This NCBI paper on history of COPD says what needs to be done to diagnosis this. SO WHY IS THIS NOT BEING DONE? THIS IS PATHETIC. This was written in 2006, over a decade ago.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27065...
EXCERPTS:
Spirometry remains the most effective means of identification and assessment of the course of COPD and responses to therapy, and is grossly underused for this purpose ...
… The spirometer is key ... yet its use is still poorly applied to the diagnosis and management of COPD … Early identification ... promises to change the outcome.
The most notable was the consensus’s statement of the NLHEP, which recommended the spirometric testing of all smokers aged 45 or older and anyone with chronic cough, dyspnea on exertion, mucus hypersecretion, or wheeze ...
And in the Summary: ... Spirometry must emerge as the fundamental way to diagnose ...