“Emotional resistance can be caused when people are forced to wear a mask. (Pfattheicher 2020)”

Yes, mouth and nose protection can be dangerous if you don't change it or don't wash it in the washing machine at at least 60 degrees!

At the end of May 2020, the clinic in Munich reported: “There are currently an enormous number of rumors and false claims circulating again, which come from would-be doctors, amateur virologists and YouTube academics. This is dangerous because fake news quickly develops into supposed “facts”. “

The topic of masks or mouth and nose protection is still a very big topic for many users and so almost every day there is a different post on Facebook that causes an uproar and unsettles other people!

We are therefore pleased to publish a statement from DGPI, bvkj, DGKJ, GPP and SGKJ on the use of masks in children to prevent infection with SARS-CoV-2 (as of November 12, 2020)!

Statement from the German Society for Pediatric Infectious Diseases (DGPI), the Professional Association of Pediatric and Adolescent Doctors (bvkj eV), the German Society for Pediatric and Adolescent Medicine (DGKJ), the Society for Pediatric Pulmonology (GPP) and the South German Society for Pediatric and adolescent medicine (SGKJ)

Hans-Iko Huppertz, Reinhard Berner, Renate Schepker, Matthias Kopp, Andreas Oberle, Thomas Fischbach, Burkhard Rodeck, Markus Knuf, Matthias Keller, Arne Simon, Johannes Hübner

Since wearing masks can reduce or prevent the spread of SARS-CoV-2 (Prather 2020; Peeples 2020), the Robert Koch Institute recommends wearing medical masks or mouth and nose covers in public spaces in addition to isolating sick people. quarantining those exposed, maintaining distance, washing or disinfecting hands and ventilating closed rooms. Medical masks are the so-called surgical masks and the filtering masks FFP-2 or FFP-3, which are approved for use in the medical field; Mouth and nose coverings (everyday masks) are not standardized and are made from different fabrics. Furthermore, by “masks” we mean surgical masks or everyday masks. Masks provide a barrier that can prevent the spread or absorption of virus-containing droplets (Chan 2020). The use of a mask makes sense if it adapts well to the wearer's face and shows as little leakage as possible when inhaling and exhaling under the mask (Regli et al 2020).

Depending on their quality, wearing masks leads to a slight increase in airway resistance and work of breathing, a slight reduction in oxygen saturation and a slight increase in the concentration of carbon dioxide in the blood in healthy adults (reviewed by Scheid 2020; Samannan 2020). All of these changes are within the range of normal values ​​and are therefore of no objective relevance to the health and performance of those affected. Mask wearers report, among other things, discomfort after several hours of use, including facial discomfort and headaches if headaches have previously occurred in other situations. During strenuous physical exertion up to the limit, performance decreased when a mask was worn (Fikenzer 2020). Employees in healthcare professions reported rhinitis after long-term wearing of masks: An allergy or contact allergy could be ruled out as the cause, but irritant rhinitis was found due to released polypropylene fibers from the filter material of the mask (Klimek 2020). Oxygen desaturation has been reported in patients on hemodialysis, but not in patients with well-controlled asthma when wearing a mask (Kao 2004).

Emotional resistance can be provoked when people are forced to wear a mask. This can be caused by the perceived interference with autonomy, by the feeling that they may be doing something different than the social reference group, and by the feeling that those who exercise this coercion are not competent to do so (Scheid 2020). In order to make wearing a mask acceptable for doubting people, factual information is often not enough: Rather, this must be combined with empathy towards vulnerable fellow human beings who particularly benefit from protection against infection (Pfattheicher 2020).

Although children under 10 are less likely to be involved in the spread of the virus (Hippich 2020), individual federal states have recommended or required the use of masks for them too. This has led to some concerns among parents and educators as to whether this measure could also involve risks. The American Centers for Disease Control and Prevention (CDC) recommends that children wear masks under certain circumstances and acknowledges that this is not always possible: A mask should only be used on awake children and not on children under 2 years of age in the event of severe breathing problems, if the children cannot remove the mask without help or if they cannot use it as intended due to a mental or physical disability, their intellectual maturity or behavioral problems. Since the first German recommendations on masks for children and those of the World Health Organization, practical experience has increased ( bvkj ; DGKJ ; WHO ). If there is a high 7-day incidence of SARS-CoV-2 in the region or district, the German Academy for Pediatric and Adolescent Medicine, together with the German Society for Hospital Hygiene, recommends that primary school students wear masks; When they are seated, they can remove the mask again while observing the distance rule ( DAKJ ).

