Across the United States the number of asthma attacks fell sharply during the pandemic. Studies in other countries such as England, Scotland, and South Korea found similar trends. While some experts thought that COVID-19 would cause a rise in the cases of asthma attacks, just the opposite was true.

According to The Atlantic, doctors are therefore re-thinking the causes of this respiratory illness that leads to 1.6 million visits to the emergency room each year, and claims the lives of 3,500 Americans annually. Asthma attacks are triggered by several environmental factors such as viruses, mold, pet dander, dust mites, smoke, and air pollution. Many of these allergens lurk in homes, but patients confined to their houses during the pandemic suffered remarkably fewer attacks.

This has led some doctors to reevaluate the importance of cold and flu viruses as triggers for the illness. Mask wearing and social distancing also resulted in a dramatic drop in the incidence of colds and flu this year. Dr. Elliot Israel, the director of the Respiratory Therapy Department at Brigham and Women’s Hospital in Boston, had begun a study of Black and Hispanic or Latino, adult asthma sufferers in 2018, just before the pandemic hit. These groups experience more severe asthma than white Americans.

His study participants were asked to track their asthma attacks, and when the shutdowns were ordered, they were able to fill out their questionnaires at home. This gave the researchers crucial information on how the patients were faring during the pandemic lockdown, according to The Atlantic.

The data underscored the fact that while there were far fewer visits to hospitals across the country for asthma attacks, it was not because people were avoiding the ER. It was because they were having fewer episodes.

The biggest decrease in asthma attacks (65%) was reported by people who normally worked outside the home compared to those who worked from home (23%). Sufferers whose asthma was caused by environmental factors also had a steep decline in the number of attacks, suggesting that pandemic protocols helped these people avoid their triggers.

This led Israel to surmise that ordinary respiratory viruses play a more important role in asthma than previously thought. Experts are concerned that this fall, as people shed their masks, the number of asthma cases will start to rise. Healthcare officials are already warning that we should expect a resurgence of nasty cold and flu viruses this fall.

But asthma and allergy experts caution that while the pandemic highlighted the role of viruses in triggering attacks, we cannot become complacent about the other factors that cause illness.

“I certainly agree that diminished exposure to viruses during the pandemic due to masking and social distancing greatly reduced the number of cases of colds and flu with decreased asthma exacerbations,” Dr. Andy Nish, a top allergist from Gainesville, Georgia, tells Newsmax. “That does not mean, however, that other environmental factors are no longer relevant. We still need to be concerned about things like exposure to smoke and pets. These are likely to be important cofactors along with viruses. Compliance with asthma medications is still important and should still be stressed to control lung inflammation.”