The recent guidelines for Covid management in children clarifies the need for masks in the population below 18 years of age. The guidelines, released by Directorate General of Health Services (DGHS), also sets parameters for Covid-related tests and medication to be followed in the case of children.

The new guidelines state that children aged 5 years or less are not required to wear masks. Those in the age group of 6-11 years may wear a mask depending on their ability to use a mask safely and appropriately under direct supervision of parents or guardians. Children aged 12-17 years should wear the masks the same way as adults.

Dr Sudip Chowdhury, consultant paediatrician, Columbia Asia Hospital,Gurugram, said, “Face masks can be safely worn by all children two years of age and older, including most with special health conditions, with rare exceptions. Children should not wear a mask if they are under two years old, because of the risk of suffocation. Also, anyone unconscious or unable to remove a face covering on their own should not wear one.”

Dr Neha Singh, consultant, Pediatrician,Gurugram however stated that “anyone can wear a mask when they need to be near other people”. “A mask is an extra way to stop germs. Some people might wear a homemade cloth mask. Masks remain a simple but powerful tool to protect against Covid-19, especially for children too young to get the vaccine yet. Until a child is fully vaccinated against Covid, they should continue to wear a face mask and keep a safe physical distance indoors around people they don’t live with or who may have the virus. Anyone unvaccinated should also wear face masks outdoors in large group settings or when physical distancing isn’t possible,” 

It must be noted that children should be given face masks that do not have any metallic components and attachments, mentioned Dr Singh.

The guidelines also cautioned against using steroids in asymptomatic or mild cases of Covid-19 in children. For moderately or critically ill children, steroids could be used under strict supervision. The guidelines strictly prohibited self-medication of steroids.

It must be remembered that steroids prolong viral shedding and hence caution is required in their use, DGHS stated in its Covid guidelines for children. It also listed the recommended doses of anticoagulants.

The guidelines prescribed a 6-minute walk test with a pulse oximeter to check for oxygen levels and signs of hypoxia in children. It also called for rational use of high resolution CT (HRCT) scans in children, urging doctors to practice caution while recommending chest CT scans for younger patients.

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