There is little data on possible adverse effects of masks for children . In a study with 8 to 11-year-old children on the question of protection against air pollution, the test subjects preferred masks that were easier to breathe through, did not make the facial skin too hot, and had an age-appropriate appearance (Smart et al 2020). Wearing masks does not lead to a relevant increase in carbon dioxide concentrations, even in children. Even for children with controlled asthma over the age of 6, the mask does not pose any danger or additional burden. Extensive experience with children with acute or chronic illnesses in children's hospitals and special outpatient clinics shows that after an age-appropriate explanation of the function and purpose of wearing a mask, they do not have problems with it. This applies both to the child as a mask wearer and to the child as a conversation partner with a doctor wearing a mask. However, communication with the child and parents can deteriorate because the mask acts as a filter, especially for high frequencies of speech, lip reading becomes impossible and the speaker's facial expression is less visible (Marler 2020). Accordingly, the doctor has to spend more time and rest on communication. Pediatricians who were not used to seeing children and their parents wearing a mask before the pandemic reported that wearing a mask made it more difficult for them to communicate, especially the younger the children were and the less experienced the doctors were (Shack et al 2020).

The SARS-CoV-2 pandemic has had a variety of adverse effects on the lives of children in Germany (Ravens-Sieberer 2020) and children in difficult psychosocial conditions are experiencing increased stress, threats to their well-being and therefore probably long-term psychological consequences. It is undisputed that children of different age groups can experience wearing the mask as unpleasant, disturbing and subjectively limiting their well-being and performance. Wearing a mask, for example in class, is a burden that must be respected and acknowledged (Spitzer 2020). The use of a mask by children requires their understanding and cooperation. That's why a pedagogically good introduction to the background and handling is essential. People who motivate children to use masks should themselves be convinced of the importance of wearing masks. Furthermore, incorrect use of masks could increase the spread of the virus through additional contamination or falsely assumed safety. The children should also not be overwhelmed by excessively long gestation periods depending on their age. In a nationwide study on the psychological stress on children and young people caused by the SARS-CoV-2 pandemic, no evidence was found that wearing masks affects children's mental health (Ravens-Sieberer 2020). On the contrary, there is increasing evidence of positive empowerment of young people and creative initiatives caused by the challenges of the pandemic (Singh et al 2020).

Recommendation:

Masks are important tools for preventing the spread of the pandemic pathogen SARS-CoV-2, which causes COVID-19 . When weighing up the individual and community risks and the given benefits, it may be necessary, justifiable and reasonable in the specific infection epidemiological situation for children to also wear masks under the conditions mentioned. Children can be asymptomatic carriers of SARS-CoV-2. Healthy children aged 10 and over can learn to use a mask safely and effectively independently. You should know how and when you can remove the mask again, also to limit the time you wear it. Children aged 6 and over can optionally wear a mask, but they should not be forced to do so and they should be able to remove it at any time if they wish. For children aged 6 and over, a size-adapted surgical mask (possibly with painting) is the most sensible solution. Self-sewn mouth and nose covers can be used as an alternative. Scarves have undefined airway resistance and could cover the face and wrap around the neck (like masks with long straps) and should therefore be avoided. Infants, sleeping or unconscious children are not allowed to wear a mask. For disabled or chronically ill children, an individual and possibly situation-dependent decision for or against a mask should be made with the involvement of the attending physician.

When used in the recommended way and with empathy for children and with common sense under the supervision of understanding adults, unwanted effects of masks are almost certainly ruled out. Fears that masks could impair breathing, endanger the supply of oxygen or lead to a dangerous build-up of carbon dioxide are unfounded. If parents and children are properly informed, masks do not lead to mental problems or even damage. Rather, they protect the carrying child and possibly also its surroundings. The subjective problems and discomfort when wearing the mask are nevertheless fully acknowledged; The crucial social task is all the more to convey the necessity of balancing benefits and risks in an age-appropriate, i.e. child-friendly manner.

