COVID-19 School Resources for Managing Asthma and Allergies

Notice: Covid-19 and Schools

It is important to remember that the COVID-19 outbreak is a constantly evolving situation and guidance is likely to change as more is understood about this novel coronavirus. For general information on COVID-19, such as signs & symptoms, please visit our

COVID-19 Information Center

The current school year will be an unusual one for everyone – but especially for students with asthma and allergies. As we move through the COVID-19 outbreak, it’s important to know the facts.

There’s so much information and misinformation available – come to Allergy & Asthma Network for trustworthy, evidence-based guidance on COVID-19, asthma and allergies – we’ll help you navigate the school year. The most important thought? Be flexible. Expect things to change as we move through the next year and be ready to adjust to the new guidance as it is available.

Image of teach with medical mask on her face holding a notebook that says "Back to school." The notebook has coronavirus images that are hand drawn on it.

How can school nurses assist schools as they develop plans for reopening?

School nurses are trusted leaders in helping schools make decisions about their COVID-19 response and should be involved in all planning to reopen schools, and deal with potential illness. Some of the activities that school nurses can help with include:

  • Disinfection procedures
  • Ventilation procedures (with consideration for students with asthma and allergies)
  • Signs, messaging and markings that promote social distancing
  • Development of appropriate plans to care for students and staff who become ill

Are there any recommendations regarding ventilation in schools with consideration for students and staff with asthma and/or allergies?

There have been concerns related to the use of air conditioners and ventilation systems during the COVID-19 outbreak. At this time, there is not a strong answer to this concern. Considerations include:

  • Most air conditioners recirculate air within a space – adding a filter into the HVAC system will filter out some of viral particles
  • Air purifiers may help to a point
  • Regularly opened windows to bring in fresh air from outside is the best recommendation at this point in time – be aware that this may expose students with environmental allergies to pollen and other outdoor allergens
  • The epidemiology supports that COVID-19 is spread by droplets and those droplets fall to the ground within 6 feet – social distancing is key

NOTE: Hand sanitizers work well to help kill viruses on hands, but they do not “clean away” food allergens. Continue to use soap and water or wipes to remove food allergens from hands and surfaces.

Should school staff be trained on signs and symptoms of COVID-19?

Training for staff will vary by school district. Parents should feel free to contact their school district or administrator to discuss how staff is being trained and to ask about the district’s procedure if a case of COVID-19 is suspected or confirmed.

School staff should be trained on the signs & symptoms of COVID-19 and what to do if they suspect that they have symptoms or if a student develops symptoms while at school.

How is food service to be handled when schools reopen?

The CDC advises that that children eat in classrooms rather than in a group cafeteria situation where social distancing may be difficult.

  • Students should bring food from home when possible
  • The school should provide pre-packaged foods when possible
  • Considerations should be made for students with food allergies
    • Provide education to staff who oversee lunches on the signs and symptoms of food allergies
    • Reinforce that staff build bridges with parents in discussing food allergies and how to protect children
    • Utilize placemats for eating.  Placemats and desks of students with food allergies should be cleaned first with a separate cloth to prevent cross contamination.
    • Epinephrine auto-injectors must be readily available where students are eating and, if appropriate, additional staff may need to be trained on administration protocols

Allergies & Asthma at School ➡

Planning for School with Food Allergies ➡

How should school health offices prepare for when schools reopen? 

School Health staff should set up the school health office to promote social distancing.  The school should make arrangements to accommodate the isolation of a student who becomes ill with the symptoms of COVID-19 during the school day.

  • Ensure adequate supply of PPE for school nurses, staff, and any students who may require it
    • Use vinyl or nitrile gloves, DO NOT substitute with latex gloves
  • Limit the number of students in the health office at one time
  • Get administrative support as needed to supervise students who may be waiting to enter
  • Stagger medication administration times
  • Isolation space and staff supervision for students with respiratory or viral symptoms 
  • Develop protocols for when to isolate and dismiss students

Are people with asthma more at risk from COVID-19?

For many students or parents of students with asthma, the return to school brings extra concern in light of COVID-19.

According to the CDC, people with moderate to severe asthma may be at higher risk from getting very sick with COVID-19. COVID-19 often affects the respiratory tract (nose, throat, lungs), which can cause an asthma flare. This could also lead to pneumonia or acute respiratory disease. A recent study from the Journal of Allergy & Clinical Immunology demonstrated that those with non-allergic asthma may be up to 48% more at risk from severe COVID-19. The same study did not find increased risk for individuals with allergic asthma.

What kind of precautions should a student or staff member with asthma take as they prepare to return to school during the COVID-19 pandemic?

