We understand that this is an incredibly difficult time for parents as they prepare to make decisions about sending their children back to school. We have received a great deal of questions about this topic, and we empathize that many of our families are weighing the pros and cons of each scenario. While we cannot make this decision for you, we hope to provide some reliable information on masks for those who plan to return to in-person teaching this year.
The AAP recommends that children 2 years and older wear masks in public places. Due to the nature of our specialty, we have a number of patients with breathing related concerns such as asthma. We will not be providing letters stating that our patients are exempt from any policy requiring masks. We believe that masks help protect our patients and those around them from contracting and spreading illness. Oxygen and carbon dioxide levels are not affected by wearing a mask, even for extended periods of time. If you have concerns about your child or yourself wearing a mask, we encourage you to make an appointment so we can help address these concerns. We would be happy to measure oxygen levels during these appointments.
There are a wide variety of masks available, and many local stores are now carrying them. In general, we recommend trying different types of masks and using one that works best for you/your child. A mask with a good fit to your face that leaves minimal to no “gaping” is ideal. You may consider a trial of different types of straps/ties to help with the fit/comfort. There are also “ear savers” available that help keep pressure off the backs of the ears if you prefer the ear-loop style masks. Some masks are designed to be washed and re-used, and others are disposable. We recommend keeping backups in the car, back pack, purse, etc in case your original mask is soiled, lost, or forgotten.
While we encourage finding masks that fit your individual preferences, we wanted to make our readers aware of two big points. First, valved masks generally do a good job of protecting the person wearing them, but allow respiratory droplets from the wearer to escape the valve, which could put others at risk. If you have a valved mask we recommend covering the valve with tape, a Band-Aid, etc. Second, research has emerged recently on the efficacy of different masks, and bandana style masks and fleece masks were found to be clearly inferior compared to other types of masks. Briefly, in this study participants wore different types of masks and the “relative droplet count” (or respiratory droplets that escaped the mask while they were speaking) was recorded. Bandana masks were minimally effective and only cut the relative droplet count in half on average. Fleece masks appeared to actually increase the relative droplet count, and the authors hypothesize that this is from larger droplets dispersing into smaller droplets as they pass through the fabric.
As we approach fall and winter don’t forget the basics of washing your hands, avoiding touching your face, and staying home if you are showing any symptoms of illness. We plan to continue to offer telemedicine visits to our patients for convenience and safety. If you have additional questions please call to schedule an appointment for the near future.
References:
https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083
You have no doubt been following the developments on COVID-19, and you may have some questions about what to do if you are experiencing symptoms of illness. We hope this information helps to clarify some questions you may have.
At this point in time, testing is not easily available to the community. Therefore, we cannot always test every person having respiratory symptoms for COVID-19. If you are experiencing any symptoms of infection, you must assume that the symptoms could be related to COVID-19. Symptoms can start from 2-14 days after exposure to the virus. Symptoms may include:
Some patients experience more mild symptoms that can be treated/monitored at home. If you have an underlying chronic lung disease such as asthma, it is important to take your medications as directed by your doctor. You can contact your doctor to let them know you are sick, and decide if any other treatments are needed. At AACPC we would welcome you to make a telemedicine visit so your symptoms and concerns can be discussed via video chat from the safety of your home. It is best to stay out of the doctor’s office to avoid exposing other people to illness.
There may be instances where a higher level of evaluation and care is needed than what you can do at home. In these cases, we recommend that you go to the ER, or call 911 if you are unable to have somebody drive you (or if it is a more urgent emergency). You should alert the medical team as soon you come into contact with them that you are having respiratory symptoms so they can use the proper precautions. Symptoms for which you should seek medical attention include:
There have been some reports of other less common symptoms that may be related to COVID-19 infection. If you or a family member experiences any of these symptoms, please call your primary care doctor to discuss further:
If you have symptoms of illness, you should only leave the home for emergencies. Let somebody else do the grocery shopping. Isolate yourself as much as possible from other household contacts and pets. Use a separate bathroom if possible. If you have to interact with anybody in your home, wear a mask. Try to get plenty of rest, but please try to change position often and avoid spending a lot of time lying flat on your back. Most patients with respiratory illnesses feel best when they change position often (every 30 min to 2 hours). Try lying on your sides, stomach, and sitting up or at a slight incline. This may help keep the air sacs in your lungs open. Monitor your symptoms (such as taking your temperature). Wash your hands often. Do not share dishes or utensils with other family members, and wash used dishes in the dishwasher, or thoroughly with soap and water. Clean all surfaces regularly. See this handout from the CDC, which outlines several of these points.
https://www.cdc.gov/coronavirus/2019-ncov/downloads/10Things.pdf
In terms of when it is considered safe to discontinue home isolation, the following guidelines are recommended by the CDC:
WE CAN’T SEE THEM, BUT THEY’RE OUT THERE…
Here is a video demonstrating how germs are spread. Gross-yes, but important to know about!
