How is Long Covid impacting schools and
what can we expect in the future?
1. Recognition of Long Covid
There are children who are struggling with disabling symptoms that can be difficult to describe including difficulty with cognitive function.
2. Future resources required by the schools
With 10-15% of children developing Long Covid symptoms post Covid-19 infection – schools will be expected to provide support for an influx of children effected by disabilities.
3. Slow the spread
The mitigation strategies put into place now predict future outcomes. Not just masks but social distancing, dividers, air filtration, cleaning, etc.
What is Long Covid?
Prolonged, sometimes permanent, post-viral illness following COVID-19 infection that was even mild or asymptomatic. Viral outbreaks have been recorded throughout human history and have gone by many names, but never well understood.
We also got worried very early on that one of the long term consequences of this terrible epidemic that there could be a large number of people who develop ME/CFS after covid. And that’s what’s happening now. And unfortunately we still don’t know enough to prevent this from happening.– Walter J. Koroshetz, M.D – Director of the NIH, National Institute on Neurological Disorders and Stroke
As kids have failed to recover from “long covid,” with some progressing into more severe illness, the NIH has now recognized that Long Covid symptoms mirror another neurological inflammatory disease that also often occurs after a viral infection – Myalgic encephalomyelitis or ME/CFS.
• Current studies find that 50% of Long Haulers meet ME/CFS criteria with 89% experiencing its hallmark symptom known as Post Exertional Malaise (PEM). Findings for both children and adults are similar.
• A key symptom is a a worsening of symptoms after exertion – or PEM. This can be physical, mental, or emotional and is typically delayed in response, 8-48 hours.
• ME/CFS is progressive in about 40% of patients. Symptoms comes in flares and can vary from day-to-day. Studies of those with long covid are showing mirroring results.
In addition to ME/CFS, children are also receiving many new and sometimes disabling diagnosis: Dysautonomia, POTS, MCAS, and more.
Recognizing the signs
- Suddenly performing poorly
- New struggles to pay attention
- New struggles to finish school work
- Becoming out of breath with minimal activity
- Complaining of racing, fast, or pounding heart
- Complaining of exhaustion
- Sitting while other kids are playing
- Becoming fatigued quickly
- Complaining of headaches
- Complaining of dizziness
- Saying “I don’t feel good” for an extended period of time
- Regularly sitting with their legs under their body (naturally compresses and raises blood pressure and “feels better”)
Recognizing the symptoms
- Post Exertional Malaise
- Orthostatic intolerance
- Pain in the muscles and joints
- Headaches of a new type, pattern, or severity
- Cognitive symptoms such as confusion, difficulty retrieving words, poor working memory, spatial instability, and disorientation
- Sensitivity to light, sound or vibration, taste, odor or touch
- Gastrointestinal symptoms such as nausea or abdominal pain
- Muscle fatiguability, weakness and fasciculation; poor coordination and ataxia
- Autonomic and endocrine symptoms such as poor temperature regulation, cold or heat intolerance
- Immune symptoms such as tender lymph nodes, recurrent sore throats, fevers, or flu-like symptoms, and new food or chemical sensitivities
The future for those with Long Covid
Though much is uncertain for the future and recovery from Long Covid, we can look to the common diagnosis for guidance.
– Full recovery from ME occurs in under 10%
– 40% will continue to worsen
– The remainder, 50%, will experience ups and downs but never fully recover.
Resource: Demystifying Chronic Fatigue Syndrome/Myalgic Encephalomyelitis – A Systematic Review
Long Covid &
There is overwhelming concern over the collapse of the already suffering health care system.
Congress funded 1.2 billion in Long Covid medical research.
Long Covid can considered a legal disability under the ADA, Section 504, and Section 1557 if it substantially limits one or more major life activities.
Long Covid is considered a disability when it effects a major bodily function, such as the functions of the immune system, cardiovascular system, neurological system, circulatory system, or the operation of an organ.
Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557
With 10-15% of those infected with covid-19 develop post viral illness – this will translate into many many students who will now experience mild-severe disability.
Some of the kids effected will leave traditional school for cyber or home school because they are unable to do in-person.
Children will need accommodations and everyday support while in your care:
– Individualized Education Plans – IEP’s
– In school therapies – physical, occupational, psychological therapy services.
The schools are expected to identify these struggling students and support them.
Slow the spread
Schools need to implement standard efforts as recommended by the CDC to slow the spread, a multi-layered approach is best.
- Social Distancing and dividers
- Ventilation & air purification
- Contact tracing
- Quarantine exposures