Photo of a girl in a classroom at school wearing a face mask
As students prepare to return to school in parts of the country, there are many uncertainties due to the COVID-19 outbreak. We see social distancing and mask recommendations. Many parents, school staff and school nurses are also asking, “What happens when a child experiences a cough or appears to be short of breath?” Is it COVID-19? Is it a cold? Is it asthma?

School nursing assessment is always necessary, but even more so this year. There will be many times that the nurse will be called upon to determine if a student’s symptoms are in line with those of COVID-19 or not.

Allergy & Asthma Network has developed an algorithm (along with care notes) for school nurses to use as they assess students with respiratory symptoms. Asthma Care at School During the COVID-19 Outbreak is a resource that can help identify a viral illness vs. asthma.

Either way, any student experiencing difficulty breathing needs attention and treatment right away.

Are the symptoms due to a virus?

If you’re concerned about a viral illness, or COVID-19, you’ll look for:

  • Fever of over 100.4
  • Cough with/without wheeze
  • Nasal congestion
  • Nausea/vomiting/diarrhea
  • Headache/fatigue
  • Muscle pain
  • Poor appetite
  • Swelling or rash on hands and feet

Are the symptoms due to asthma?

Asthma symptoms include:

  • No fever
  • Audible wheeze or cough
  • Chest congestion or tightness
  • Fatigue
  • Not able to fully participate in daily activities
  • Stops talking to catch breath

What should you do? In light of the pandemic viral outbreak, extra precautions should be taken. If you suspect a virus, the student should be isolated, and the parent should be called to take the student home to consult with their healthcare provider. The student should wear a mask.

If the student has asthma, that should be treated as well by following the student’s Asthma Action Plan, calling the parent as needed, and administering medication as directed. If no viral signs are present, the student can return to class following a period of observation.

If COVID-19 is confirmed in a student, the school, in collaboration with the local health department, should assess the risk and consider a 2-5 day building dismissal to clean, disinfect and contact trace.

If a student seems sick, keep them at home and follow the 3 Ws:
• Wear a mask
• Watch your distance
• Wash your hands

We encourage you to keep up with the latest information about COVID-19 by visiting our COVID-19 Information Center regularly.

Additional Resources

COVID-19 School Resources for Managing Asthma and Allergies

Allergies and Asthma at School – Resources for Parents and Schools

Planning for School with Food Allergies