COVID-19: Returning to school for the child with a chronic illness

Is it really safe for children to return to school?

Many experts agree that it appears to be safe for children to return to school. The risk of serious illness from COVID-19 in children is very low.  There have been no deaths in Canada in children and very few worldwide. Very few children have been hospitalized for COVID-19 infections in Canada. 

The following (PDF) document (available in French only) is meant to help guide health professionals in their evlauation of which condiitons may present a high risk for children as they return to school this fall. 

Below are some recommendations from experts from the Montreal Children's Hospital in accordinace with the Québec Ministry of Health, on the return to school or day care by medical condition (spring 2020).

These guidelines were developed based on the current evidence and current low rates of community transmission of COVID-19. Guidance may change as new information becomes available or if rates of community spread change substantially. Please check this site regularly for updates. 

What is worse for children? Isolation or the risk of COVID-19?

It is very important to recognize that COVID-19 will likely be around for a long time, or at least until there is an effective vaccine. Children cannot be kept out of school forever. There are also risks related to isolating children at home that must be considered. The longer we keep our children isolated, the more the bad sides of isolation show. Eventually, most people will probably agree that continued isolation is not the answer.

As far as we know, most children with chronic illness are at low risk of having complications from the COVID-19 infection. 

If my child returns to school. do they need to do anything special to protect themselves? 

Whether or not you decide to send your child back to school, social distancing (staying 2 metres away from others) when in public, and frequent, effective hand washing for 20 seconds with soap and water are essential.  Children need to follow these physical distancing and handwashing recommendations while at school, and when they return home from school.  Right now, masks are not essential when leaving the house, but should probably be used when it is not possible to ensure 2 metre physical distancing. Masks may be very difficult to use properly in very young children, and therefore are not necessarily recommended.

If your child has any symptoms that may be caused by COVID-19, they should NOT go to school (these symptoms include; fever; cough; stuffy nose; runny nose, sore throat, headaches with muscle aches, vomiting or diarrhea).

General guidelines

The majority of the children followed for chronic health conditions at the Montreal Children’s Hospital can go to school and should not develop significant symptoms from COVID-19. However, there are particular conditions or some children with severe forms of disease who may be more affected by COVID-19 and who should stay home until advised by their doctor that it is safe to return. 

As you can imagine, it is hard for our doctors and nurses to answer every question personally. If, after reading this, you still have questions, please contact us by consuting our department directory. Contact information for each department is included on each department page.

Recent concerns anbout Kawasaki disease

Kawasaki Disease has been on the news a lot lately for the possibility of a link with COVID-19. We know that this is a stressful and unknown time for everyone. We want to reassure you that the news about Kawasaki Disease is about new cases only. We don't suspect that children who previously had Kawasaki Disease are at higher risk. It is very rare to have Kawasaki disease a second time.

If at any time, your child displays symptoms suggestive of Kawasaki Disease (Fever for 4 days or more, associated with either: conjunctivitis (red eyes), red/cracked lips or red tongue, rash, swelling or redness of the hands or feet, or swollen gland in the neck), please seek medical attention directly with your family doctor or pediatrician.

Back-to-school resources: