World Lung Day 2021 Partners

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    The Forum of International Respiratory Societies (FIRS) would like to thank all organisations who have pledged to support World Lung Day (WLD).

    WLD falls on 25th September and is a day to rally advocacy for respiratory health and air quality globally. You can see the full list of organisations supporting WLD 2020 below.

    No signed up yet?

    If you would like to support WLD please email This email address is being protected from spambots. You need JavaScript enabled to view it..

    View WLD partner logos below or view the World Lung Day partner list.

    The 2021 World Lung Day toolkit will be available soon. 


     
    World No Tobacco Day 2021

    On World No Tobacco Day (31 May, 2021) the Forum of International Respiratory Societies (FIRS), calls on governments and policymakers to make greater political and financial commitments to support and promote tobacco cessation services.

    According to the World Health Organization (WHO), tobacco use kills more than 8 million people each year. Tobacco use also remains the main and most preventable cause of lung disease among both adults and children, and it is well-understand that the “big five” respiratory diseases (asthma, COPD, lung cancer, tuberculosis, pneumonia) and other acute lower respiratory tract infections are caused or worsened by tobacco product use and second-hand smoke exposure.

    Despite this, smoking-cessation treatment remains poorly implemented in healthcare around the world; according to the WHO Report on the Global Tobacco Epidemic, only 23 countries worldwide offer cessation services that WHO describes as meeting best-practice levels.

    Tobacco and nicotine addiction is not a lifestyle choice, but a chronic relapsing disorder that should be treated accordingly. When nicotine, the psychoactive component of tobacco, is inhaled, it reaches the brain rapidly and is highly addictive. Most smokers want to quit, but evidence has shown that only 3–5 percent of people who attempt to quit without professional medical support succeed after 6 months, highlighting the need for professional assistance when quitting tobacco.

    In support of WHO’s World No Tobacco Day 2021 year-long global campaign to help 100 million people quit tobacco, FIRS urges policymakers and healthcare regulators to act urgently to:

    • Make greater political and financial commitments to support tobacco and nicotine product cessation services that provide evidence-based effective treatments, including behavioural support or motivational interviewing in combination with pharmacotherapy.
    • Optimise health systems by providing system-level tobacco cessation interventions, from primary care to secondary care, community programmes, and internet support.
    • Support the implementation and enforcement of comprehensive tobacco control policies, such as those outlined in the WHO Framework Convention on Tobacco Control, to prevent tobacco product use and protect public health.

    The unprecedented response to the COVID-19 crisis demonstrates more than ever the importance and effectiveness of making meaningful policy changes to tackle health challenges. FIRS urges policymakers to act now and help people to quit tobacco for good, protect public health and save lives, and reduce the burden on healthcare systems that is caused by tobacco product use.

    For more information about FIRS please contact Lisa Roscoe: This email address is being protected from spambots. You need JavaScript enabled to view it..


    World Lung Day 2021: Care for Your Lungs

    World Lung Day (WLD), 25 September, is a day for lung health advocacy and action, an opportunity for us all to unite and promote better lung health globally.

    If you haven't joined yet, sign up as a WLD partner by emailing This email address is being protected from spambots. You need JavaScript enabled to view it., all our partners are included on our partners page

    World Lung Day Toolkit

    Taking care of our lungs is now more important than ever. So, this year on 25 September, we will be asking the world to ‘care for your lungs’ and keep them healthy.

    The 2021 WLD theme will focus on:

    Care for Your Lungs:

    • Say no to tobacco
    • Protect them through vaccination
    • Breathe clean air
    • Take regular physical exercise

    Say no to tobacco

    Tobacco causes 8 million deaths every year and is the main cause of many lung diseases. Tobacco smoke contains more than 4,000 chemicals, many of which are toxic and can cause cancer.

    Stopping smoking is the best way to improve your lung health and overall health.

    Quitting tobacco has the potential to reverse some of the damage done by tobacco smoke to the lungs, but not all. Early cessation is therefore essential to preventing the onset of chronic lung disease, which is irreversible once developed. The benefits of quitting tobacco are almost immediate.

