Severe asthma occurs in 4-5 per cent of people with asthma. NICE defines it as “asthma that requires treatment with high-dose inhaled corticosteroids (ICS) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming ‘uncontrolled’, or which remains ‘uncontrolled’ despite this therapy.”2,3

In August 2019 Asthma UK noted that deaths from asthma attacks were the highest they had been in 10 years. Deaths have increased by more than 33 per cent over the last decade, with more than 1,400 people dying from an asthma attack in 2018, up 8 per cent on 2017. The largest increase was in the 35-44 years age group with a 42 per cent year-on-year increase.4

Asthma UK was concerned that a lack of basic asthma care may have contributed to the rise as 60 per cent of people with asthma in England and Wales (around 2.9 million people) are not receiving basic care as recommended by national guidelines.

This was before the arrival of severe acute respiratory syndrome coronavirus 2 – SARS-CoV-2 or Covid-19. People with respiratory conditions who become infected with the virus have a significantly greater risk of complications, requiring hospital admission, and a higher mortality rate. Analysis of nearly 5,700 Covid-19 deaths in England suggests there is a 1.25 hazard ratio for increased mortality risk with Covid in patients with severe asthma compared to the overall cases.5,6