Children and masks

I refer to the article entitled ‘Unmask the kids’ by David Marinelli (April 24). The first three paragraphs are reasonable but I feel that I have to briefly provide counterarguments to multiple false and misleading statements that follow. 

Mask wearing does not affect blood oxygen levels, even with prolonged wear or tight-fitting masks. Nor does it cause increased carbon dioxide.  Using a mask does not cause significant rebreathing of exhaled air.  Marinelli himself writes that microbes pass through the fabric; so do the molecules in the air.

He is falsely alarming parents that mask wearing may damage childrens’ brains. 

Regarding the effectiveness of masks for infection control, it depends on filtering capability, face fitting and wearing behaviour. Cloth masks, the main type used by children, are mainly helpful to limit, to a small extent, large droplet spread in the near vicinity of the wearer. This is not ideal but still useful. They protect others, rather than the wearer.  Hence, only if worn by everyone in a given space and together with other measures (especially ventilation), can cloth masks help reduce one’s infection risk.

The negative effects of masks on breathing are mostly restricted to discomfort, especially in high temperatures and in individuals that may feel ‘claustrophobic’ with a mask on and a slight increased resistance to the mechanical effort to breathe.

With regard to communication, non-transparency masks definitely cut out the cues we infer from lower facial expressions. However, despite mask regulations, children are still usually exposed sufficiently to unmasked communication in their home environment, outdoors, on the media, etc.

Aided by adults so that it is appropriate for age, mask use has no detrimental effects on children. Parents/guardians need to dedicate enough time to interact with their children so that they can contribute to their mental development.  Obviously, there are exceptions, such as behavioural issues and use of spectacles, which may make mask use impractical.

So, is it worthwhile imposing mask use by children? Yes, is the short answer. While the long-term risk of infection to the child’s health is very low, children can be carriers to more susceptible individuals, such as grandparents. Trying to avoid children getting sick may avoid the premature death of an older member of the family.  The context is that of a pandemic virus that has carried a major death toll, especially in the older population worldwide.

In addition, limiting child sickness helps reduce the time spent in quarantine, which, when prolonged or repeated, can have worse consequences than appropriate mask use.

There is a lot of wrong information that we can come across, even from sources that should be reliable. I agree with Marinelli that we need to question and verify and think with our own heads.  However, mandates and laws are there to push people who otherwise won’t do ‘right thing’ voluntarily. 

I have no conflict of interest and what I wrote is based on scientific facts and evidence. I also don’t like wearing a mask  but I do so, as one needs to contribute to the collective pandemic efforts.

The latter are not ideal and they keep evolving based on the situation and what we learn as we go along but that doesn’t make such efforts wrong, despite vested interests that may exist and which have contributed to the disillusionment of many. 

But, in public health, any argument needs to take into consideration the complexity of the situation and help to protect the vulnerable and everyone’s well-being equitably. 

JAMES VASSALLO MD, Ophthalmologist – Lija

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