The World Health Organization (WHO) has clarified its mask-wearing guidance for children for the first time, stating that, in general, children aged five years and under should not be required to wear masks.
However, it says children aged 12 and over should wear masks to help tackle the COVID-19 pandemic under the same conditions as adults, while children between six and 11 should wear them on a risk-based approach.
Children aged 12 and over should particularly wear a mask when a one-metre distance from others cannot be guaranteed and there is widespread transmission in the area, the WHO and the United Nations Children's Fund (Unicef) said in a document on the WHO website dated August 21.
What should be considered when making children wear masks?
Whether children between six and 11 should wear masks depends on a number of factors, according to the WHO document, including the intensity of transmission in the area, the child's ability to use the mask, access to masks and adequate adult supervision, the two organisations said.
The potential impact on learning and psycho-social development, and the interactions the child has with people at high risk of developing serious illness, should also play a role.
Children aged five years and under should not be required to wear masks based on the safety and overall interest of the child, the WHO and UNICEF said.
Studies suggest older children potentially play a more active role in transmission of the new coronavirus than younger children, the WHO and UNICEF said, adding more data was needed to better understand the role of children and adolescents in the transmission of the virus, which causes COVID-19.
How WHO’s new guidance on children wearing masks is different
The new guidance from WHO and Unicef is in contrast to that from the US Centers for Disease Control and Prevention (CDC), which recommends that children aged two years and older should wear a mask in public when they cannot practice social distancing.
It also contrasts with advice given by the UAE government at a media briefing in Abu Dhabi in early August, where Dr Omar Al Hammadi, the official spokesperson for the UAE Government, stated that it is recommended that children wear face masks in public provided that they are more than two years old.
However, in the UAE it is only mandatory for children aged 6 years and above to wear face masks in public.
The WHO first advised people to wear masks in public on June 5 to help reduce the spread of the disease, but had previously not issued specific guidance for children. In the absence of previous guidance from WHO, many policy-makers were following the advice from the CDC.
The UAE’s policy on children wearing masks in public
During the COVID-19 pandemic, wearing masks in the UAE is mandatory for all in public places, public transportation or commercial centers, when walking outside in high-density public areas and in private transportation. However, on 31 May 2020, Dubai Government issued new guidelines under which certain people under certain situations would be exempted from wearing a mask even in public areas.
Individuals who have been exempted from wearing a face mask in the UAE
The individuals have been exempted from wearing a face mask in public are:
- children under six years of age
- people of determination - those with cognitive, intellectual or sensory disorders or any impairments that prevent their ability to breathe or communicate, normally
- those for whom masks can lead to sensory triggering (a medical report is needed to confirm the condition)
- individuals who require supplemental oxygen or have severe respiratory issues or have difficulty breathing with a mask (medical report is needed to confirm the condition).
The UAE government is very clear that children under the age of 2 should never wear a face mask for safety risks due to the risk of suffocation or strangulation and that any child wearing a mask should be capable of removing the mask if needed.
Conditions under which masks can be removed in the UAE
The UAE government website states that masks can be removed under the following situations:
- when driving alone, or with your family members
- while eating or drinking in indoor and outdoor settings, that is at restaurants
- when engaging in strenuous indoor and outdoor physical exercise
- while being alone in a certain setting, like your office and no one is around
- while undergoing specific treatments such as dental work, eyes, nose and throat examinations, and other treatments related to hair and beauty.
However, physical distancing must be observed at all times.
The WHO and Unicef guidance on children wearing face masks in full
In general, children aged 5 years and under should not be required to wear masks, according to new guidance on the WHO website, which was written in collaboration with Unicef.
This advice is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance. There may be local requirements for children aged 5 years and under to wear masks, or specific needs in some settings, such as being physically close to someone who is ill. In these circumstances, if the child wears a mask, a parent or other guardian should be within direct line of sight to supervise the safe use of the mask.
An international and multidisciplinary expert group brought together by WHO reviewed evidence on COVID-19 disease and transmission in children and the limited available evidence on the use of masks by children.
Based on this and other factors such as childrens’ psychosocial needs and developmental milestones, WHO and UNICEF advise the following:
Children aged 5 years and under should not be required to wear masks. This is based on the safety and overall interest of the child and the capacity to appropriately use a mask with minimal assistance.
WHO and UNICEF advise that the decision to use masks for children aged 6-11 should be based on the following factors:
• Whether there is widespread transmission in the area where the child resides
• The ability of the child to safely and appropriately use a mask
• Access to masks, as well as laundering and replacement of masks in certain settings (such as schools and childcare services)
• Adequate adult supervision and instructions to the child on how to put on, take off and safely wear masks
• Potential impact of wearing a mask on learning and psychosocial development, in consultation with teachers, parents/caregivers and/or medical providers
• Specific settings and interactions the child has with other people who are at high risk of developing serious illness, such as the elderly and those with other underlying health conditions
WHO and UNICEF advise that children aged 12 and over should wear a mask under the same conditions as adults, in particular when they cannot guarantee at least a 1-metre distance from others and there is widespread transmission in the area.