Three-and-a-half-year-old Elijah spent October battling a new illness every week. First croup, strep throat and then a persistent fever that wouldn’t go down.

It’s a situation many parents have been facing this fall amid a surge in respiratory illnesses among children, but Elijah’s family had another worry to juggle: his asthma.

“Asthma is a chronic disease in which the airways within the lung are inflamed and sensitive,” Dr. Samir Gupta, a respirologist with St. Michael’s Hospital in Toronto and an adviser with the Lung Health Foundation, told in an email.

“Unfortunately children with asthma can develop flare-ups of their asthma periodically, and viruses are a common trigger for these kinds of flare-ups. Therefore, a child with asthma who contracts a viral respiratory illness is not only at risk from the virus, but also at risk from the flare-up of the asthma, which can often be worse than the virus itself.”

Asthma affects more than three million Canadians, and with pediatric hospitals across Canada struggling with more patients than previous fall/winter seasons, parents of children with asthma are feeling the pressure more than ever.

Elijah’s mother, Kavitha Aryharan, told in an email that a child his age “doesn’t really understand social distancing” and can generally only keep a mask on for two hours at most.

“As a parent, you are always worried that your child could get sick, especially being in daycare,” she said. “This season has added another layer of anxiety with the rising cases of children in hospitals along with flu, RSV and COVID.”

Toward the end of October, a chest X-ray at the hospital revealed that Elijah had pneumonia. He was finally able to get treatment to help him recover, but Elijah struggled in the meantime, coughing day and night.

Aryharan knows firsthand what her son was experiencing while ill, because she also has asthma.

“I feel like it hits us much worse, and this October was the worst we’ve ever had it,” she said.

After a lifetime of managing her asthma on her own, now she’s working with an organization that is hoping to help more Canadians understand lung health and advocate for themselves amid this increase in respiratory illnesses.

The Lung Health Foundation (LHF) is a national organization that focuses on trying to prevent and manage lung disease in Canada.

This fall, they’re trying to let more Canadians know about a new resource that can help those with asthma and parents of kids with asthma understand more about their options: connecting with a certified respiratory educator.

“A Certified Respiratory Educator (CRE) is a specialized health professional, certified in the area of respiratory illnesses,” Jessica Buckley, President & CEO of Lung Health Foundation, told in an email.

“They support individuals with chronic respiratory illnesses such as asthma and [chronic obstructive pulmonary disease] so that patients can effectively manage their illness and improve the quality of their lives. Their goal is to keep individuals out of the hospital as much as possible.”

She explained that CREs can help patients and parents of kids with asthma know what questions to ask when a diagnosis of asthma is given, and how to advocate for themselves in future doctor appointments, as well as inform them about more tools and options for managing asthma.

Before she began working with LHF, Aryharan said she had never heard of a CRE.

“I remember thinking what a great resource to have, especially in those moments where you can’t get a doctor’s appointment fast enough, or that you need to get information fast,” she said.

The 38-year-old explained that when someone with asthma is dealing with an illness that has a respiratory element, symptoms such as coughing and difficulty breathing can be much stronger, saying she has had “endless coughing fits” before that kept her from sleeping at night.

Even when not ill, asthma can impede a person’s day-to-day life.

“My scariest moment was when my chest got really tight and I felt like I couldn’t breathe during a game of volleyball,” she said. “I never had experienced that before. Sometimes, when you have asthma, you have to slow down.”


The first step, according to LHF, is to create an action plan. This can be done using a toolkit that is available through LHF as well as other organizations such as Asthma Canada.

The action plan uses a traffic light system of green, yellow and red to help patients understand how well their asthma is being managed and what activities they are able to do. If a person is in the green zone, their asthma is being managed well and they are able to participate in most activities that others their age are doing. If you or your child with asthma are experiencing issues such as asthma symptoms disturbing your sleep, contracting a cold or infection, needing your reliever medication too many times a week or missing school or work due to asthma symptoms, you might be in the yellow zone and need to talk to your doctor.

The red zone, characterized by issues that include excessive coughing, excessive wheezing, anxiety, severe tightness in the chest, sweating and medication no longer working, signals that you need medical assistance immediately.

“A critical first step in the care of children and adults struggling with a respiratory illness such as asthma is to manage their disease before it escalates to the point of needing urgent medical care,” Buckley said.

Aryharan said she hadn’t known about such action plans until she spoke with a CRE, and that it has helped her narrow down triggers when her or Elijah’s asthma symptoms get worse.

“For E.J., a big trigger is catching a cold,” she said. “It’s hard to keep small children from being close to one another, but my husband and I, as well as his daycare, is diligent about him washing his hands. We were able to get him his flu shot, which gives us peace of mind. I never want mine or Elijah’s asthma to stop us from living our life.”

Monitoring your asthma or your child’s asthma is hugely important during any viral respiratory season, Gupta said, including keeping your medication updated and avoiding triggers as much as possible.

“At the same time it is important to take all possible measures to reduce the chance of the child contracting a viral respiratory illness, and to reduce the chances of a severe illness if they do contract it,” he said. “For both the child and their close contacts, This means wearing a mask where possible, frequent handwashing, avoiding crowded indoor spaces with poor ventilation where possible, and keeping up with all vaccinations including especially flu vaccination and COVID vaccinations.”

Those hoping to learn more can connect with a CRE for free by phoning LHF during business hours or by using their online chat room, the organization said.

In the meantime, it’s important to remember a layered approach to protection, Dr. Dawn Bowdish, Executive Director of the Firestone Institute for Respiratory Health and an LHF Board member, told in an email.

“Masking, vaccination, ventilation and reducing social contacts are tools that we can use to reduce the risk of contracting influenza, RSV and COVID-19, and of spreading it to vulnerable members of our community,” she said. “None of these tools provide perfect protection (although high quality, well fitted masks come close), but in combination they can substantially reduce risk.”

Bowdish, who is also an immunologist and professor at McMaster University, added that getting your flu shot as early into flu season as you can is a huge help as well.

“Unfortunately, vaccination rates have fallen over the pandemic, especially in young people and pregnant women,” she said, noting that pregnant women pass on antibodies to protect babies for the first six months of life. “What I fear we haven’t learned from the pandemic is that serious respiratory infections such as influenza and COVID-19 can have lasting health impacts.”

For Aryharan, being empowered with the ability to provide more protection for her son is hugely important.

“As they say, knowledge is power,” she said.

Her advice for other parents is to take advantage of any resources out there so you can advocate for your child, know what triggers an asthma flare-up, and how to manage it.

“Because Elijah is only 3.5, when he gets older, I’d want to teach him about the resources, and what to look for when his asthma is acting up,” she said. 

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