Should I send DS to School Tomorrow? (Covid Related)

[wendyroo]

DS10 attends an emotional impairment classroom (5 students total) at the local public school, but last week also spend some time each day in a gen ed classroom (many more students). Other than that, he goes nowhere, does nothing, sees no one outside the family.

Yesterday DS started having an occasional barking cough. It sounds like he has croup.  And as soon as he laid down for the night he stated coughing up a storm and could hardly stop all night despite a humidifier, cough medicine, ibuprofen, inhalers, etc. However, since he has asthma, this is not at all unusual. Every winter, except last when he never left the house at all, he has gotten a mild cold which settled in his lungs from early fall until mid-spring. Today he is back to intermittent bouts of a dry, hacking cough. He has no other cold or COVID symptoms.

We went out first thing this morning and got him a COVID test, but results are not expected for 3-5 days or much longer if the lab is busy (which it probably is).

The school has documentation from DS's allergist that he has asthma. Along with the fact that DS is not running a fever, they would probably let him go.

But would you send him? How long would you keep him home if he continues to cough (which he probably will for the next 6-7 months), but never develops any other symptoms?

[JennyD]

I would wait for the results of the covid test and then -- assuming it's negative -- send him.

 

[ktgrok]

6 minutes ago, wendyroo said:

DS10 attends an emotional impairment classroom (5 students total) at the local public school, but last week also spend some time each day in a gen ed classroom (many more students). Other than that, he goes nowhere, does nothing, sees no one outside the family.

Yesterday DS started having an occasional barking cough. It sounds like he has croup.  And as soon as he laid down for the night he stated coughing up a storm and could hardly stop all night despite a humidifier, cough medicine, ibuprofen, inhalers, etc. However, since he has asthma, this is not at all unusual. Every winter, except last when he never left the house at all, he has gotten a mild cold which settled in his lungs from early fall until mid-spring. Today he is back to intermittent bouts of a dry, hacking cough. He has no other cold or COVID symptoms.

We went out first thing this morning and got him a COVID test, but results are not expected for 3-5 days or much longer if the lab is busy (which it probably is).

The school has documentation from DS's allergist that he has asthma. Along with the fact that DS is not running a fever, they would probably let him go.

But would you send him? How long would you keep him home if he continues to cough (which he probably will for the next 6-7 months), but never develops any other symptoms?

General advice from one of my medical providers is to isolate and test if you have NEW symptoms of potential covid. So in this case, the cough is new. Wait until a test shows if he is positive or negative. If he tests negative, then he can go to school as long as no other, new, symptoms arise. So if he continues to cough and it is not different in quality or severity, that's fine. but if he develops something new, like fever, nausea, or the cough is substantially different a month from now, then again isolate and test. 

That seems both practical and considerate. 

[prairiewindmomma]

My kids have asthma too—and also cough through the winter, typically. I had a long in person chat with the school nurses. Under guidelines, I could not send my kids to school:

1. The cough is a new cough (even with history)

2. If my kids start to cough at school, they will be put in the isolation room and given 20 minutes after albuterol administration for it to resolve. If it doesn’t, they will be sent home. My district as of today has not been able to acquire tests to be able to do a “test to remain” policy. I suspect if my kid starts a persistent cough and we got a negative test something would work out—but the district is still actively making decisions.
 

We have really tweaked all of the med protocols because I anticipate this will be a big mess. If I were you, I would call tomorrow to excuse your kid and then ask to talk with the nurse. Y’all will need to be in close contact this winter.

[Insertcreativenamehere]

I can see this from two viewpoints.

I have a 9 yo in a similar special ed classroom, with 4 students total. He does not go out to mainstream classes at all. He is at very high risk for Covid. Pneumonia and RSV have landed him on a ventilator in the past and he had a tracheostomy for three years. Even something as mild as a cold puts him out of school for a week or longer -- meaning putting the asthma action plan into motion: prednisolone, supplemental oxygen at night, etc. I'd be very concerned if one of his classmates had such a cough and came to school. 