    • After just 20 minutes of quitting smoking, your heart rate drops.
    • Within 12 hours, the carbon monoxide level in your blood drops to normal.
    • Within 2–12 weeks, your circulation improves and lung function increases.
    • Within 1–9 months, coughing and shortness of breath decrease.
    • Within 5–15 years, your stroke risk is reduced to that of a non-smoker.
    • Within 10 years, your lung cancer death rate is about half that of a smoker.
    • Within 15 years, your risk of heart disease is that of a non-smoker.

    Care for your lungs, say no to tobacco. Here are some resources to help you:

     

    Say no to vaping

    Vaping is the use of an electronic system to deliver inhaled drugs, most commonly nicotine and cannabinoids (natural or synthetic forms of marijuana).

    There is increasing evidence that inhaled nicotine from e-cigarettes damages lung tissue and lowers the body’s natural resistance to infections and to cancers and emissions from these devices are hazardous to lungs.

    Care for your lungs, say no to vaping. Here are some resources to help you:

    Protect your lungs through vaccination

    Vaccines save millions of lives each year. Vaccines work by training and preparing the body’s natural defences, the immune system, to recognise and fight off the viruses and bacteria they target. If the body is exposed to those germs later, the body is immediately ready to destroy them thereby preventing illness.

    Getting vaccinated can protect you from lots of different infectious diseases and help you keep your lungs healthy. Pneumococcal pneumonia, COVID-19, influenza and whooping cough are examples of respiratory infections that can be prevented by vaccination.

    Vaccination can also help to protect other people. People can be protected if those close to them (like friends and family members) and enough people in their communities (including healthcare professionals) are vaccinated, because it stops infections from spreading.

    People with a lung condition or other health conditions can be at a higher risk from lung infections. You can prevent some of these infections by getting vaccinated.

    Care for your lungs, protect them through vaccination. Here are some resources to help you:

    Breathe clean air

    Air pollution kills an estimated 7 million people worldwide every year. WHO data shows that 9 out of 10 people breathe air containing high levels of pollutants.

    Air pollution has a negative impact on human health and exposure to it can affect 100% of the population, from unborn babies to the very elderly. The lungs are the first point of entry for air pollution into the body and are therefore the first affected organ. Air pollution affects everyone−rich and poor, developed and developing countries, but it hits the hardest where the exposure is greatest, low and middle-income countries.

    Care for your lungs, breathe clean air. Here are some resources to help you:

    Take regular physical activity

    Regular physical activity and exercise improves quality of life, whether you are healthy or you have a lung condition. Many people associate keeping fit with maintaining a healthy heart, losing weight and reducing the risk of illnesses such as diabetes, but exercise also helps keep lungs healthy.

    When you exercise, your heart beats faster and your lungs work harder. Your body needs more oxygen to fuel your muscles. Your lungs step up their activity to deliver that oxygen while expelling additional carbon dioxide. In addition, your lungs expand during exercise compared to when not exercising, preventing compression of lower lung areas.

    It is best to ask the guidance of a doctor or physiotherapist before you begin changing your activity levels, to ensure that your plans are in line with your capacity and are safe. All exercise and physical activity programmes must be built up over time to allow the body to adapt.

    Care for your lungs, take regular physical activity. Here are some resources to help you:

     

    Partner Graphics

    Please help us raise the profile of World Lung Day by sharing the save the date graphics via your own communication channels. We also have a 'Proud to be a World Lung Day Partner' graphic, add your own logo to the blank white circle and share on social media. 

    Please use #WorldLungDay on social media.

    We have also created graphics to use on World Lung Day and in the build up to the day. These are below.

    There are also blank versions of each, which you can use to add your own language to the graphic. 

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    World Lung Day Events

    Will you be holding a WLD event this year?

    We encourage you to arrange your own local, regional or national public education activities, where possible, to help spread the important messages of the campaign across the globe this WLD.

    To support you with your activities, you can apply for a Healthy Lungs for Life grant of up to €1,000. Healthy Lungs for Life is a global awareness campaign run by the European Lung Foundation (ELF) and the European Respiratory Society (ERS), a FIRS founding member.

