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COVID-19 Guidelines for Schools and the Impact on Kids With Food Allergies and Asthma

 

Update – Aug. 21, 2020

Sixteen leading food allergy experts, including some of our medical advisors, released school guidelines addressing food allergies in light of COVID-19. We have added those recommendations to this blog post.


Schools face major challenges as they reopen for the 2020-2021 school year. To help reduce the spread of the new coronavirus that causes COVID-19 among staff and students, schools will follow new policies and practices. This causes many parents to wonder how this will affect their child with food allergies or asthma.

In most school districts, we can expect to see policies about face coverings or masks, physical distancing and cleaning. These new policies may affect how schools handle food allergies. But in most cases, the impact on kids with food allergies should be minor. In fact, some policies may enhance prevention of food allergic reactions. Here are how some COVID-19 policies may impact food allergy management:

  1. Face coverings or masks – Overall, wearing a face covering or mask should not have much impact on food allergy management. Parents and teachers should remind kids to not share masks to prevent both COVID-19 and food cross-contact. If you supply masks for your child, write their name on the inside with a laundry marker to make sure they can always identify their mask.
  2. Physical distancing – Keeping kids apart should reduce the chances for food sharing and accidental food cross-contact at mealtimes.
  3. Classroom meals – Some schools may serve meals in the classrooms. Kids will likely be separated due to physical distancing. This can reduce food sharing and cross-contact. Because some teachers may be new to the role of monitoring lunch, schools should empower them to read labels to identify food allergens. Kids With Food Allergies (KFA) has guides on how to read food labels. Teachers should also discourage food sharing to prevent both food allergy reactions and COVID-19.
  4. Handwashing – Frequent handwashing, especially before and after eating or touching food, has always been encouraged to prevent food allergy reactions. Many schools will require more frequent handwashing to reduce the spread of the new coronavirus. This can also lower the chance of food cross-contact on shared surfaces.
  5. Increased cleaning – Schools will increase cleaning to reduce the spread of the new coronavirus. Cleaning more often can also reduce the spread of food particles. To also reduce the chance of food allergy reactions, schools should clean desks before and after meals and snacks.

What Parents Can Do to Prepare for the New School Year

Start the process now to get your child’s school health forms signed. It may take longer this year because of COVID-19. Contact your school to get the current copies of their forms. And then call your child’s doctor to find out how they are handling form signing. Some offices may only sign them by appointment this year. Make plans now so you can submit the signed forms to the school as soon as possible.

If your child has a school care plan such as a 504 plan, contact the school to find out if policy changes will affect the plan.

Help your child prepare for the new school year now:

  • Have them practice wearing a mask so they can become comfortable with one.
  • Teach them how to wash their hands properly.
  • Encourage them to tell an adult if they have any symptoms (such as their mouth feels funny, they are itchy, their throat hurts, etc.). Try some role-playing to help your child practice.

Guidance for Schools on Food Allergies, Asthma and COVID-19

There are several resources schools can use to protect students and staff with food allergies and asthma during COVID-19 policy changes.

The Centers for Disease Control and Prevention (CDC) has guidance for reopening schools during the COVID-19 pandemic. They encourage schools to keep food allergies in mind when creating new policies. The CDC also offers general guidance schools can follow to manage food allergies, called “Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs.”

Sixteen food allergy experts released recommendations for how schools can handle food allergies in light of new COVID-19 policies.

They created eight recommendations for schools:

  1. Before and after meals, wash hands with soap and water and clean surfaces. Don’t allow food sharing.
  2. Remember that food allergen bans are not medically necessary and should not be included in 504 plans. They do not decrease the risk of anaphylaxis, a severe allergic reaction.
  3. Make reasonable changes to 504 plans to work with new school recommendations.
  4. Stock epinephrine in all schools. Consider plans to keep student epinephrine in their classrooms when possible.
  5. Train all school staff to recognize and treat food-allergic reactions, including anaphylaxis.
  6. Create a zero-tolerance policy for food allergy bullying.
  7. Consider modified approaches in individual schools and classrooms based on special situations.
  8. Communicate clearly with food allergy parents and encourage open discussion.

The recommendations also outline everyone’s role in managing food allergies in schools during the COVID-19 pandemic.

The Asthma and Allergy Foundation of America (AAFA) also created a COVID-19 and Asthma Toolkit for Schools. This resource supplements current district, state and federal reopening guidelines. It has resources to help schools better manage asthma and while addressing the new coronavirus. It also has AAFA’s “Is it COVID-19, the Flu, a Cold, Allergies or Asthma?” symptoms chart for quick reference (in English and Spanish) and a list of resources.

The toolkit includes easy-to-use checklists schools can use daily to manage asthma and minimize the spread of the new coronavirus.


While increased cleaning can help reduce the spread of the new coronavirus, it can be an asthma trigger. Asthma is the leading chronic disease in children. There is a good chance nearly every U.S. classroom has a student with asthma. Many staff members have asthma too.

Schools should take special care to clean in a way that reduces the spread of the new coronavirus but doesn’t increase asthma symptoms in staff and students. Teachers and staff should not bring in cleaning or disinfecting products from home to avoid the risk of mixing chemicals. Only use district-approved and provided products. Children should not be allowed to clean any hard surfaces in the classroom.

School staff should also remember cleaning and disinfecting are not the same. Some cleaners clean and some disinfect. Clean first to remove particles and residue (including food) from surfaces. Then disinfect to remove possible virus particles.