I also have a 14 yo in a mainstream high school who has cough-variant asthma and with the exception of last year, he gets a cough much like your son's most winters. He was out of school for three days with some non-Covid respiratory illness a few weeks ago and I sent him back once all of the other symptoms abated even though his cough lingered for another day or two. He's vaccinated and wore a mask, and all of the staff and kids in his school have had the chance to be vaccinated, so the calculus is very different. 

It's a hard call, I get that! 

 

Edited September 26, 2021 by Insertcreativenamehere

[AmandaVT]

As a teacher working in a school with a fairly large covid case count right now, please don't send him until the test comes back. We are all exhausted and running on fumes right now. Even if it's probably Asthma, it's safer and much less added stress on school personnel to keep him home for a couple of days. Our school nurse was in tears the other day from the stress of it all and she is an amazing, tough, woman. 

[Drama Llama]

. . . 

Edited October 26, 2021 by BaseballandHockey

[Tanaqui]

One thing we learned with this pandemic - which honestly, I thought we all kinda knew but apparently not? - is that asthma symptoms in children most commonly manifest during or after a respiratory illness, even one which was otherwise largely asymptomatic.

Unless you know what the trigger was for this asthma attack then the most likely answer is that he is or very recently was sick with something contagious. Sending kids to school with contagious illness is what causes that illness to spread, and that is how asthmatic children end up missing school for asthma.

[wendyroo]

8 minutes ago, Tanaqui said:

One thing we learned with this pandemic - which honestly, I thought we all kinda knew but apparently not? - is that asthma symptoms in children most commonly manifest during or after a respiratory illness, even one which was otherwise largely asymptomatic.

Unless you know what the trigger was for this asthma attack then the most likely answer is that he is or very recently was sick with something contagious. Sending kids to school with contagious illness is what causes that illness to spread, and that is how asthmatic children end up missing school for asthma.

Normally his asthma is triggered by allergies (he has documented, severe allergies to every mold, grass, weed, tree, pollen and animal they tested him for) and colder weather, and temperatures have dropped from high 80s to low 60s over the last week.

Certainly he could have a mild cold, though he doesn’t even have a sniffly nose or anything. And the school guidelines specifically state that children can come to school even if they do have clear nasal discharge. 

We might have found somewhere we can get him a rapid test on Wednesday. So we will keep him home at least until then. But once he gets a negative test we will have to reach some understanding with the school. I told them up front about his asthma; I got them all the documentation from the allergist. His asthma has never been well controlled in the winter, and he always has a persistent croupy cough from October through April. It is always a delicate balancing act between medicating him enough to keep him functional, but using as few steroids as possible because they greatly increase his violence and aggression and make him an even bigger danger to those around him. 

[KSera]

Gosh, so sorry about this scenario, it sounds like it will make for a rough winter 🙁. The guidelines where I am are that people must quarantine while waiting for the results of their Covid test, so it wouldn’t be a question here. Being able to get a rapid test on Wednesday would be really good. I sure wish those rapid tests start becoming easier to get ahold of; I regret only having stocked up on four. 

[ktgrok]

14 minutes ago, wendyroo said:

Normally his asthma is triggered by allergies (he has documented, severe allergies to every mold, grass, weed, tree, pollen and animal they tested him for) and colder weather, and temperatures have dropped from high 80s to low 60s over the last week.

Certainly he could have a mild cold, though he doesn’t even have a sniffly nose or anything. And the school guidelines specifically state that children can come to school even if they do have clear nasal discharge. 

We might have found somewhere we can get him a rapid test on Wednesday. So we will keep him home at least until then. But once he gets a negative test we will have to reach some understanding with the school. I told them up front about his asthma; I got them all the documentation from the allergist. His asthma has never been well controlled in the winter, and he always has a persistent croupy cough from October through April. It is always a delicate balancing act between medicating him enough to keep him functional, but using as few steroids as possible because they greatly increase his violence and aggression and make him an even bigger danger to those around him. 

