CDC and AAAAI Differ on Asthma Management at School During COVID-19 Pandemic

On June 3, 2020, the US Centers for Disease Control and Prevention updated their FAQs on students returning to school in the context of the COVID-19 pandemic. Specifically related to students with asthma, the FAQs address: asthma treatments with inhalers/spacers, the use of nebulizers, and the use of peak flow meters.
The CDC provides the following recommendations during this COVID-19 pandemic:
  • Asthma treatments using inhalers with spacers are preferred over nebulizer treatments whenever possible.
  • Nebulizer treatments at school should be reserved for children who cannot use or do not have access to an inhaler
  • Peak flow meters can be used in schools
  • Schools should obtain the appropriate personal protective equipment (PPE) for staff who administer nebulizer treatments and peak flow meters to students with asthma.

More detail, including the studies cited by the CDC in the development of their recommendations can be found here.

On June 5, 2020, the American Academy of Asthma, Allergy, and Immunology’s COVID-19 Task Force responded to these recommendations with some concerns:
  • The CDC suggests that aerosols generated from nebulizers may not be infectious. The task force states, “The supporting data for this is very poor, however.”
  • The task force does not believe the CDC goes far enough with their PPE recommendations for performing nebulized therapy
  • The task force questions the overall safety of peak flow usage in public without wearing gloves, mask and eye coverage.

The AAAAI response can be found here (scroll toward the bottom of the page for the relevant post).