Should very young kids wear masks?

As the Omicron variant of Covid-19 begins to spread in New Zealand, a lot of focus is being placed on how best to keep our tamariki safe.

Both Prime Minister Jacinda Ardern and Education Minister Chris Hipkins said yesterday that the aim was to keep children in schools amid the ongoing pandemic.

From February 4, students and staff from year four and up will be required to wear face masks indoors and when in close contact with others, including inside classrooms and assemblies. Portable air cleaners are also set to be used in schools to combat the spread of Covid-19.

But when it comes to keeping our very young children safe, what are the best measures?

Public health experts and paediatricians agree there are a range of measures that can be put in place to help protect young children who cannot be vaccinated themselves. These include adult vaccinations, well-ventilated settings, and time spent outdoors.

In the US, the Centres for Disease Control (CDC) recommends that children aged 2 and over wear face masks in indoor settings. Epidemiologist and Professor Michael Baker, from the department of public health, University of Otago, Wellington, has mooted the idea of mask-use among young children here. He says this is an area we could look at because under-5s can’t be vaccinated, some early education centres have densely packed environments, and if transmission occurs in them then children could possibly bring the virus back home to adults.

‘‘It’s possibly one of the biggest gaps in our defences at the moment,’’ he told Stuff.

Baker says he’s not implying that every single 2-year-old needs to be in a mask all the time, but he’s more pointing out that other countries have different recommendations, and that New Zealand is ‘‘being far too conservative in our approach to limiting the spread of respiratory viruses indoors’’.

The mask-measures that are required in New Zealand schools this year are for year four and above, which begins with children aged about 7-8. But Baker says there’s no reason why 5-year-olds couldn’t wear them.

‘‘We haven’t got high vaccine coverage of children, we’ve got no vaccines for preschool children. We just need to think about where the rest of the world is at on this topic, and how far we are behind... We’re just going to have to look at what we can do to reduce transmission in those age groups.’’ Baker notes that mask-use is just one tool we can use. Children staying home if they’re sick, well-ventilated rooms,

and cohorting are other measures that can be used to reduce possible transmission.

Starship Children’s Hospital Developmental Paediatrician Dr Jin Russell said that her preference is for young children to spend more time outdoors and in well ventilated spaces with vaccinated adults. Russell, who is also a PhD student at the University of

Auckland school of population health, agreed that we needed to improve the ventilation of spaces and spend more time outdoors, as this reduces the risk of Covid-19 transmission and has a lot of other health benefits.

‘‘I think it’s important to balance the developmental needs of very young children and reducing Covid-19 transmission.’’

She highlighted some practicalities of having 2-year-olds in masks, which ‘‘can be tricky’’ due to frequent feeds, bottles, and naps, which mean masks have to be taken on and off a lot.

‘‘It can also be tricky to achieve a good fit, without muffling the child’s voice. Children who are school-aged generally tolerate wearing masks well,’’ she added.

Dr Amanda Kvalsvig, epidemiologist in the department of public health, University of Otago Wellington, said that if kindergarten-age children wanted to wear a mask, they can – it is protective. But if they’re not comfortable with the idea, no-one will insist. ‘‘In overseas countries with strong mask cultures, young children have taken to mask wearing very easily because they see older children and adults wearing masks, and they want to do the same,’’ she said.

Baker said that New Zealand doesn’t have much of a maskculture here, when compared to other countries who have been living with the virus and have built masks into their normal operations.

Kvalsvig said that as Omicron begins to spread in New Zealand, parents and staff are expressing concerns about early childhood settings.