Might be worth ordering some at home tests to keep on hand? 

[KungFuPanda]

I'd keep him home because coughing in a mask is really gross and uncomfortable.

[wendyroo]

10 minutes ago, ktgrok said:

Might be worth ordering some at home tests to keep on hand? 

But are the results of an at home test worth anything to a school? If I currently had an at home test, and administered it, and it showed he was negative, would the school accept that if he was still coughing a lot tomorrow?

Realistically, he is one of the most sheltered people at that school, and one of the least likely to contract COVID (from places other than school). Masking in our community is about 1%. The vast majority of the kids at school are playing sports, eating out, going to church, having play dates...all close together and unmasked. My DS doesn't even take off his mask during recess. He has not been in any public building other than 1 trip to the pediatrician since March 2020.

He is going to be coughing for the next 6 months. He has a doctor's note that explains his non-contagious illness. The school is not offering any virtual options. They can test him every day if that is what they want to do, but I am not going to spend hundreds of dollars on tests, especially if they won't accept the results.

[KSera]

6 minutes ago, wendyroo said:

If I currently had an at home test, and administered it, and it showed he was negative, would the school accept that if he was still coughing a lot tomorrow?

I can’t answer whether the school will accept it, because it depends on their policies, but I would take it in the morning right before school if you were going to go that route. The rapid tests don’t show necessarily whether someone has any Covid in their system, but they are pretty decent at showing whether the person is contagious at the time they take the test. So taking the test as close to going to school as possible would be of most use. That’s why some schools are doing the test to stay program where if a student tests negative on the rapid test, they can stay in school despite symptoms.

Edited September 26, 2021 by KSera

[Drama Llama]

. . . 

Edited October 26, 2021 by BaseballandHockey

[Longtime Lurker]

1 hour ago, KSera said:

Gosh, so sorry about this scenario, it sounds like it will make for a rough winter 🙁. The guidelines where I am are that people must quarantine while waiting for the results of their Covid test, so it wouldn’t be a question here. Being able to get a rapid test on Wednesday would be really good. I sure wish those rapid tests start becoming easier to get ahold of; I regret only having stocked up on four. 

Here, too. Better check with the school about that.

[wendyroo]

13 minutes ago, BaseballandHockey said:

If last year was the one exception, how does that fit with the idea that it's not a cold.

My cough-variant asthma kid has paperwork on file, and he could attend with a cough, once it's established the cough isn't covid.  So, if he gets a cold, or overwhelmed by leaf mold or something we would keep him out till there was a negative test, and then he would return.  I don't know if they'd accept home rapid tests.  

But we're in an area where I could get a testing appointment faster than that.  

He doesn't like to be outside, and last year there was no reason he had to leave the house, so his fall allergies were much less severe. We run several HEPA filters, a whole house humidifier, and wage war on dust and allergens in the house. Plus, one of his major asthma triggers is cold air, so not leaving the house at all in the fall and winter eliminated that stress on his breathing. His pediatrician noted his wheezing and raspy breathing at his 2-day old check up...on a particularly chilly day in May when there was virtually no chance he had a cold.

His allergies have been HORRIBLE since he started school...both from the allergens in the school building and the tress/grasses/weeds growing all around the playground. Per his allergist's recommendation, he is now taking three daily allergy meds, plus doubling up on both his daily and emergency inhalers to keep him breathing semi-freely. He has been firmly in his yellow zone for the last month, but did not start coughing until the weather turned and he was outside daily for bussing and recesses.

There are no home tests within several hundred miles of here. My brother got a PCR test 13 days ago, and still has not gotten his results, so I'm not holding out much hope for the test DS took this morning. It is questionable whether we can get him a rapid test even by Wednesday. When we called around to several places that said they were scheduling mid-week, they said they don't actually have any tests and are just hoping to have some by then.

