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I enjoyed reading this article which provides a comprehensive guide for GPs assessing & managing asthma during the pandemic.
In the print version, the photograph with Box 3 shows a woman using a metered-dose inhaler (MDI) for administering inhaled corticosteroids. It is ironic, given the same edition devotes a whole section to 'Health in the Anthropocene' that a photograph of a more environmentally dry-powder inhaler (DPI) was not used.
MDIs account for 3.1% of England's health and social care greenhouse gas emissions and a target for the reduction of their use is included within both the NHS Long-term Plan and the 20/21 GP contract. In part this will require clinicians over-riding the 'default' setting of issuing an MDI to patients with asthma. To support this, it would help if photographs for DPIs were more widely used in journals and in the public domain to challenge the status quo of 'MDI first'.
(1) Pencheon, D & Wight, J. Making healthcare and systems net zero. BMJ 2020:368:m970