TABLE 1

Proposed Actions at the Patient Level

A. Advocacy and Partnerships
• Endorse and encourage compliance with recommendations on national plans and guidelines against global pandemics that were put forward by WHO.
• Promote and implement health literacy measures to the general population, with a focus on CRDs and symptoms such as cough and breathlessness in the context of epidemics and pandemics.
• Advocate and promote acceleration of R&D in novel and neglected infectious diseases, preparedness against pandemics in the context of an international network.
• Advocate data collection on characteristics of COVID-19 in regard to its infectiveness and tropism to respiratory cells and risk of interstitial pneumonia and ARD (acute respiratory distress).
• Partner with and support countries, health care professionals and researchers in investigating how differently COVID-19 affects different vulnerable populations (e.g. older adults versus children, men versus women, those with any underlying respiratory diseases, different co-morbidities, different socioeconomic status), which may yield insights into disease pathogenesis, informing precision-health management and development of therapeutics.
• Partner with and support GARD countries, health care professionals and researchers in studying the risk of COVID-19 among people with CRD.
• Develop and implement strategies to offload the overstretched health care systems (overworked, overexposed health care and essential service workers) by supporting self-management, and reducing avoidable hospital admissions from CRD.
• Enforce/ensure institutional and local plans pertaining to sufficient essential supplies (e.g. personal protective equipment (PPE), diagnostic and screening tests, medications etc.) in combating an epidemic/pandemic, i.e. improve epidemic preparedness.
B. Patient Groups
• Promote strong and regular interaction with respiratory patient groups and associations for articulated actions regarding validated patient information on COVID-19 infection and CRDs
• Direct patients to reliable websites such as the WHO COVID19 dashboard (www.who.int/emergencies/diseases/novel-coronavirus-2019) and the International Primary Care Respiratory Group (IPCRG, www.ipcrg.org/news/covid-19-open-source-sources-of-information) for Q&A.
• Emphasize to patients the importance of hand-washing, social and physical distancing, stay at home and maintain self-isolation if infected.
• Raise awareness of the importance of good practice of disease self-management (e.g. asthma, COPD), healthy life styles (healthy-eating, quit smoking, exercise, etc.) to help reduce comorbidities that make individuals more susceptible to COVID-19 infection or severe progression.
• Explain to patients the importance of not discontinuing their CRD medications (e.g. ICS), but when in doubt, contact their health care provider (www.who.int/emergencies/diseases/novel-coronavirus-2019).
• Promote smoking cessation (including water pipe or hookah) as not only is smoking a recognised risk factor for many chronic diseases including COPD, hypertension, cardiovascular disease, and respiratory tract infections, it has been reported that smoking is also most likely associated with the negative progression and adverse outcomes (including ICU support, mechanical ventilation and death) of COVID-19 [50], and the sharing of a mouth piece in water pipe smoking could facilitate the transmission of COVD-19.
• Underscore the importance for patients with sleep respiratory disorders (SRD) to continue with the continuous positive airway pressure (CPAP) therapy during the pandemic in order to maintain high level of immunological defenses.
• Support and share information on occupational risks and COVID-19 (e.g. health care workers and other essential service workers).