Advice regarding the wearing of masks for children who have asthma

As Covid-19 infections in South Africa taper off and schools reopen, parents of children with asthma have raised concerns about them having to wear masks throughout the school day. In particular, they are worried that the mask will affect the child’s breathing and the oxygen and carbon dioxide levels in the child’s blood. However, there is absolutely no evidence that cloth masks affect these levels, and we believe they are safe, even for children who have asthma.

Face shields offer an additional layer of protection as they cover the eyes as well as the mask, preventing droplets that may contain the virus from landing on the face. On their own, however, they are not as effective as cloth facemasks. If a child who has asthma becomes short of breath when wearing a mask, his/her doctor may motivate for a face shield as an alternative measure. It is important for the face shield to extend well below the child’s chin and wrap around to the ears to give as much protection as possible. Face shields should be seen as the exception and not as an alternative for all other children at the school. This will have to be carefully explained to other children and parents.

If the child is able to tolerate a mask, but becomes tired or uncomfortable from wearing it, he/she can have a short mask break whilst ensuring physical distancing from others (1.5-2 metres away). Masks and face shields must be washed every day with soap and water.

It is important for children with asthma to continue taking their regular asthma medication during the Covid-19 pandemic. If the child’s asthma is not well controlled, then that child should not attend school and must consult the primary care clinic or doctor for advice regarding his/her treatment.