteen months! We know the oesophageal thrush has returned at least once during that time. That amount of the stuff on a daily basis, plus antibiotics plus another med is not helping in that area. From the feel of it I’ve got it again, but I’ve just finished another load of antibiotics for another suspected chest infection. Two of those in one year is unheard of for me - well for several decades anyway
Yeah I don’t really get side effects (had a little oral thrush last year but that has never come back since). With all these medications, I’m disappointed we’re not being considered for group 6, I definitely feel there are too many on inhaled steroids and this is one of the reasons for the omission.
Even so, as I’m only 25 i do think I should be at the ‘bottom’ of group 6 (back end of April) due to my age. If my CCG follow through with what they have told me and I am in group 6, I would feel really bad for older people with moderate asthma across the country who won’t be vaccinated as their GP/CCG has interpreted the priority list differently. Hope your side effects/chest infections ease up soon!
I was temporarily excited to see the ‘news’ today but it seems that it’s just a poorly worded article from research reading Twitter posts! I had hoped that I had been reinstated into group 6 again but I suspect not
Thank you:-). Chest infection is a lot better, and I’ve just arranged a phone consultation with the GP to see if I can get some fluconazole to deal with the thrush.
I have actually been referred to a respiratory cons after a consultation with a gastro cons to see if I can be switched to an Alvesco inhaler which apparently is much better for those susceptible to oesophageal thrush (interestingly I never get oral thrush). Goodness knows when I’ll get to see one though.
The think the problem is that those making the decisions split asthmatics initially into severe and everyone else, not realising just how variable the condition could be. “Everyone else” is a massive group, lumping together moderate and mild asthmatics, and all the varying degrees within those two subgroups. There just doesn’t seem to be enough appreciation or understanding of just how variable the condition is outside of the asthma community or those directly involved with it.
Well what started as an exciting day, has come down with a clatter! What an anticlimax!😔. Even my GP is backpedaling, what a complete mess in communication!☹️
I know I feel really confused by it all why are we asked to get the flu jab etc.
Flu’s a different virus and the problems associated with it have been known for decades. There’s plenty of evidence that all asthmatics benefit from having that vaccine. Last time I got flu (in a year when they got the predictions wrong) I ended up on oral steroids even though my asthma had been very well controlled for years prior to that.
I was told by my GP in December that I would be offered the vaccine around February. I am 21 and I take fostair 100/6 4 puffs a day, ventolin 2-3 times a week, montelukast and I’ve had a couple short courses of pred in the last year and I also get the flu jab. When I heard that we had now been potentially dropped from group 6 I was going to ask my gp for some clarification however my surgery’s website states to NOT contact and ask about the vaccine and to just wait for a letter. So instead I emailed my local MP. I got a reply which literally said ‘I don’t know where you have got the idea that Asthmatics have been dropped from group 6’ and then went on to say that if I get the flu vaccine and have a steroid inhaler then I will be in group 6. I am getting different information all over the place, so I am just completely and utterly confused. I know that I don’t have severe asthma but I really feel like I shouldn’t be pushed back to getting vaccinated at the same time as completely healthy 20 year olds.
The people who advise the Government, the Joint Committee on Vaccination and Immunisation are specialists in virology. They state the single factor for which Covid 19 causes death is age. Groups 1-4 account for 88% of all deaths, groups 1- 9, 99%. The JCVI have also said that research shows that being asthmatic does not cause problems if you catch Covid 19 if you are not Clinically Extremely Vulnerable.
Given that just under half a million people a day are being vaccinated,it won't be long until the 99 % are vaccinated.
I can understand the concern of those with asthma who are not CEV. Originally they were defined by use of the type of inhaler, which has proved to be unhelpful. My advice is to read the JCVI reports rather than rely on the media.
I appreciate what you're saying, Thomas, but research clearly shows increased risk of poor outcomes associated with neutrophilic asthma, for example, and this is not reflected in the severe Vs all other asthma categorisation that they're applying. There's also increased risk of long covid. (The only condition that has an association with long covid in fact).
I think those clearly in the mild camp have cause for reassurance but those in the middle or narrowly missing CEV, have every reason to be concerned. Not to mention that those with asthma who are now missing out on imminent vaccination by virtue of being under 50, are unlikely to be able to avoid Covid as they have kids at school and jobs to go to.
Blanket stats miss a lot of people at the edges and I strongly believe that in this case it would make far more sense to err on the side of caution given that the risk from asthma appears to be a complex one that's not fully understood.
The JCVI is solely concerned with reducing deaths from Covid 19 in its first phase, i.e. groups 1-9. There will then be another phase, potentially to vaccinate those at risk of hospital admission, and / or vaccinating people in specific occupations.
I realise that's what they're saying but if that were really the only consideration in the current phase, they wouldn't be vaccinating healthy unpaid carers or healthy NHS staff who are working from home, for example. So despite their rhetoric, this just doesn't ring true.
As someone who was worried the inhaled steroid criteria would be chucked off of group 6 I thought I would update: This afternoon I received a vaccine invitation.
I am 45 on various inhalers and have had 3 courses of pred this year.
If it's any consolation, a relative from another Borough has received an invitation too and she literally just has one dose of brown inhaler daily.
Fingers crossed for you all, the anxiety is real and unpleasant.
Sorry that should read as 3 courses of pred in a one year period.
Many thanks Artichokes. It really is looking promising, I've read on another forum from others who were convinced they would not be eligible now getting vaccine invitations - hope you hear something soon.
It’s an absolute farce. In some areas, people only on low dose inhaled steroids are getting it and in others, those on high dose inhaled steroids, LABAs and montelukast aren’t. It seems to be down to your GP but they’re making wildly different decisions.
Apologies for the long post. I’m still mightily upset but I’m just trying to look for reassurance somewhere and I wasn’t getting it from the places I wanted to find it.
I’ve been a little obsessive with my reading today on this and came across the paper written by the Oxford scientists. It’s not peer reviewed so has to be taken with a pinch of salt but the thing that strikes me isn’t the fact that glucortisoids helped treat covid, they seem to be concluding that the efficacy of them is at least equal to that of the vaccine - at least in terms of mitigating symptoms.
It was only a small trial and I’m no scientist but it did make me feel a little better about this news. The relevant text is here:
We have demonstrated that the inhaled glucocorticoid, budesonide, given for a short duration, may be an effective treatment of early COVID-19 disease in adults. This effect, with a relative reduction of 90% of clinical deterioration is equivalent to the efficacy seen following the use of COVID-19 vaccines14,15 and greater than that reported in any treatments used in hospitalised and severe COVID-19 patients16
I also came across an explanation by someone who’ll you have to trust me is someone who knows what he’s talking about as to why asthma sufferers aren’t suffering as much from covid as you might expect.
Don't get me wrong, asthma certainly can't be a good thing in respect of any respiratory disease. But mild Covid is generally confined to the upper respiratory tract while asthma is generally more problematic in the bronchioles of the lungs. So it appears that asthma only becomes a significant issue in more severe cases of Covid, which by definition (as it has advanced to the lower respiratory tract/ lungs), has arisen because of other risk factors (or just bad luck on very rare occasion).
I'll leave it there but C-19 binds to a very specific cell surface protein (ACE2) and so the immunological response from this point on is very different to the immunological pathway which gives rise to asthmatic episodes. Very complex but you are far better off being a fit 65 year old with no underlying health condition aside from mild/ moderate asthma, than being a 55 year old who is obese, diabetic, or has cardiac issues (the cardiac piece goes back to ACE2). Hopefully a little reassuring for you? The best thing you can do is live a healthy lifestyle regardless of the asthma.