No Masks for Kids Under Five: What Are the Revised COVID-19 SOPs for Children?

The Union Ministry of Health and Family Welfare has issued a revised COVID-19 advisory for children.

Wearing of masks is not recommended for children aged 5 years or below, the Union Ministry of Health and Family Welfare said in its revised COVID-19 guidelines on Thursday, 20 January.

Are masks required? What are the treatment measures? How to follow COVID-appropriate behaviour? Here is what we know from the revised advisory:

Who should wear masks and who should not?

Children aged:

• Kids aged five years or less should not wear masks.

• Kids of 6-11 years may wear a mask under the direct supervision of parents/guardians.

• Those aged 12 years and above should wear a mask under the same conditions as adults.

What are the common symptoms of COVID-19 in children?

The following are the common symptoms in children:

• Fever

• Cough

• Headache/body ache

• Weakness/malaise

• Diarrhoea

• Sore throat/throat irritation

• Loss of smell/taste

• Anorexia/vomiting/nausea

Only symptomatic treatment is recommended for children.

What are the suggested COVID-appropriate behaviours?

COVID-appropriate behaviours can be divided into "3Ws" and "2Vs".

3Ws:

• Watch your distance (more than 2 metre)

• Wear a mask

• Wash your hands

2Vs:

• Ventilation (open spaces less risky than closed)

• Vaccination (from 15-18 years)

What are the post-COVID care measures for children with asymptomatic or mild cases?

Children with asymptomatic infection or mild disease should receive:

• Routine childcare

• Appropriate vaccination (if eligible)

• Nutrition counselling

• Psychological support

What are the post-COVID care measures for children with moderate to severe symptoms?

For children with moderate to severe COVID:

• Parents/caregivers should be counselled regarding persistent/worsening respiratory difficulty.

• They should be explained the indications for bringing the child back to the facility.

Children who develop any organ-specific dysfunction during their hospital stay or subsequently should receive appropriate care, as per the guidelines.

Are there any treatment recommendations for children?

For children less than 18 years of age, usage of the following is not recommended irrespective of the severity of infection:

• Antivirals

• Monoclonal antibodies

What are the guidelines for antimicrobials?

Antimicrobials are recommended on the basis of severity.

• Asymptomatic and mild cases: Not recommended.

• Moderate and severe cases: Should not be prescribed unless there is clinical suspicion of a superadded infection.

• Septic shock: Empirical antimicrobials (according to body weight) are frequently added.