Skin Infection Risk to Communication Woes: Time to Relax Mask Rule for Schoolkids, Say Experts

With the onset of summer and fewer Covid-19 cases, usage of masks should be relaxed among schoolchildren, according to health experts.

Among children, wearing masks leads to redness and rashes on the skin, reduced ability to communicate, low attention span and suffocation.

Also, as the benefit of using masks is low when the virus circulation is limited, experts feel the central government should remove the compulsion for kids.

However, they emphasise that the policy regulating the usage of masks should be watched for mutation of the virus, even as current data suggests the disease caused by the Omicron variant is less severe.

THE GUIDELINES

According to the guidelines released by the central government in January, masks are not recommended for children aged 5 years and below. Children aged 6-11 years may wear a mask depending on the ability of the child to use a mask safely and appropriately under direct supervision of parents/guardians. However, children aged 12 years and above have to wear a mask under the same conditions as adults.

While the government rules make it mandatory for children aged 12 and above to wear masks at all times, many schools expect children in the 6-11 age group to do so on the premises.

“It is a medical truism that everything that has effects also has side effects,” said Dr Maninder Singh Dhaliwal, associate director of pediatrics, Medanta Hospital, Gurgaon, when asked about the usage of face masks.

Dhaliwal said that face masks may further cause “perioral dermatitis with rashes and redness”, an infection of the skin around the mouth because of saliva, sweat, and moist vapour between the mask and the skin. This may provide a breeding ground for bacteria.

“We have to always find a balance between risk and benefits,” Dhaliwal said, hinting that the mandates to wear masks could be brought back based on the number of cases or epidemiological trends of the districts.

In an opinion published in the ScienceDirect, Elsevier’s leading platform of peer-reviewed scholarly literature authored by German neuroscientists, psychiatrist Manfred Spitzer stated that “covering the lower half of the face reduces the ability to communicate, interpret, and mimic the expressions of those with whom we interact”.

Spitzer, whose opinion titled ‘Masked Education? The Benefits and Burdens of Wearing Face Masks in Schools During the Current Corona Pandemic’ was released in September 2020, said that “positive emotions become less recognisable, and negative emotions are amplified”.

The article said that emotional mimicry, contagion, and emotionality, in general, are reduced, hence the bonding between teachers and learners.

POLICY INTERVENTION NEEDED

Dr Chandrakant Lahariya, an epidemiologist and public health specialist, believes that the one urgent Covid-19 policy intervention needed in India is to make mask wearing “voluntary” for all schoolchildren.

“The benefit of wearing masks in low-transmission areas is limited. Most importantly, when most adults are not wearing masks, why are children being forced to wear them,” he asked, adding, “The health hazards of cloth masks have not been studied to my knowledge.”

However, he pointed out: “There are health hazards of long-term masking with N95, which results in an increase in carbon monoxide and carbon dioxide inside the masks to high levels, which could be harmful for children.”

“Children attend school to get involved in various sports and other activities. Masks are not advised when they are involved in any moderate to severe physical activity,” Lahariya said.

“With schools resuming, the centre needs to consider that a majority of age group that is asked to wear masks (from ages 12-17) is already eligible for vaccination,” said Dr Anil Pandey, principal investigator at ESIC Medical College and Hospital, Faridabad, which conducted trials on kids for both Covaxin and Corbevax. “Even if the child has got the first dose, it means he or she is safe and also they can’t spread Covid-19. For them, the requirement of masks can be released immediately.”

For younger children, Pandey said, the restrictions could be eased on the basis of negligible Covid-19 cases in India, lower chances of a critical fourth wave and of children contracting serious disease.

“Otherwise, vaccination and masks should be made mandatory for all teachers and even the administration and house-keeping staff of schools.”

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