My Child Has Asthma: Should They Return To School? We Asked The Experts

Let’s face it: the question about whether kids should return to school buildings during this shitshow of a pandemic has been heavy. Parents, teachers, and school administrators have been losing sleep over it for weeks. Re-opening plans have been hatched, and then changed. Parents are scrambling to figure out childcare, wondering if their school plans are safe, trying to make sense of weird-ass schedules, and just basically feeling like they don’t know WTF is going on or what to do.

Kids, Asthma, Respiratory Infections, And COVID-19

If your child is one of the more than 6 million kids in America who suffers from asthma, you are probably seriously stressing over the back to school issue. After all, right now, the CDC lists moderate to severe asthma as a condition that may predispose someone to a more severe case of COVID-19.

Asthma can be triggered by exercise, stress, cigarette smoke, and allergies—and for many children, respiratory viruses are a main trigger for asthma attacks. I can personally attest to this. Both of my sons have asthma that is mainly triggered by respiratory infections. Even the common cold can set them off into a severe bout of asthma. My little guy was rushed to the ER with the worse asthma attack of his life last spring—again, triggered by an unknown, garden variety cold virus.

I don’t think there is anything more terrifying than watching your child gasp for breath—their little chest retracting in and out, a look of sheer terror in their eyes. I wouldn’t wish this experience on my worst enemy.

Like many parents of asthmatic children, I have been worried sick about COVID-19. If my child can get severe asthma attacks from the common cold, what about a deadly respiratory infection that targets the lungs?

My kids haven’t played with another child since March. They basically stay home, take walks, go for car rides, and have had a few very controlled socially distanced/masked visits in their grandparents’ backyards. That’s it.

When the return to school issue came up, I was wracked with worry—and my kids’ asthma was the top reason for this stress. Could even the best-laid school safety plans keep my kids protected from the virus? How would I know what to trust? How much risk could I take?

Really, any child contracting the virus is something to be concerned about, because even healthy children have been hospitalized with the virus, or complications from it. Even healthy children with no underlying conditions have died from it.

But the idea that COVID-19 could be potentially much worse for asthmatic children is definitely something to consider if you are the parent of an asthmatic child weighing all your options for the fall.

It should go without saying that the person you should take medical advice from most seriously is your pediatrician—they can help you make this decision based on their knowledge of your child and any other factors that might be relevant.

Two Pediatricians Weigh In On Asthma And School Openings

That said, I reached out to two doctors—Dr. Joi Lucas, a pediatric pulmonologist and Medical Director of Pediatric Pulmonology at Lakeland Regional Health, and Dr. Jay Lovenheim, a pediatrician in Lovenheim Pediatrics, West Orange NJ—for their opinions and their honest answers to our most frequently asked questions about COVID-19, asthma, and back-to-school.

Because the more knowledge, the better, right?

Dr. Lucas agrees with the CDC assessment that asthma may be a risk factor for a more severe COVID-19 infection. “The CDC acknowledges coronavirus-2019 (COVID-19) resulting from SARS-CoV-2 infection presents a risk for worsened symptoms in moderate to severe asthmatics,” he tells Scary Mommy.

Dr. Lovenheim echoes these sentiments. “According to what we know about COVID 19, any child or adult with certain underlying conditions are more susceptible to developing a severe case and complications,” he tells Scary Mommy. “Among those conditions, asthma is known to be a risk factor.”

Given that, how can a parent decide whether sending their asthmatic kid back to school is a good choice?

Dr. Lucas says that it might depend somewhat on the severity of your child’s asthma.

“Mild asthmatics who do not need daily medication may be able to safely return to school,” he explains.

“However, I advise caution with in-person school for children with uncontrolled asthma, moderate, or severe persistent asthma,” he continues. “Specifically, for children who required hospitalization for asthma, frequent emergency department visits, or oral steroids during the prior year, I recommend virtual or homeschooling.”

Dr. Lovenheim agrees that your child’s asthma is something to strongly consider in your decision to return to brick or mortar schooling. But that needs to be weighed against other factors as well.

“This would be something that should factor into a parent’s choice to send their child back to an in-classroom school setting,” he says. At the same time, he explains, “the child’s underlying medical issues should be weighed against the policies and procedures that your school district will be able to implement to protect our children.”

Your area’s community spread might be a factor for you to consider, says Dr. Lovenheim—and areas with lower community spread may be a lower risk choice at this time. Although each family has to make the choice that feels best to them, Dr. Lovenheim recommends in-person school “when possible and safe.”

He also recommends contacting your pediatrician to help make this choice.

But what if you have no choice but to send your asthmatic child to school—for example, if you are a single parent with no other childcare options, or an essential worker who can’t work from home?

“If higher risk asthmatics must return to in person school, efforts to mitigate the risk of COVID-19 spread should be implemented including wearing a mask, socially distancing, temperature checks, and frequent hand hygiene,” says Dr. Lovenheim.

Of course, that’s all assuming that your school has the budget to do so and that these requirements are in their reopening plans … and that kids and staff will be compliant and wear the masks and do the social distancing.

Sigh.

Making The Best Decisions For Your Family

Personally, after a bunch of soul-searching (and sleepness nights) I decided to go with my gut and choose a remote option for my kids this coming school year.

Why? Well, because there are just so many unknowns about how this awful virus affects asthmatic kids. After all, this is a brand new virus, and we are only about half a year into understanding it. Maybe asthmatic kids will generally be okay if they contract the virus. Maybe they won’t. We don’t know enough yet.

After experiencing traumatic moments with my kids during their asthma attacks, that risk is something I just can’t take. Plus, even though community spread is somewhat low in the area where I live, I don’t feel 100% certain that my kids will be properly protected from the virus in a school building, even with the best laid plans and supportive teachers. All it takes is one infected person to spread the virus to potentially hundreds of children, who will take it home to their families.

I fully understand my choice not an option for all parents, nor is it something all parents would prefer.

I would urge all parents in this position to contact their pediatrician for help in making this difficult choice given the options that are available. They know your child’s particular asthma situation, and can help you make an informed choice.

Also, remember this: this pandemic is only for now. It will get better, but in the meantime, it’s going to be a bit of a chaotic mess as we navigate school, work, and keeping our kids as safe as we can. But we can do this, parents. We can, because we have no other choice.