COVID-19 "infodemics" and asthmatic children: The return to school challenge.

To the Editor:

We read with great interest the Rostrum article by Abrams et al, highlighting the relevance of clear and consistent recommendations about the relationships between asthma, allergies, school attendance, and coronavirus disease 2019 (COVID-19) infection in childhood. An adequate communication of the known evidence to children with asthma and their families will help on the decision-making process of a central question: should I allow my child with asthma to go back to in-person learning in the school or not?

Although the personal and community impact of returning to school is still a controversial issue, there is growing evidence that asthma and its treatment are not risk factors for increased morbidity and mortality of COVID-19 in children and, as the authors highlight, may even have a protective role. , In spite of the recent progress, there are still open questions regarding severe acute respiratory syndrome coronavirus 2 infection in schoolchildren: Bayham and Fenichel found that school closures, in the absence of other child-care options, may reduce health care labor force, impacting COVID-19 mortality, while Brauner et al found that closing schools and universities had a large effect on mitigating and suppressing outbreaks of COVID-19. Supporting this effect of school reopening is the recent resurgence of cases in the United Kingdom being concentrated among schoolchildren (2-16 years old) as well as adults in the 35 to 49 age group, possibly comprising their caregivers.

In a recently published review, we addressed the clinical and management challenges of pediatric asthma in the current pandemic, and the available evidence of a low actual risk of COVID-19 morbidity or mortality in these patients. The publication was complemented and immediately followed by a lay summary, in a press release to local and national media. What caught our attention with the publication of this narrative review was the media interest in this specific medical topic, notably at both regional and national levels, including general and children's health education websites. The summary of the article was rapidly disseminated in more than 50 media outlets, and it was widely quoted in the press, leading to a healthy discussion of a wrongly perceived risk.

At this moment in the pandemic, where anxiety generated by misinformation becomes more and more noticeable in families, appropriate information on sensitive topics, such as the return to school of children with asthma, the most common chronic respiratory illness in childhood, makes this issue a subject of interest to the lay public. An additional focus on individual risk stratification (eg, coexposure to relevant allergens and comorbidities) and controller medication adherence will be essential to allow children and their families to retain asthma control and to safely return to in-person school.

As doctors and researchers, we cannot ignore the growing relevance of the lay and social media in the dissemination of accurate information in a clear language. On the contrary, the current pandemic has taught us, with all its information and political biases, the importance of engagement with these powerful media tools, which can decisively contribute to educate and communicate scientific evidence in this digital and “infodemics” era.