Back to school student with mask for COVID-19 protection

Krames StayWell is proud to partner with the American Lung Association and share this guest blog.

Traditionally, as the end of summer draws near, back-to-school hype begins. Parents and children eagerly gather school supplies and prep for a return to the classroom. But this year, with the COVID-19 pandemic still looming over us, planning for the 2020-2021 school year has been quite different. Some schools will be open for in-person classes, but many will only open virtually. Still, others may choose a combination of the two, also known as a hybrid model. This makes parents’ job of navigating the risks involved with sending a child to school this year extremely difficult. Parents whose children have moderate to severe asthma may be at higher risk of complications if they get COVID-19 thus making the decision even more challenging if their school district is only offering in- person instruction.

[Educate and help patients manage asthma with Krames Patient Education from the American Lung Association.]

Here are a few important things for parents and caregivers to keep in mind for this school year:

  • You can keep asthma well controlled by monitoring symptoms, avoiding asthma triggers, and taking asthma medicines as prescribed, including daily long-term controller medicines.
  • Before school starts, consider visiting your childs healthcare provider for an asthma check-up and review their asthma action plan.
  • Be sure to get vaccinations, including an annual flu shot, as soon as possible.
  • Assess your childs readiness to self-carry and self-administer their asthma medicines, and if your child does not self-carry, ask your childs doctor if they are ready.
  • Request a quick-relief inhaler with a valved holding chamber/spacer. Make sure to keep one at home and one at school. The use of a nebulizer may spread COVID-19 virus particles in the air and may not be allowed to be used in school settings.
  • Communicate early and often with your childs school about their asthma. Make sure you understand the schools asthma medication policies and practices and the steps they take to treat your child when they have symptoms.

To help you navigate your decision whether or not to return to in-person schooling, the American Lung Association has compiled some frequently asked questions about children with asthma returning to school during the COVID-19 pandemic.

Q: Is it safe for my child with asthma to return to in-person classes during COVID-19?

This is a decision that should be made in consultation with your childs healthcare provider. The Back to Schoolseason for children with asthma often results in more frequent symptoms and asthma flare-ups. Children with moderate to severe asthma may be at higher risk of getting more serious symptoms if they are infected with COVID- 19, but the disease is still so new that experts are still doing research on this topic.

Q: Is it safe for my child with asthma to wear a mask?

The Centers for Disease Control and Prevention (CDC) recommends that everyone two years of age and older wear a cloth face covering while around others. Children with asthma should be able to wear a cloth face covering if their asthma is well-controlled. Because some children may find it difficult to wear a mask for an extended period, parents should purchase or identify a facial covering that is comfortable for their children to wear. There are many different types of face coverings with a variety of fabrics, designs, straps and fits that may make one mask more comfortable than another.

Q. Is it safe for my child with asthma to wear a mask for extended periods of time?

Children with asthma should be able to wear a non-N95 facial covering without affecting their oxygen levels. Non-N95 facial coverings are currently the recommended public health practice by the CDC for the general public, including children. Have your children practice wearing their face mask at home for an extended period. Check out these steps to help your children get used to wearing a cloth face covering.

Q. How do I communicate the health needs of my child with asthma with school personnel?

Prior to the start of the school year, reach out to the designated school health staff to let them know that your child has asthma and may require quick-relief medicine during the school day to relieve symptoms. Schools may require an asthma action plan, health forms, a quick-relief inhaler and spacer or valved holding chamber. Quick-relief medicine using a nebulizer may not be possible this school year due to potential increased risk of the transmission of COVID-19 by droplets that are expelled in the air and should be discussed with school health staff.

Q. Will my child with asthma be allowed to use their quick-relief medicine if they are experiencing asthma symptoms during the school day?

Yes. The use of a quick-relief inhaler, with a spacer or valved holding chamber, should not spread viral particles because, when used correctly, the medicine is inhaled into the lungs and not expelled. Coughing is a common asthma symptom and using an inhaler could also cause a child to cough. Children should maintain a physical distance of at least 6 feet and cover their mouth if their asthma or the use of an inhaler makes them cough. It’s important to communicate with the school health office to inform them that your child has asthma and to complete any paperwork that may be required by the school to allow your child to self-carry and self-administer their asthma medicine during the school day. If your child forgets their medicine or is not able to self-carry, discuss treatment options with the school health staff.

Q. Are quick relief inhalers just as effective at stopping my child’s asthma symptoms from getting worse as a nebulizer?

Yes. Studies have shown that using a quick-relief inhaler with a spacer/valved holding chamber can help get the medicine deep into the lungs where it works best. For more information on proper use, see Using an Inhaler with a Valved Holding Chamber.

Additionally, using disposable valved holding chambers or spacers with a quick relief inhaler in place of a traditional valved holding chamber or spacer should be discussed with your child’s healthcare provider.


Preparing for the 2020-2021 school year during the COVID-19 can be frustrating, but you are not alone! Below are some resources to help parents and caregivers navigate the school year during this unique time.

Help patients successfully manage asthma with patient education from the American Lung Association

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