[Longtime Lurker]

3 minutes ago, wendyroo said:

He doesn't like to be outside, and last year there was no reason he had to leave the house, so his fall allergies were much less severe. We run several HEPA filters, a whole house humidifier, and wage war on dust and allergens in the house. Plus, one of his major asthma triggers is cold air, so not leaving the house at all in the fall and winter eliminated that stress on his breathing. His pediatrician noted his wheezing and raspy breathing at his 2-day old check up...on a particularly chilly day in May when there was virtually no chance he had a cold.

His allergies have been HORRIBLE since he started school...both from the allergens in the school building and the tress/grasses/weeds growing all around the playground. Per his allergist's recommendation, he is now taking three daily allergy meds, plus doubling up on both his daily and emergency inhalers to keep him breathing semi-freely. He has been firmly in his yellow zone for the last month, but did not start coughing until the weather turned and he was outside daily for bussing and recesses.

There are no home tests within several hundred miles of here. My brother got a PCR test 13 days ago, and still has not gotten his results, so I'm not holding out much hope for the test DS took this morning. It is questionable whether we can get him a rapid test even by Wednesday. When we called around to several places that said they were scheduling mid-week, they said they don't actually have any tests and are just hoping to have some by then.

I have some home tests and I suspect I am only about 30-45 minutes from you. I would be happy to meet you in the middle tomorrow and give you one. DS has autism and other special needs and I understand not wanting him to miss school unnecessarily. PM me if that would be helpful.

[prairiewindmomma]

1 hour ago, wendyroo said:

But are the results of an at home test worth anything to a school? If I currently had an at home test, and administered it, and it showed he was negative, would the school accept that if he was still coughing a lot tomorrow?

 

This is the question to ask the school nurse. I have a stack of Binax tests here at home. Under the current policies of my district, a vaccinated student who does not meet list one criteria of symptoms but does meet list two criteria of symptoms and has a negative test (at home counts) can return to classes. It's just dealing with the coughing at school that we have to still negotiate out.

I would keep home tomorrow call and sort it out.  Whomever is making the decision to send kids home at the school is the one you need to talk to. Then, whatever decision you come to needs to be marked and highlighted in the health management plan.  If you need to call an IEP meeting to sort out the asthma/attendance stuff, my kids have asthma in their IEP and HMP for a reason....pull the card and trigger the pressure. It's also not ok to essentially exclude a kid from a year of school.  (FWIW, this is my plan when all of this comes to a head. I'm pushing for a test to stay plan for my kid, with the school providing the tests. My understanding is that they are on order and just starting to come in.)

[prairiewindmomma]

Walmart online has BINAXNow tests at $7/test ($14/2 pk). Shipping is taking an extra week, but I have a stash on hand.  The supply fluctuates day to day, so if they are out today, check again tomorrow. Keep looking until you can order. 🙂 We haven't had tests in person in stores here for months.

[rebcoola]

I would assume they would take binax tests.  Our schools have them on-site and offer them to close contacts or the occasional coughing kid.

[Farrar]

I agree with those saying you should keep him home. He's not vaccinated, it's a new symptom. I understand why you want to send him. I would feel the same. But I think the right thing to do is pretty clear. He should not go until he has a negative test. If the cough persists despite negative tests, then it's no longer a new symptom and then you can start sending him.

I'd get the home tests so you can have your own peace of mind as the season progresses.

[Roadrunner]

I have a kid with severe allergies and asthma. Only mine is vaccinated. We have some days where his allergies are so bad, he simply can’t go, because we know we will freak people out around. And he takes daily medicine to control it, but it doesn’t always help.

In your case, I would call the school nurse and do as they tell me. Hopefully they will offer a rapid test and clear him, so he wouldn’t miss more than a day.

This is tough. 

[kiwik]

Here if you get tested you have to stay home until you get a negative result - but you can't self test so it is more controlled.  But it is rarely longer than 24 hours. It will probably resolve itself before you get the results.  I have a terrible asthmatic cough in winter and people looked at me badly enough before Covid.

Edited September 27, 2021 by kiwik

[SKL]

I would get a rapid test ASAP and send him if it's negative.