    Apply before Saturday 31 July for a chance to receive a grant for your WLD activities.

    Social Media


    World Asthma Day: 5 May 2021

    According to the World Health Organisation (WHO) Asthma Report, more than 339 million people suffer from asthma, which can cause wheezing, breathlessness, chest tightness, and coughing. The WHO estimates that in 2016, 420,000 people died from asthma – 1,150 each day. Although asthma cannot be cured, it is possible to control the disease to reduce and prevent asthma attacks, also called episodes.

    This year’s World Asthma Day theme is “Uncovering Asthma Misconceptions”. The Forum of International Respiratory Societies (FIRS) joins this call to action, to address common widely held myths and misconceptions concerning asthma that prevent people with asthma from enjoying optimal benefit from the major advances in the management of this condition.

    Common misconceptions surrounding asthma include:

    1. Asthma is a childhood disease; individuals will grow out of it as they age.
    2. Asthma is infectious.
    3. Asthma sufferers should not exercise.
    4. Asthma is only controllable with high dose steroids.

    The truth is:

    1. Asthma can occur at any age (in children, adolescents, adults and the elderly).
    2. Asthma is not infectious. However, viral respiratory infections (such as the common cold and the flu) can cause asthma attacks. In children, asthma is frequently associated with allergy, but asthma which starts in adulthood is less often allergy-related.
    3. When asthma is well-controlled, asthma subjects are able to exercise and even perform in top sports.
    4. Asthma is most often controllable with low-dose inhaled steroids.

    This year is the 23rd annual World Asthma Day, an event recognised each May to raise awareness of asthma worldwide.

    World Asthma Day was first held in 1998 and has grown each year to become one of the most important asthma events globally. On World Asthma Day, hundreds of awareness-raising activities will take place in countries all over the world.

    FIRS invites everyone to participate in World Asthma Day events on the 5th May, 2021. Further information about GINA and World Asthma Day can be found at ginasthma.org.


    Vaccination is a key part to control the COVID-19 pandemic. For vaccines to work they should have acceptable efficacy and safety and be delivered equitably worldwide

    VACCINE EQUITY AND ACCESS – A GLOBAL IMPERATIVE

    Vaccines against COVID-19 are a key complimentary intervention to bring the pandemic under control globally. To overcome the pandemic and reduce inequities in global health, COVID-19 vaccines should be available in every country. For the health of everyone, equitable access to COVID-19 vaccines is urgently and quickly needed in all countries.

    The speed of development of effective vaccines for COVID-19 has been unprecedented, with several now widely available and in use.  COVID-19 vaccination is one of the most pressing global issues. Vaccines are being distributed in more than 85 countries, with cumulatively more than 200 million doses administered globally [1].  However, vaccination is predominantly occurring in high income settings while in many low- and middle-income countries, vaccination has not started or is occurring in very small numbers.  For example, currently less than 0.2% of vaccination is occurring in Africa and Central America [1].  At current rates, widespread access to vaccination in African countries is only predicted to occur between April 2022 to 2023 [2].

    Priority for vaccination should be given to health workers, followed by those who are most vulnerable to develop severe disease and those who are most exposed to infection.  The elderly, those with diabetes, obesity, chronic lung or heart disease or immunosuppression should be prioritised after health care workers for vaccination.  Other cadres of workers who may face high exposure such as those working in old age facilities, firemen, police, school teachers and border control personnel should also be prioritised for vaccination after health care workers.

    Inequities in global access to vaccination have exposed and worsened large disparities between countries. Countries with the lowest rates of vaccination are also those with the most fragile health systems, lack of infrastructure for widespread vaccination programs, lack of access to oxygen and other lifesaving interventions and more economically disadvantaged populations. The COVAX facility was established by the World Health Organization, with the Global Alliance for Vaccines (GAVI) and the Coalition for Epidemic Preparedness Innovations (CEPI), to ensure global access to COVID-19 vaccines.  However, COVAX has secured a supply of doses of approximately 20% of the population of the 190 participants’ economies (92 low and middle-income countries and 98 high-income countries) for the end of 2021; plans for additional doses to increase coverage by 2022 will depend on regulatory approvals, country readiness and infrastructure.  Greater co-operation and collaboration between high-income countries, donor foundations, vaccine manufacturers and low and middle-income countries is needed to ensure access to vaccines on a not-for-profit basis, equitable distribution, and sustained programs to ensure vaccination.

