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No Masking for Children Below 5? Decoding the Revised COVID Guidelines

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Children below the age of five should not be made to wear face masks, said the Ministry of Health and Family Welfare's latest COVID-19 guidelines for children and adolescents, published on 20 January, Thursday.

In the 'Revised Comprehensive Guidelines for Management of COVID-19 in Children and Adolescents (below 18 years)', the Union Health Ministry stated that "masks are not recommended for children aged 5 years and under."

The guidelines also stated against the use of monoclonal antibodies and antivirals for those less than 18 years of age, irrespective of whether the COVID-19 cases are severe or mild.
The 'Revised Comprehensive Guidelines for Management of COVID-19 in Children and Adolescents (below 18 years)' were reviewed by a group of experts in view of the third COVID-19 wave, mainly attributed to the Omicron variant.
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What the New Guideline Says

Here are some notable key points regarding masking for kids from the updated guidelines released by the Union health ministry.

  • Masks are not recommended for children aged 5 years and under.

  • Children between the age group 6-11 may wear a mask depending on their ability to wear a mask safely and appropriately under the supervision of parents or guardians.

  • Children aged 12 years and above should wear a mask to protect themselves from COVID-19, just like adults.

  • Make sure your hands are cleaned with soap and water or hand sanitiser before handling a mask.

The reason why masking is not recommended for children aged 5 years and below is mostly because of safety concerns.

Earlier the World Health Organization (WHO) had also advised against the use of masks for this age group.

A report published by the World Health Organization (WHO) in August 2020, stated that the decision was "based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance."

According to the WHO, even children falling in the age group 6-11 should only wear masks if,

  • There is a widespread COVID-19 transmission in the area where the child resides.

  • The child is able to wear a mask safely and appropriately.

  • There is proper adult supervision, and instructions to the child on how to wear a mask and dispose it off safely after use is given.

  • The child is around people who are at a "high-risk" of contracting the COVID-19 virus.

However, children aged 12 years and above should wear a mask to protect themselves from the virus and the rules are same as adults.

Other COVID-19 Guidelines To Manage COVID in Children

Along with the rules on masks for children, some other important COVID-19 guidelines published under the 'Revised Comprehensive Guidelines for Management of COVID-19 in Children and Adolescents (below 18 years)' are as follows:

  • Use of antivirals or monoclonal antibodies is not advised for children less than 18 years of age, irrespective of the severity of the COVID-19 infection.

  • Antimicrobials should not be recommended to treat moderate and severe COVID-19 cases unless there is "clinical suspicion of a super added infection".

  • If steroids are used, they should be "tapered over 10-14 days" as per clinical improvement.

Apart from these guidelines, the Health Ministry has said that children who experienced asymptomatic infection or mild COVID-19 disease should receive routine care, and vaccination at the right time, if eligible.

Parents or caregivers of children who have moderate to severe COVID should be counselled regarding monitoring of persistence or worsening respiratory difficulty.

Children who develop organ specific dysfunction during hospitalisation should be given proper care.

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