Back to School with Asthma Toolkit for Schools

Asthma is a leading chronic condition that causes students to miss school, which can directly affect their academic success. Due to the current COVID-19 pandemic, this brings new challenges for schools. Children with moderate to severe asthma may be at higher risk of complications from COVID-19, and parents may be struggling with this decision to send their children back to school. The Centers for Disease Control and Prevention has updated their COVID-19 prevention strategies for schools (July 9, 2021) including: promoting vaccination, consistent and correct mask use, physical distancing recommendations, screening tests and ventilation practices. Schools can help by passing along the message for parents to consult with their child’s healthcare provider to address concerns and develop a plan. 

When preparing for students to return for in-person learning, there may be many questions about how school administrators, nurses, teachers and staff are managing the effects of COVID-19 in their school and how this may affect students with asthma. Addressing asthma management in school can help establish an environment that supports both learning and safety.

 Top 4 Ways School Staff Can Support an Asthma-friendly School

• Know which students are at risk for an asthma emergency.
  At the beginning of the school year, make sure your school's Health Inquiry Form includes asthma-related questions. Tracking students with asthma can ensure that students with the greatest need receive proper health services. Here are some tips to get you off to a good start:
  • Send a welcome letter to all parents at the beginning of the school year that communicates the school’s medication policies and procedures and includes any required forms. Information in the letter may include how asthma treatments will be delivered based on recommendations from the CDC in consideration of COVID-19. 
  • Set up an information table at Back to School Night and have a staff person available to answer questions. If your event will be held virtually, provide a FAQ section to address common questions and concerns as well as links to resources for additional information.
  • Have an Asthma Action Plan on file for each student with asthma.
  • Ensure immediate access to asthma medication by:
    • Using our Student Readiness Assessment Tool to help you identify a student's readiness to self-carry and administer their quick-relief inhaler. 
    • Adopting a stock bronchodilator policy to provide immediate access to quick-relief asthma medication to students with asthma.
    • For schools that administer nebulized albuterol, CDC recommends using precautions as nebulizers could be a potential risk for the transmission of SARS-CoV-2. It is recommended that students switch to metered-dose inhalers with a dedicated spacer, if tolerated. If MDI with spacer is not possible, designated school health staff should wear personal protective equipment, isolate the student with nebulizer to a closed room (preferably with ventilation to the outdoors), and maintain a safe distance (6 feet or greater) or outside the door if possible, while still monitoring the student receiving the treatment. Proper cleaning and disinfecting of the equipment and room should be completed at the end of each treatment.
• Ensure good indoor air quality (IAQ).
  Poor indoor air quality can affect the health of students and staff. Many indoor air pollutants can cause asthma symptoms. Help keep your students safe by reducing or eliminating IAQ problems in the classroom by watching out for asthma triggerssuch as mold, pet dander, air fresheners and cleaning chemicals.
  • Ventilation Practices
    • The Environmental Protection Agency (EPA) recommends routine Heating, Ventilating, Air-Conditioning (HVAC) system maintenance to support healthy indoor environments. 
    • American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) developed guidance about ventilation requirements during COVID-19. 
  • Cleaning Practices
    • Normal routine cleaning with soap and water removes germs and dirt from surfaces. The CDC recommends cleaning with mild detergent or soap and water prior to disinfecting surfaces. You can learn more about cleaning/disinfecting surfaces during COVID-19 from the CDC website.
    • Custodial staff should verify the safety of products used in the school setting by using EPA-approved disinfectants against COVID-19 and be trained in the proper use of disinfectants. 
    • Six Steps for Safe & Effective Disinfectant Use

How asthma-friendly are your classrooms? Use the Healthy Air Walkthrough Classroom Checklist to find out.

• Educate, educate, educate.
  Offering asthma education to teachers, school staff, parents and children will make the classroom that much safer. Programs like Asthma Basics, an online course to help make sure the adults in your school understand asthma, also helps prevent asthma emergencies. Students with asthma can benefit from the Open Airways For Schools® program (children ages 8 to 11), and Kickin’ Asthma program (adolescents ages 11-16) where they can learn about their condition in an interactive and supportive group environment. Find more information on providing asthma education to school personnel, parents and students in the AFSI Toolkit. 
• Encourage physical activity when a child with asthma is able.
   Staying active benefits all students but may be daunting for students with asthma or their caregivers. Providing asthma education to PE instructors or coaches, managing physical activity and offering modifications to activity when needed can keep students with asthma in the game.

The American Lung Association offers several resources for schools to be prepared for the 2021-2022 school year. 

• Four Steps to Create an Asthma-Friendly School (online course)
• Asthma-Friendly Schools Initiative Toolkit
• Model Policy for School Districts: Stock Bronchodilators
• Student Readiness to Self-Carry and Use a Quick-Relief Inhaler Assessment Tool and Training
• Asthma Action Plan for Home and Schools (Spanish) 
• Practical Guidance For Schools & Schools Districts: Enhancing School Wellness Policies to Protect Student Lung Health