Covid-19 and Food Allergies is something that has been weighing on my mind as a Food Allergy Mom. The fear of going to the emergency room is real and we want to avoid it at all costs – right? But what if your child is experiencing an anaphylactic reaction? Would you go to the Emergency room and risk a Covid-19 exposure? Or would you administer the prescribed epipen and wait out the acute symptoms at home. What is the right procedure during these Covid-19 times?
*Make sure to contact your allergist to discuss your current Emergency Anaphylactic Action Plan to see if a revised version is right for you or your family member. I am a concerned food allergy mom, not a doctor.
“The Journal of Allergy and Clinical Immunology : In Practice,” published a very interesting piece suggesting an update to the EAP algorithm. I found it a highly interesting read but want to stress that this discussion is for acute anaphylactic reactions only:
“Patients with history of severe anaphylaxis such as those who have been intubated and ventilated, or had reactions treated with more than two doses of epinephrine should follow their routine anaphylaxis plan and activate emergency services immediately when anaphylaxis is recognized.”source
Before Covid-19, the Food Allergy community typically followed Emergency Action Plans (EAPs), similar to this FARE EAP. Now, food allergy families have to decide if the risks associated with an acute anaphylactic reaction outweighs potentially Covid-19 contaminated Emergency Rooms and hospitals. The specific procedure in question is calling 9-1-1 immediately after administering the epi-pen. The standard is to call 9-1-1 and alert them of the situation and then wait for the paramedics to arrive and assist.
Covid-19 and Food Allergies – what next?
Covid-19 has really jostled up this procedure. Not only does a food allergy family member have to judge the severity of an acute anaphylactic reaction but if they do deem the situation dire and in need of support, they have to wait for the paramedics to arrive. This is another wilted piece of the puzzle as ambulances may take longer to arrive then their usual call times.
“Usually when something sounds like an emergency, someone is in cardiac arrest, trauma, etc., we move pretty quick,” the paramedic said. “We can’t do that now. Putting on all the (personal protective equipment, or PPE) properly takes time, and for us could be a matter of life and death as far as our safety goes. So we don’t rush.source
With longer than average ambulance wait times, contaminated hospitals, and mentally exhausted family members, it is essential that food allergy families have a contingency plan in place while the world navigates our current normal with Covid-19. The original EAP from FARE offered only 2 steps with the newer Covid-19 update including 6 (PDF below). This is a significant difference and requires that those family members making the decisions are confident with their ability to calmly and properly assess the health of the Food Allergy person they are supporting. The newly added steps 3-6 on the updated EAP, are easy to understand and plan for. We do not have a blood pressure or pulse monitor, so that is something we may look into further.
Talk to your allergy specialist
One of the recommendations is to clearly communicate with a health professional about your current Emergency Action Plan in question. “We recommend using telemedicine to proactively discuss the modified management of anaphylaxis and communicate thresholds for activating EMS, per individual patient’s profile, local COVID-19 burden, and careful assessment of the risk-to-benefit ratio.” source
IF you are like me, I have been watching our local health unit’s website like a hawk and have been obsessively listening to the Covid-19 counts of our local hospitals. However, I realize that this in no way qualifies me to judge what constitutes our risk-to-benefit ratio and I will be deferring to our allergist to help guide us through this stressful time.
The heavy feelings that accompany Covid-19 and food allergies are real and scary. The reason for this article is to share with you this updated Emergency Action Plan but also to let you know that you are not alone. Let me tell you, I am knocking on wood over here with the hopes that no one in our food allergy family has to deal with the gut-wrenching decision of calling 9-1-1 during an anaphylactic reaction. During this unique time in history, I find it best to prepare for the worst, while hoping for the best.
Your food allergy friend,