As a new school year begins amid the COVID-19 pandemic, deciding to send children back to the classroom can be difficult, especially when your child has pulmonary hypertension (PH). Three pediatric PH specialists share guidance to help parents determine appropriate learning options for their children with PH.

Consider your child’s circumstances. When deciding whether your child should return to in-person classes, consider individual risk levels, says Edward Kirkpatrick, M.D., pediatric PH director at Children’s Hospital of Wisconsin in Milwaukee. Some children with minimal PH symptoms might be at lower risk of developing COVID-19 or other virus complications. Those with compromised heart function, oxygen requirements or are prone to pulmonary infections might be at higher risk of complications. “It is up to the family and their providers to see where the child falls,” says Dr. Kirkpatrick.

Consult your child’s PH care team. Your child’s PH care team knows his or her condition and risk level best, says Nidhy Varghese, M.D., medical director of the pulmonary hypertension program at Texas Children’s Hospital in Houston. They will consider your child’s physical and emotional health – as well as your emotional health, she says. “Ultimately, it is a decision that comes down to the parent and the medical team discussing the child from all different angles.”

Weigh your options. There are risks and benefits to online and in-person learning. Consider how many COVID-19 cases are in your area, the school’s practices to protect students, whether masks are mandatory in the classroom and similar issues, Dr. Varghese recommends. “Going back to school can be really anxiety provoking for the family,” says Dr. Varghese. Researching ahead of time can help reduce worry when deciding to send your child back to school, she says.

Communicate with the school, advises Eric Austin, M.D., pediatric PH director, Vanderbilt Children’s Hospital in Nashville. The CDC recommends parents discuss measures to reduce the risks of contracting and spreading COVID-19 with schools and teachers. For example, ask whether the school can install a plexiglass divider or allow your child to stay in one classroom all day, Dr. Varghese says.

Inform administrators and teachers about your child’s condition. “Review plans of action with the school, teacher, staff, and if available, nurse team,” Dr. Austin says. Consider making the discussion part of your 504 planning meeting, Dr. Varghese says.

Reinforce precautions with your child. If a child is going back to the classroom, remind him or her not to touch the eyes, nose and mouth, Dr. Austin says. Children can wear nonprescription or prescription eyeglasses to shield their eyes if they are comfortable wearing them, he says. Make sure your child has his or her own water bottle and hand sanitizer to avoid touching shared items. Help your child understand why he or she should avoid before- or after-school activities to reduce exposure.

Make a contingency plan. Create an action plan for new issues that arise with your child’s PH, Dr. Austin says. If your child’s siblings attend class in person, there is a chance they could be exposed to COVID-19 at school. Make sure you have a plan on how to isolate anyone in your home who is exposed to COVID-19, Dr. Kirkpatrick says. He recommends self-quarantining in a separate room, distancing from other family members and possibly wearing masks at home to prevent exposing your child with PH.

Continue following your child’s usual medical regimen. It’s important students receive regular pediatric care and take their medications when going back to school. “It’s common for kids to have to take their PH meds while in school, and families need to make sure that the school can accommodate them,” Dr. Kirkpatrick says. Ask the school to let you know if the school nurse will be out for the day, so you can make needed adjustments, Dr. Kirkpatrick says.

Bonus Tip – Prepare for flu season. Flu season is always a huge risk for young PH patients, Dr. Varghese says. Parents should continue to practice infection control and ensure your children receive their yearly flu vaccines, Dr. Kirkpatrick says.

“Maintain a high index of suspicion, and continue to maintain all of the protection intervention families are doing now through COVID season and through flu and cold season,” Dr. Varghese says. If COVID-19, the flu or other illness flare up in your community, consider keeping your child home for a day or so as extra precaution, Dr. Austin says.

Learn more about back-to-school planning in the Pulmonary Hypertension Association (PHA)’s updated COVID-19 FAQ.

Want to know whether other parents are sending their children with PH back to school? Join PHA at 7 p.m. EDT Sept. 11 for a virtual pediatric support group. Bring your questions and concerns about going back to school. Reserve your spot.

Nidhy Varghese, M.D.

Eric Austin, M.D.

Edward Kirkpatrick, M.D.