You can access AAFA’s free COVID-19 and Asthma Toolkit for Schools two ways:

Read the toolkit online.

Sign up to receive your copy. You will be alerted if any changes are applied to the toolkit or future editions are released.

Kids With Food Allergies is a division of AAFA.

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Comments (5)

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Hi Ellen - there are people who cannot wear a face covering and there are exceptions for that. For others, it may take experimenting with different fabrics and masks styles to find something that will work for short periods of time in high-risk situations. Unfortunately, the recommendations and guidelines (federal, state and local) are not very clear and that is frustrating. If you and your kids can wear a face shield, that sounds like a good option.

I recently saw a notice in PA that actually included the exceptions. I think that was the first time I'd seen that posted vs buried on a website.

And reading labels is very important to prevent reactions. There is one small store I go to that has an "only touch what you are going to buy" policy stated before you enter. They have a sentry at the door and you have to verbally agree to the rules before entering. That means I can't pick something up to check ingredients. It's a butcher shop, so I only buy what I know and skip any packaged goods that I might normally check out.

I CAN'T wear a face covering.  It is a seizure trigger for me.  Just as there should not be a one-size-fits-all 504 plan, so too there should not be a one-size-fits-all cloth face covering plan.  I am frustrated with the "recommendations" and the "guidance" I get from officials.  I am frustrated with quite frankly, blatantly discriminatory practices put in place "for the greater good" which deny reasonable accommodations for me and my children, as well as access to services.  It is really difficult to read every label every time in a grocery store if I can't enter without a cloth face covering, and I have seizures if I do.  I will not be requiring my sensory processing disorder kid to "get used to" wearing masks, when I can't wear one myself.  It is a face shield or nothing.

I would have thought that you of all people would understand.

Thanks for your feedback, Steph and Ellen!

When schools follow guidelines to prevent allergic reactions, it reduces the likelihood of a severe reaction.

If one does occur, there will be multiple signs...and if those signs are the under the mask, it is likely that the student would be uncomfortable enough to touch/remove the mask. It's important for caregivers to empower students to alert an adult if they are not feeling well.

The risk assessment at this time is that the risk of coronavirus infection warrants the recommendations for everyone to wear face coverings. For families or schools that feel more comfortable using a clear face covering, there are a few options that have been developed (to aid communications for the deaf and hard of hearing community). This option might be considered for children who have frequent, unexplained allergy symptoms near the mouth.

We recommend that parents and caregivers do some role-playing with their children to talk about what to do if they feel allergy symptoms. We also recommend that kids start practicing wearing masks now (if they haven't been wearing them regularly yet) to help them adapt for when/if school reopens.

My FAK has both food allergies and asthma, and I'm trying to get his 504 plan to allow him NOT to wear a cloth face covering.  The way the governor's executive order reads, that means he has to wear a face shield instead.  Wearing a cloth over his mouth and nose for 7 hours is not a good idea.  A face shield should allow a teacher to see any hives or facial swelling, should they occur, should allow him better air flow, and won't attract dust mites on the cloth for concentrated breathing.  We ripped out the carpet in the house because of the dust mites and it made a big difference, so wearing plastic instead of cloth should also help keep asthma at bay.

Because DS isn't airborne ANA, and there should be a lot less sharing of common items, eating meals in the classroom won't be that bad for us.  I expect the school to instruct parents not to bring PB&J for lunch, and for it not to be followed, same as always.

A bigger issue is the hand washing.  Because of the way the local schools are set up, they're not actually washing with soap and water.  It'll be hand sanitizer 10 times a day, like it was in February.  That's a problem.  Hand sanitizer does not actually physically remove food proteins from hands, like the scrubbing action used with soap and water.  It also dries out his skin and makes his eczema flare.  I requested in his 504 plan that he be able to wash with soap and water instead of hand sanitizer, but we'll see.

The other thing I requested to change was to move to self-carry and self-administering his inhaler.  I'm not certain that they'll have PE this year, but if/when they do, he should not be making twice weekly trips to the nurse's office to use his inhaler before PE, and potentially be exposed to the sick kids waiting to be picked up in the nurse's office.  As a fifth grader, he should be allowed to use his inhaler in the classroom instead this year.

Just because I requested these things, doesn't mean I'll get them.  Nor does it mean that I won't just throw in the towel and move to actual homeschooling, and not the horrible waste of time that the school district's "distance learning" was.  As a cynical skeptic who has seen the way the sausage is made too many times to think that public school teachers can pull off effective online learning when that's not what they signed up to do, I'm not exactly thrilled with their content or approach, nor is it a good fit for my child.  The girls are a different story.

In my cynical version of school reopening, the district runs out of money for cleaning supplies because State tax revenue takes a nosedive due to the large amount of people not in the workforce, and then blames the janitors for not cleaning enough.

I disagree with the statement that wearing a face covering shouldn't impact food allergy management.

Do any kids with food allergies develop visible perioral hives with exposure? Or redness, lip swelling? 

Do any of the above kids develop these telltale signs without awareness?

In other words, an observer (like a teacher, or fellow student) might be the first to say, "Hey, why is your mouth red?!)

How will this happen when the child is wearing a mask?

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Kids With Food Allergies
A Division of the Asthma and Allergy Foundation of America
1235 South Clark Street Suite 305, Arlington, VA 22202
Phone: 1-800-7-ASTHMA (1.800.727.8462)
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