Top pediatrician gives mask-wearing advice for children in schools

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By Orville Williams

Head of the Paediatric Unit at the Mount St John’s Medical Centre (MSJMC), Dr Shivon Belle-Jarvis, is urging parents, teachers and policymakers to be cognisant of the ever-evolving guidance for the wearing of masks by children, ahead of the new school year.

Students are scheduled to return to the classroom early in September and Dr Belle-Jarvis acknowledged the anxiety of parents and guardians, that the risk of Covid-19 transmission among children is significantly high, due to their unpredictable behaviour.

“It has been a concern for most, if not all parents, because we as adults often struggle with wearing a mask for prolonged periods. If you just observe a child, after they have the mask on for sometimes five minutes, there’s a struggle to take it off,” the doctor said.

She spoke on the dynamic nature of the advice given by global health agencies and how that advice may impact policy in Antigua and Barbuda.

“We’ve recognised as well that the guidance on mask-wearing has actually varied based on the governing bodies. The Centers for Disease Control (CDC) would have recommended that no child under the age of two should actually wear a mask…[and] they also made it clear that anyone who has challenges with breathing or challenges in terms of development, really should not be obligated to wear a mask, because breathing difficulties can be exacerbated and they may not be able to physically remove the mask should breathing difficulties ensue,” Dr Belle-Jarvis continued.

She also noted the World Health Organization’s (WHO) recent guidance, advising against children under five years being required to wear masks and special guidance for those between six and eleven years, as well as their strong recommendation that children over 12 years old should be the ones encouraged to wear masks.

The pediatrician, however, reminded that the WHO has emphasized that individuals need to look at their nation’s recommendations, with Antigua and Barbuda’s at this point, being that children two years old and above can wear [masks].

While there will be policies that are understandably set in stone, Dr Belle-Jarvis urged consideration for specific cases, on an individual basis. In certain instances, she suggested that physicians should be allowed to advocate on behalf of their younger patients.

“Small class sizes, that is key; appropriate distancing where possible, that is [also] key. For children who are deemed to be high-risk, those with – for example – congenital heart disease or born with heart problems, those who have asthma or other respiratory or breathing problems, they should not be required to wear a mask.

“[Also], those who have disabilities where they depend on lip reading, imagine if the teacher is using a mask, how are they going to follow? In those cases, special allowances can be made for the teacher to use a shield, so that lip reading can be facilitated.

“I must highlight, those with asthma [and] those who are uncontrolled, we may definitely consider that your physician should be able to say this is a child who has severe asthma, who is uncontrolled and therefore should not be asked to wear masks. There are going to be special cases and [they] have to be taken on a case-by-case basis,” Dr Belle-Jarvis advised.

She warned that, in the classroom setting, children will need to be afforded breaks during the sessions that last several hours. She also implored the support and participation of parents in the collective effort, reminding that their actions will have a significant impact on the children.

“What I want to [say] to reassure parents, is if our children are unable to wear the face masks, we have to try to show them by example; you can’t be asking the child to wear a face mask and you don’t have it on.

“[Additionally], these children who are thought to be high-risk may even consider doing the online system as opposed to the blended system initially, until things are [clearer] ,” she said.

The pediatrician further appealed for patience and understanding from all sides throughout the entire process, noting the unique circumstances and the added pressure that will be on teachers to monitor the children. “Covid-19 is new; it is a fluid situation [and] the guidance will continue to change. We really need to look at this seriously, sit down with our parents [and] teachers, they’re our main stakeholders. It is new for all of us,” Dr Belle-Jarvis said.

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