In addition to practicing activities to prevent COVID-19, it is crucial that people with asthma make sure their asthma is well controlled.  This includes:

  • Make sure you have your asthma medications and supplies (at least 30 days on hand)
  • Follow your Asthma Action Plan 
    • If you don’t have an asthma action plan, make an appointment TODAY to develop one with your doctor
  • Take your asthma medications as directed and don’t’ stop any without first discussing with your doctor
  • Know your asthma triggers and avoid them when possible
  • Know how to use your inhaler – videos are available to help
  • Learn ways to cope with stress and anxiety as strong emotions can trigger an asthma attack 

Before returning to school it is a good idea to meet with your doctor to discuss concerns and make sure your Asthma Action Plan is up to date.

Should a child or staff member who is coughing from asthma and/or allergies be forced to go home?

Two of the symptoms of COVID-19 are coughing and shortness of breath, which may overlap with symptoms of asthma and allergies. Due to this, students experiencing a cough and/or shortness of breath should consult their healthcare provider before attending school.

Are disinfectants and hand sanitizers safe for students or staff with asthma?

Routine cleaning and disinfecting is key to maintaining a safe environment for faculty, students, and staff.

  • Cleaning removes dirt and some germs and is generally done with soap and water.
  • Disinfecting kills most germs and should be done with approved cleaning agents for the school setting.

For many students and staff, cleaning products and disinfectants are triggers for their asthma. People with asthma should try to stay away when cleaners are being used and immediately following their use.

What COVID-19 face mask policies should be in place in schools?

CDC guidelines to wear face masks are based on levels of COVID-19 in each community. The levels are determined by the total number of people with COVID-19 admitted to the hospital; hospital beds in use; and the total number of new COVID-19 cases in the area.

If a community has a high level of COVID-19, it’s recommended people wear a mask indoors in public settings, including K-12 schools. Masks do not need to be worn outside.

If a community has a medium or low level of COVID-19, face masks are based on personal preference or risk. However, for communities at medium level, people who are immunocompromised or at high risk for severe illness should talk with their doctor about wearing a mask indoors.

Check your community’s level on CDC’s website.

Some individual schools or school districts may elect to continue having students wear masks. Check with your local school for information.

Should masks be worn by people with asthma?

Guidelines for wearing a mask are evolving. Currently, CDC says people living in a community with high levels of COVID-19 should wear a face mask indoors. This includes people who are immunocompromised or at risk for severe illness, such as those with moderate to severe asthma. If the level of COVID-19 in a community is medium, people who are immunocompromised or at risk for severe illness should speak with a doctor.

There are different styles and fits for face masks, so people with asthma should try different ones to see which masks make it easiest to breathe. Also, it is important to double check the materials (including straps) to make sure the mask or straps don’t contain any allergens. Straps, for example, may contain natural rubber latex, which could be an issue for someone with a latex allergy.

If you are experiencing difficulty breathing while wearing a mask, schedule an appointment with a healthcare provider to review your asthma control and/or seek emergency care.

Regarding face masks, the American College of Allergy, Asthma & Immunology (ACAAI) recommends the following:

If you feel you can only wear a mask for a short time, plan for any necessary outings to public places to be as short as possible and to wear your mask as long as possible. It may be helpful to try different face coverings at home to find one that is most comfortable, and practice wearing the mask at home for a period before your next outing. Always use a clean mask for each outing. If possible, don’t take your mask off and put it back on during a single outing, as touching the mask increases the possibility of contamination.

Photo of classroom with children at their desks wearing masks. Teacher also has a mask.

The American Academy of Allergy, Asthma & Immunology (AAAAI) recommends the following:

There is no endorsement of a “best mask” for patients with chronic lung diseases. Cloth masks are recommended for non-healthcare personnel. Fabric selection must balance sufficient capacity to trap viral particles with comfort. Recommended fabrics include cotton blends, 100% cotton T-shirt fabric and sheets/pillowcases with high thread counts. Two layers of fabric or one layer of fabric plus a filter layer are most commonly recommended. Too many layers will result in a mask that makes breathing difficult. Make sure that you cannot see daylight through the mask. If someone is having trouble breathing, they should probably avoid wearing a mask as this could paradoxically lead to worsening of their respiratory status. The CDC recommends wearing a bandana, which may be the most comfortable approach for persons with lung conditions since it is not constricting. It is important to keep in mind that the purpose of the mask is to reduce transmission of viral particles to other persons.

For the latest information on mask recommendations, please see Why Face Masks are Critical for People with Asthma During the COVID-19 Pandemic.

What are potential complications for children and COVID-19?

As a result of COVID-19, some children have experienced Multisystem Inflammatory Syndrome in Children, or  MIS-C. It is a condition where different parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

The exact cause of MIS-C is unknown, but many children with it had COVID-19 or were around someone with it.

    What are the symptoms of Multisystem Inflammatory Syndrome in Children?

    • Fever
    • Abdominal pain
    • Vomiting
    • Diarrhea
    • Neck pain
    • Rash
    • Bloodshot eyes
    • Feeling extra tired

    **Not all children have the same symptoms