How to Support Kids in School Who Develop Long-Haul COVID

Sixteen-year-old Connor McPhilomy was athletic, played baseball, and loved being social and spending time with friends. In January 2021, he started experiencing COVID-19 symptoms. Despite short periods of time when he seemed to be doing better, the symptoms kept returning. He was diagnosed with long-haul COVID in May.

While many people who contract COVID-19 recover fully within a few days or weeks, some deal with symptoms that linger for months or longer, making it difficult to do normal activities. Healthcare professionals say they’re seeing fatigue, shortness of breath, and other symptoms in kids that can make attending and focusing in school challenging.

Karen Gentile, MSN, RN, CPNP, a nurse practitioner at National Jewish Health notes the toll this is taking on her community. "We are seeing muscle aches, chest and joint pain, ongoing fevers, dizziness, dysautonomia, headaches, brain fog, difficulty concentrating in school, and exercise intolerance,” she says. Gentile works extensively with treating children diagnosed with long-haul COVID.

Long-haul has not only impacted Connor physically, but also mentally, emotionally, and academically. His mom, Stephanie McPhilomy, is determined to help him have as many opportunities as possible, including attending in-person classes. “Connor’s always loved school. And he loves being at school, with friends,” she states.

Dealing with these symptoms can make it a struggle to get out of bed every day, let alone go to school. But when the kids want to regain some autonomy and a sense of normalcy, school can be a big part of that equation. We’ll discuss when to send a child with long-haul COVID back to school, how long COVID symptoms could impact a child’s ability to function in school, and what accommodations could help support them in the classroom.

What is Long-Haul COVID?

The Centers for Disease Control and Prevention states that when an individual experiences new, returning, or continuing health problems for four weeks or more after the date of initial COVID-19 infection, they are experiencing post-COVID conditions. Those conditions can have different names, including chronic COVID, long COVID, long-term effects of COVID, post-acute COVID-19, and long-haul COVID.

Julie Walsh-Messinger, PhD, an associate psychology professor at the University of Dayton elaborates on the discrepancies of data on the virus. “Like everything with COVID-19, there are stats, but they range widely," she says. "[Some say] as low as about 10% of kids; [others] as high as over 60%. If you’re using a 30-day definition, you’re going to have higher rates. They range widely, and we really need more systematic studies and a clear definition of what we’re using for long COVID."

Dr. Walsh-Messinger also says that while it’s hard to narrow down specific factors that make some kids at higher risk for long COVID, research indicates that females may be more susceptible. Gentile says the majority of her facility's long COVID patients have been teenagers.

Parents to kids with long-haul COVID want to know how to help their child return to the healthy, active lifestyle they once enjoyed.

When to Send Your Kids Back to School

With no clear-cut guidelines on long-COVID itself, figuring out when to send your child back to school can be even trickier. Will your child be able to focus? Will they get too tired? Are they ready for the workload? The answers depend largely on your child and the severity of their long-COVID.

"What we do know with long COVID is that less is more. If you think your child is ready to go back to school, give them at least another week. Ideally, when to return to school is a decision that should be made with the child's pediatrician," advises Dr. Walsh-Messinger.

The child’s mental health is another key factor. Being isolated can be very hard emotionally on children who are already dealing with sickness. Sometimes the ability to reach out and have comradery can make a positive difference in the recovery process.

Once you’ve spoken with your physician and any needed specialists to determine that your child can return to school, the next step is to decide what school will look like for your student.

In-Person vs. Remote Learning

After an initial bout of COVID in March 2020, 15-year-old Aiden McGinnis seemed to have bounced back. The following September, he returned to school and athletics. But during the second week of school, he started showing mild COVID symptoms again. They quickly exacerbated, and by October 2020 he had to stop attending in-person classes due to fatigue and other symptoms.

“He kept having relapses, so the school worked with us to do remote,” says Jeannie McGinnis, Aiden’s mother. In November 2020, Aiden was diagnosed with long COVID. He continued to attend school remotely until July when the school year ended for him in England. Aiden’s symptoms are what helped them decide that schooling virtually was the right decision.

“By October 2020, he constantly felt unwell with fatigue, mild fevers, aches, skin issues, and then [he] also developed ‘covid toes and fingers’—purple, inflamed, some lesions,” Jeannie McGinnis says.

Stephanie McPhilomy notes that giving Connor the chance to spend time with his friends and experience some sense of normalcy was a big motivation for their school decision. “That mental health piece was what really pushed us to decide in-person versus remote learning,” she states.

Experts note that the decision on how to do schooling is a personal one, varies from child to child, and is based on a multitude of factors. But keeping in mind whether your child can handle the physical rigors of walking to and from classes, has the energy to interact with other children, and is able to focus on schoolwork for extended periods of time, is a good start.

Supporting Kids When They Return to School

It's important to provide students dealing with long-haul COVID the support they need to succeed.

“It is extremely important that schools allow a flexible schedule for kids with long-haul COVID…[that] should include flexible start and end times, shortened school days, and online versus in-person learning options,” notes Gentile. “The fatigue from long-haul COVID-19 can be so debilitating that often kids are only able to concentrate and participate in school for a short period of time.”

McPhilomy says she’s incredibly grateful for the plan her son’s school developed that allows him to go to school two to three days per week and stay home on days he doesn’t feel well. While he may run behind on some assignments, teachers give him grace with deadlines and also meet with him virtually or in person when needed. McPhilomy says it’s important for parents to know what to ask for to help their child.

“Request the minimal assignment load that is mandatory to pass the class. Advocate that your student needs teaching, even if they’re not able to be there in person,” she recommends. She also says asking teachers to post class lectures online is helpful. When her son started back to school, he only took one class initially. Experts say starting slow can help a child get their footing and know just how much they’re able to handle.

The involvement of the doctor treating McGinnis’ son made a big difference in getting him the support he needed. “The long COVID physician specialist wrote a letter to the school in March 2021, stating that Aiden needed to pull back significantly from his schedule of full days, despite being remote, as it hindered recovery,” she notes.

The care team's involvement and school personnels' willingness to accommodate a student make a big difference. Every person involved in a child’s journey, including parents, teachers, administrators, and healthcare personnel, has to be patient and understanding when it comes to helping a child who has long-haul COVID. But with the goal of helping each individual succeed to the best of their ability, each child can get the support that they need.