The back-to-school period brings a dramatic increase in cases of asthma attacks in children and young people due to the cold weather, common viral infections and reduced asthma medication compliance. It is a challenging time for children with asthma and this year, the challenge is even greater due to COVID 19. The uncertainties and unknowns around how COVID 19 will have an impact as children return to schools adds to the stress.
COVID 19 affects people of all ages, and the US Center for Disease Control and Prevention had initially stated that people with chronic lunch disease, including moderate to severe asthma, may be at higher risk of developing a more severe form of COVID 19 than healthier people. However, research on pediatric patients at a hospital in Italy shows that the allergy may be “protective” and that therapies could have a “protective” effect for respiratory disorders. This finding, however, needs to be confirmed.
What is asthma and what are its symptoms?
Asthma is a chronic lung disease that makes breathing difficult. It causes inflammation in the lungs and can be life threatening if not treated properly. The symptoms of asthma include tightness of the chest, wheezing, shortness of breath and difficult breathing while crying, running or laughing.
What are the triggers for asthma attacks?
Infections cause airways to get inflamed, but it is just one of the reasons why a child might have asthma. The other triggers for asthma include:
- Allergies: Allergic reactions are one of major causes of an asthma attack. Children with asthma may be allergic to animals, mold, dust, insects and even some types of food.
- Exercise: Exercise can be a major trigger for asthma in young people. In these cases, it is always advisable to save the pediatrician’s details with a child’s health record. EHRs like EduHealth are particularly helpful in such cases, because they let the school nurse find information as well as contact the doctor easily. The doctor may be able to prescribe medications that helps to keep the airways open during exercise. With monitoring, most children can continue with physical exercises without worrying about an episode. Here are some recommendations from NASN and Shape America on how to recognize and respond to an asthma emergency in physical education.
- Emotions and stress: Crying, being in a stressed situation or fear may trigger an asthma attack. Stress could even make an episode worse, so it is very important to keep the child calm.
- Weather: Cold air is the most serious triggers for children at risk for asthma attack. Smoking and other risk factors contribute too. So, living with family members who smoke, or an area where children are exposed to smoke can trigger episodes. Other chemicals that seep into the air, like pollution, paint fumes, cleaning sprays (called aerosols) can be harmful too.
How to manage asthma when children head back to schools?
Managing asthma is especially important this year because the symptoms mimic those of COVID 19. The best approach for asthma would be to make sure asthma symptoms are well-controlled as we approach cold and flu season, to avoid respiratory complications.
For children attending schools, a recommended approach is providing the school with an “asthma action plan” and emergency inhalers. Parents and school nurses should also be sure that asthma control medicines are working well.
Experts recommend that it’s safe for kids with asthma and allergies to wear a mask at school, and that having symptoms under control will make wearing a mask more tolerable.
How to know if the students’ asthma is under control?
When asthma is well-controlled, children have a better chance of recovering faster or avoiding illness complications. However, it is important to know if their asthma is under control, especially as the flu and other respiratory illnesses are beginning to spread.
First ask these questions:
- Do you have to take your quick-relief inhaler more than two times a week?
- Do you wake up at night with asthma more than two times a month?
- Do you refill your quick-relief inhaler more than two times a year?
- Do you measure your peak flow at less than two times 10 (20%) from baseline with asthma symptoms?
If these questions apply to the kids, you may need to be in contact with their health care provider.
How children with asthma can avoid COVID 19?
Social distancing remains the best method for preventing COVID 19. However, it is not possible when children must return to schools.
The Asthma and Allergy Foundation of America (AAFA) has released a comprehensive guide, the “COVID 19 and Asthma Toolkit for Schools” to help educators, school health care community and families of children living with asthma follow the best practices to stay healthy as they return to schools. They’ve recommended that students and staff with asthma who return to schools must have their condition under control because they’ll be facing a seasonal asthma epidemic on top of a major viral pandemic at the same time.
AAFA’s ‘COVID-19 and Asthma Toolkit for Schools’ creates a roadmap for:
- Bringing in new COVID 19 school policies to help students and staff with asthma
- Creating asthma friendly school spaces that prevent the spread of COVID 19
- Specific COVID 19 protocols for school nurses and staff managing asthma
- Developing individual asthma management plans for each student including having extra medicines and tools on-hand during emergencies like the COVID 19 pandemic
What if the child still gets sick?
Sometimes, no matter how we try, things get out of hand. As soon as you know that a child is sick, contact the health care provider. The sooner the episode is treated, the better are the chances of keeping it from getting worse.
- Contact the healthcare provider. EduHealth electronic health record platform will give you quick access to relevant information like the students’ health, medication and healthcare provider information. However, if you think the child may be contagious, call the health care provider first to avoid spreading the illness to others.
- Tell the healthcare providers the child’s symptoms.
- If you suspect the child has been exposed to the flu or is showing symptoms of the flu, share that information with the healthcare provider.
- Let them know the medications you’ve given the child.
- Follow the school’s asthma action plan.
- Ensure the child gets plenty of rest, drinks enough water and has healthy food. Ensure that they avoid the asthma triggers.