    VACCINE EFFICACY

    To understand if a vaccine can combat infection from SARS-CoV2, the virus responsible for COVID-19, efficacy and safety have to be assessed under the most rigorous conditions in trials comparing them with placebo in ideal trial conditions and then followed in a real world scenario.

    Efficacy (%) is often misunderstood. If a vaccine has 95% efficacy it does not imply that 95% of people who receive it won’t get COVID, and 5% will get sick. Rather it means that those in the vaccinated group compared to placebo group are 95% less likely to get COVID. As the vaccine efficacy is one of the few numbers to be quoted on vaccines, a further problem is that numbers for different vaccines are often directly compared, side by side. This is only helpful in a broad sense as all the trials are comprised of slightly different cross sections of people with differing proportions in different age groups and varied proportions with chronic health conditions, for example.

    What is acceptable efficacy?
    Regulatory authorities indicated that vaccines with an efficacy of 50% or more would be acceptable. By comparison influenza vaccine efficacy is around 40-60%, but is still considered to be beneficial. It turns out that the COVID-19 vaccines are much more efficacious with efficacy ranging from 50% to 95%.  Phase 2 and 3 trials also tell us about side effects of the vaccine, so the true risk benefit can be judged.

    What does vaccine effectiveness mean?

    Once vaccines have received emergency use or conditional approval, they are rolled out into the community and their effectiveness is established by measuring real world disease rates in those who are vaccinated compared to those who have not been. So far, the COVID-19 vaccines are proving at least as effective or even higher in the community as the trial efficacy results suggest, which is excellent news.

    Impact of vaccines on severity of COVID-19

    Phase 3 trials have also examined the impact on severity of infection i.e., on those with mild, moderate and severe disease requiring hospitalisation and on deaths. Encouragingly, the vaccines seem more able to reduce severe than mild disease, which should reduce impact on health services. Vaccines consistently show a substantial reduction in severe disease and hospitalisations.  Early data suggest transmissibility of the virus may also be reduced. We do not know yet the duration of protection provided by the vaccines, or whether they prevent re-infection or infection with variant viruses.  As with the studies on long term side effects, this work will continue alongside simultaneous efforts to modify the vaccines to address the evolution of COVID-19.

    Phase 2 studies looking at the immune response generated by the vaccine and some phase 3 trial results show almost equivalent efficacy in the elderly. Studies on subgroups with underlying chronic conditions and immunosuppressive disorders, plus use in during pregnancy and lactation are continuing, and trials have begun assessing efficacy in adolescents and children.   

    Can we rely on the results?

    The question is often raised as to how is it that COVID-19 vaccines including some with highly novel technology such as the mRNA vaccines have been developed and tested within a year, when vaccine development has previously taken many years of even decades. Science has risen impressively to the challenge with its technological advances and global economic support allowed the rapid development but crucially no corners have been cut in the evaluation of these new vaccines. COVID-vaccine development has benefited from years of preceding work on other vaccines.   Instead of the development stages being carried out sequentially over long periods of time, trials have been done in an overlapping or parallel way with mixed public/governmental, academic and private pharma initiatives covering the financial risk.  Regulators such as Food and Drug Administration USA (FDA), European Medicines Agency (EMA), Medicines and Healthcare Products Regulatory Agency UK (MHRA) and many other national groups under the umbrella of the International Coalition of Medicines Regulatory Authorities (ICMRA) have acted together to carry out rolling reviews of trial data and also at many stages provided detailed and iterative feedback to optimise trial design. This has been a remarkable achievement and means the results can be trusted.

