K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
If children with asthma use “breathing treatments” or peak flow meters, do schools need to be concerned about aerosolizing the virus that causes COVID-19?
First, students with symptoms of COVID-19 should not attend school. Symptoms
of asthma and COVID-19 may overlap, including cough and shortness of breath.
Therefore, students experiencing acute asthma attacks should not be attending
school without approval by a healthcare provider; if an asthma attack starts
at school, a student may need a bronchodilator treatment before being sent
home or before an ambulance arrives. The American Lung Association’s Model
Policy for School Districts: Stock Bronchodilatorspdf iconexternal
icon recommends using inhalers with disposable
spacers/mouthpieces and nebulizers with disposable tubing with
mask/mouthpieces. Inhalers and nebulizers should be used and cleaned according
to the manufacturer’s instructions.
During this COVID-19 pandemic, asthma treatments using inhalers with
spacers (with or without face mask,
according to each student’s individualized treatment plan) are preferred over
nebulizer treatments whenever possible. Based on limited data, use of asthma
inhalers (with or without spacers or face masks) is not considered an aerosol-
generating procedure.
Based on limited available data, it is uncertain whether aerosols generated
by nebulizer treatments are potentially
infectious. During this COVID-19 pandemic, nebulizer treatments at school
should be reserved for children who cannot use or do not have access to an
inhaler (with or without spacer or face mask).
Schools should obtain the appropriate personal protective equipment (PPE) for
staff who administer nebulizer treatments. PPE for use when administering
nebulizer treatments to students with asthma consists of gloves, medical grade
facemask and eye protection.
School staff should be trained on when to use PPE, what PPE is necessary,
where this PPE is stored, how to properly don (put on), use, and doff (take
off) PPE, and how to properly dispose of used PPE. CDC has
information on using PPE. Staff
should also be trained on how to administer nebulizer treatments.
During this COVID-19 pandemic, if a nebulizer treatment is necessary at school
for a student, the number of people present in the room should be limited to
the student and the staff member administering the treatment. If appropriate
based on the student’s age and level of maturity, the staff member could leave
the room and return when the treatment is finished. After the nebulizer
treatment, this room should undergo routine cleaning and disinfection. CDC has
information on how to clean and
disinfect and how to prevent asthma attacks triggered by cleaning and
disinfecting
activities.
Use of peak flow meters, including in the school setting, includes forceful
exhalation. Forceful exhalation is not considered an aerosol-generating
procedure associated with increased risk of transmitting the virus that causes
COVID-19. However, for some people with asthma, using a peak flow meter can
trigger cough.
People with moderate to severe asthma may be at higher risk of getting very sick from
COVID-19. CDC has more information on COVID-19 for
schools and healthcare
providers
(including school nurses).