key: cord-0756605-sclhas0a authors: Gyawali, Mallika title: Protection of our Future Generation: Use of Face Masks in Children amidst COVID-19 Era date: 2021-08-31 journal: JNMA J Nepal Med Assoc DOI: 10.31729/jnma.6705 sha: 2ae1c47fd4f077c9d5278cabc35ef8fb46b7f1b4 doc_id: 756605 cord_uid: sclhas0a During the Coronavirus disease-19 (COVID-19) crisis, the universal use of face masks in addition to hand washing and practicing safe distancing is recommended worldwide. Children, like adults, also get infected through direct contact or airborne droplets. Face masks efficiently prevent respiratory droplet transmissions. However, asking children to wear face masks can be challenging and may have potential advantages and disadvantages. In this viewpoint, we discuss the effectiveness of face mask usage in children and its associated challenges, myths, advantages, and disadvantages. In children, infection with the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is asymptomatic or mild in nature. 1 Some can develop life threatening symptoms or a severe multisystem inflammatory syndrome. 2 Along with wearing masks, children should be taught appropriate hand washing with soaps and physical distancing that are proven techniques preventing the viral spread. 3 While using any type of mask, a cloth mask or a surgical mask, ensuring the right fit is crucial. 4 However, parents are usually concerned about their children wearing masks. 5 Therefore, this article highlights the advantages and importance of using masks in children. 11 A few common myths include: Myth: Masks make it harder to breathe. Fact: As shown by a cohort study in Italy, the use of masks is not associated with a change in respiratory function with no episodes of oxygen desaturation or respiratory distress. 12 Cloth masks are made of breathable material that allows enough oxygen transport. Myth: Masks can trap the carbon dioxide we normally breathe out due to inadequate gas exchange. Fact: Properly fitted masks allow adequate airflow. A study in the USA has shown that no gas exchange abnormalities have been observed with the usage of surgical masks. 13 However, children below two years should not wear masks as they can't remove them by themselves and there are safety concerns. Myth: Masks shut down the immune system. Fact: Masks don't weaken the immune system; instead they prevent the spread of infection from person to person by acting as a physical barrier to the virus and they also prevent cooling of the nasal mucosa that can increase viral survival. 14 Myth: There is no adequate data supporting mask usage. Fact: A systematic review published in the Lancet journal showed masks, in general, are associated with a large reduction in risk of infection from SARS-CoV-2 and Middle East respiratory syndrome coronavirus 2 (MERS-CoV-2). 3, 15 Masking should be done in addition to practicing proper sanitation habits. Globally, wearing masks has been one of the most competent preventive measures that can protect children by reducing the spread of virus-laden respiratory droplets. Masks can also provide protection against other various respiratory viruses like Influenza or Rhinovirus. 16 Furthermore, masks can protect kids from dirt and allergens, keep their noses warm in winter, and keep bad smells away. Finding a mask that is the right fit for a child is pretty difficult. Masks can also hinder verbal conversations. Using face masks can replace the focus from other important measures such as distancing, hand washing, and staying home when feeling ill. Children can also keep on touching or adjusting their masks which can increase the viral load in their hands. Additionally, face masks hamper the mirroring of facial expressions which is an essential component of a teacher-student relationship. Finding an appropriately sized mask in the market for children is pretty difficult. Also, children are usually carefree and aren't worried about mask use and maintaining a distance while meeting their friends most of the time. Wearing facemasks in children can cause anxiety issues and seem scary occasionally. All these challenges can be handled with proper explanation and compensating proper behavior regarding masks. At this time of the SARS-COV-2 pandemic, masking is a useful add-on to social distancing and hand hygiene practices. As children learn very quickly, they can adapt to masking with careful guidance from parents and teachers. Hence, even though there are various myths and disadvantages related to masking, wearing a proper mask by encouraging children will help prevent and control the spread of the coronavirus and make all our lives safer. COVID-19 in Children and Teens USA USA:Centers for Disease Control and Prevention Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet How masks protect against COVID-19: Understanding the science -Boston Children's Answers Free Full Text Articles are Available at www.jnma.com.np covid-19-mask-science The impact of face masks on children-A mini review USA:Centers for Disease Control and Prevention USA:Centers for Disease Control and Prevention Coronavirus disease (COVID-19): Children and masks World Health Organisation Everything you need to know about children and mask use COVID-19 and masks: Tips for families South Asia:The United Nations Children's Fund Mask Mythbusters: 5 Common Misconceptions about Kids & Cloth Face Coverings Assessment of Respiratory Function in Infants and Young Children Wearing Face Masks During the COVID-19 Pandemic Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with Chronic Obstructive Pulmonary Disease Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer Airborne transmission of COVID-19 and the role of face mask to prevent it: a systematic review and meta-analysis