    SAFETY OF COVID 19 VACCINES

    After reviewing the available data of >200 million doses administered worldwide by 5 March, 2021[1], surveillance has identified few serious side effects and confirms the rigorous standards for safety, effectiveness, and manufacturing quality needed to support emergency use authorisation of the available vaccines.

    Facts about the safety of COVID-19 vaccines [3]

    • None of the vaccines will cause development of COVID-19 since they do not use the live virus.
    • None of the vaccines enter the cell nucleus and therefore, do not modify our genetic composition.
    • Vaccines won’t cause a positive viral test but will trigger an immune response that will test positive in antibody tests.
    • To date, no death has been attributed to the vaccine administration.
    • There is no evidence linking any vaccines to infertility.
    • Specific populations in whom risk benefit of vaccination should be considered – these populations are at increased risk of severe COVID but there is limited data on vaccination
      • Pregnant/breastfeeding women
      • HIV/AIDS or other immunocompromised conditions
      • Cancer patients during chemotherapy administration period
    • Side effects are common but are usually mild and present in the 1-3 days after administration and resolve in 24-48 hours. Viral vector vaccines have less severe side effects and all vaccines have fewer side effects in the elderly. Side effects increase with the 2nd dose of vaccine, reflecting an immune response and are more severe with the second dose of the mRNA vaccines. All individuals should be monitored for 15-30 minutes after being vaccinated to evaluate the presence of any serious adverse effect.
      • Local side effects: Pain, swelling and redness at the injection site.
      • Systemic side effects: Fatigue and headache are the most common symptoms while fever, joint or muscle pain and diarrhea are less frequent.
      • Severe adverse events: Rare and similar to other vaccines.
        • Anaphylaxis: Occurs rarely (2-5 people per million vaccinated) with mRNA vaccines [4]. Severe allergic reactions with hives, swelling, palpitations, agitation and shortness of breath due to airway closer (wheezing). Usually present within 30 minutes of administration and all facilities administering the vaccines should be equipped with the necessary supplies and trained personnel. Those who develop anaphylaxis should not get the second dose of the same type of vaccine.
        • Bell´s Palsy: Needs further studies to confirm causality.
        • Transverse Myelitis: Needs further studies to confirm causality.
      • For pain, fever or discomfort acetaminophen can be used. It is not recommended to take acetaminophen prior to getting the shot as a preventive measure.

    Surveillance

    In addition to expanding access to vaccines, work needs to be done to expand surveillance monitoring systems for vaccination programmes so that we have better data about who is getting vaccinated and who is not.  Surveillance schemes are also designed to identify clusters of possible vaccine-related adverse effects eg. rare blood clots associated with low levels of platelets, and investigate these as rapidly as possible.  As an example of this process the European Medicines Agency has concluded that benefits of the Astra Zeneca vaccine outweigh the risk of rare blood clots [5].

    Vaccines in children

    Most of the current available vaccines have only been approved for individuals over 18 years old, although the Pfizer/BioNTech vaccine is authorised for use in those 16 years and older. However, children can become seriously ill from COVID, so rapid expansion of the eligibility of this population is warranted. Trials are underway to assess the efficacy and safety of COVID vaccines in children and it is hoped that these results will soon become available.

    References

    [1] Our World in Data. Online: https://ourworldindata.org/covid-vaccinations.

    [2] Economist Intelligence Unit, Jan 2021.

    [3] https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html.

    [4] Shimabukuro TT, Cole M, Su JR. Reports of Anaphylaxis After Receipt of mRNA COVID-19 Vaccines in the US—December 14, 2020-January 18, 2021.JAMA. 2021;325(11):1101-1102. doi:10.1001/jama.2021.1967.

    [5] European Medicines Agency https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still-outweigh-risks-despite-possible-link-rare-blood-clots.

    FIRS COVIS-19 Vaccine Writing Team

    Mark Cohen, Heather Zar, Anita Simonds and Robert Horsburgh.

    About the Forum of International Respiratory Societies (FIRS)

    The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world's leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

    The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 100,000 members globally.

    For more information about FIRS please contact Lisa Roscoe This email address is being protected from spambots. You need JavaScript enabled to view it..


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