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Back to School with COVID-19 in New England

AAFA New England recognizes the many challenges COVID-19 has presented to our asthma and allergy community since its arrival, and now that includes the return to school.  There are many questions and concerns about how learning can proceed safely while limiting the spread of this virus. Parents of students with asthma or food allergies have additional concerns.  The information provided below is meant to help inform this process for parents of school-aged children who have asthma or allergies.

Planning before School Starts

  • Protocols are being developed in each state for procedures related to COVID-19.  
  • In-class learning, remote learning, or a hybrid (combination of the two) will likely be based on the number of documented cases of COVID-19 infection in a geographic area.

     *Remote learning requires access to computers and reliable internet access, which  may not be available to all students in underserved communities – plans that address this are needed.

  • Education on the signs and symptoms of COVID-19 is recommended for staff.
  • A dedicated isolation space at school is recommended to be in place for anyone being evaluated for COVID-19.

*A plan for the individual’s return to school after recovery from COVID-19, should be in place.

  • Stock albuterol and epinephrine is recommended, when state regulations allow.


  • A flu vaccine is highly recommended for all students. 

*In Massachusetts, the flu vaccine is now required for all entering students. 

  • Medical paperwork required by the school should be provided to the nurse by parents of children with asthma or food allergies.
  • Medications should be provided to the school nurse, such as inhalers and epinephrine.

*The use of nebulizers at school is not recommended to reduce the spread of COVID-19.

  • Know your child’s asthma zone and asthma action plan if your child has asthma.  Teach your child the proper technique for using an inhaler, as appropriate for their age.
  • Maintain good adherence with asthma and allergy medications as prescribed by your child’s doctor. 
  • Children’s anxiety about COVID-19 may occur; listening and talking calmly, using facts where appropriate, may help reduce concerns.  It can be helpful to focus on routines and prepare children for what food allergy management practices will be the same, and what will be different from previous school years, and that handwashing, surface cleaning and no food sharing will be important for all children now.

Communication is Important: Contact your school district administration to learn the specifics of your school’s plan, and how updates will be communicated.

Recommendations to Stop the Spread at School

  • Stay home if sick. 
  • COVID-19 screening may be a part of school protocols.
  • Asthma action plans and food allergy action plans will be developed by the school nurse for students with these diagnoses, along with an IHP and/or 504 Plan, which will reflect changes in the school environment due to COVID-19.
  • Physical distancing of at least six feet between individuals, and desks no less than three feet apart is recommended by the CDC. 
  • Face masks worn by students and staff alike while at school is recommended, as are scheduled “breaks” when masks are removed, along with physical distancing. The CDC recommends masks as the best way to prevent the spread of COVID-19, but not for children under two, or anyone having trouble breathing. Masks and latex-free gloves should be made available. 

*Students with well-controlled asthma should be able to wear a face mask without difficulty.   Check with your child’s physician if you have concerns and discuss with the school nurse.

  • Handwashing with soap and water (20 seconds) is effective in removing COVID-19 and should be practiced frequently. Hand sanitizers need at least 60% ethyl alcohol or 70% isopropyl alcohol to be effective. 

*Hand sanitizers are not effective in removing food proteins.

  • Enhanced cleaning procedures and supplies are recommended, including the use of EPA disinfection protocols effective against COVID-19. 

*Cleaning chemicals can trigger asthma symptoms for some individuals.  Talk with the school nurse if this is a concern. 

  • Eating in the classroom is recommended by the CDC during this pandemic.

*To decrease risk of allergen exposure for students with food allergies, strict handwashing, before/after eating (not hand sanitizer); desks and surface washing, especially after eating; risk reduction procedures regarding specific food allergens  in the classroom; no food-sharing; and physical distancing are highly recommended procedures.  

*Wearing a face mask could hide symptoms of an allergic reaction on the face.  School staff should receive education on the signs and symptoms of anaphylaxis.

* Other procedures for distancing during meals, such as staggering meal times and locations, may be used.     

  • Indoor Air Quality should be addressed.  Air purifiers with filters may be used to improve indoor air quality. 

*The ionizer function may be turned off to avoid possible irritation of airways resulting in asthma symptoms.  

Collaboration is Important: Partner with your school nurse who will be a leader in helping to keep your child with asthma and/or food allergies healthy during this pandemic.  

The information and guidance provided is based on its availability at the time of publication.  It is not meant to replace federal, state, county or town requirements. 

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