For the board of the German Society for Pediatric Infectious Diseases (DGPI):
  • Prof. Dr. med. Hans-Iko Huppertz, office of the German Society for Pediatric Infectiology, Chausseestr. 128/129, 10115 Berlin, [email protected]
  • Prof. Dr. med. Johannes Hübner, Dr. from Hauner'sche Children's Clinic, LMU Munich, Lindwurmstr. 4, 80337 Munich, [email protected]
  • Prof. Dr. med. Arne Simon, Clinic for Pediatric Oncology and Hematology, Saarland University Hospital, Kirrberger Straße, Building 9, 66421 Homburg/Saar, [email protected]
For the professional association of children and adolescent doctors (bvkj eV)
  • Dr. med. Thomas Fischbach, Mielenforster Straße 2, 51069 Cologne, [email protected]
the German Society for Child and Adolescent Medicine (DGKJ):
  • PD Dr. med. Burkhard Rodeck, Christian Children's Hospital Osnabrück, Johannisfreiheit 1, 49074 Osnabrück, [email protected]
  • Prof. Dr. med. Reinhard Berner, Clinic and Polyclinic for Pediatric and Adolescent Medicine, Carl Gustav Carus University Hospital, TU Dresden, Fetscherstr. 74, 01307 Dresden, [email protected]
For the German Society for Pediatric Pulmonology (GPP):
  • Prof. Dr. med. Matthias Kopp, University Children's Clinic, Inselspital, Freiburgstrasse 15, CH- 3010 Bern, [email protected]
For the South German Society for Children and Adolescent Medicine (SGKJ):
  • Prof. Dr. med. Markus Knuf, Clinic for Children and Adolescents, Helios Klinikum Wiesbaden, [email protected]
  • Prof. Dr. med. Matthias Keller, Third Order Children's Clinic, Bischof-Altmann-Str. 9, 94032 Passau, [email protected]
  • Prof. Dr. med. Renate Schepker, NDT South Württemberg / Ulm University, Weingartshofer Str. 2, 88214 Ravensburg, [email protected]
  • Dr. med. Andreas Oberle, Social Pediatric Center, Olga Hospital, Stuttgart Clinic, [email protected]
Credentials:
  1. Chan EYY, Shahzada TS, Sham TST, Dubois C, Huang Z, Liu S, Ho JY, Hung KKC, Kwok KO, Shaw R (2020) Narrative review of non-pharmaceutical behavioral measures for the prevention of COVID-19 based on the health-edrm framework. Br Med Bulletin doi 10.1093/bmb/ldaa030
  2. Fikenzer S, Uhe T, Lavall D, Rudolph U, Falz R, Busse M, Hepp P, Laufs U (2020) Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clin Res Cardiol doi: 10.1007/s00392-020-01704
  3. Hippich M, Holthaus L, Assfalg R, Zapardiel Gonzalo JM, Kapfelsperger H, Heigermoser M, Haupt F, et al (2020) Public health antibody screening indicates a six-fold higherSARS-CoV-2 exposure rate than reported cases in children. Med doi.org/10.1016/j.medj.2020.10.003
  4. Kao TW, Huang KC, Huang YL, Tsai TJ, Hsieh BS, Wu MS (2004) The physiological impact of wearing an N95 mask during hemodialysis as a precaution against SARS in patients with end-stage renal disease. J Formos Med Assoc 103:624–628
  5. Klimek L, Huppertz T, Alali A, Spielhaupter M, Hörmann K, Matthias C, Hagemann J (2020) A new form of irritant rhinitis to filtering face-piece particle masks during COVID-19 pandemic. World Allergy Org J doi 10.1016/j.waojou.2020.100474
  6. Marler H, Ditton A (2020) “I'm smiling back at you”, exploring the impact of masks wearing on communication in healthcare. Int J Language Communication Dis doi 10.1111/1460-6984.12578
  7. Peeples L (2020) Face masks: what the data says. Nature 2020 Oct;586(7828):186-189.
  8. Pfattheicher S, Nockur L, Böhm R, Sassenrath C, Petersen MB (2020) The emotional path to action: empathy promotes physical distancing and wearing of face masks during the COVID-19 pandemic. Psychol Sci 2020 Sep 29;956797620964422
  9. Prather KA, Wang CC, Schooley RT (2020) Reducing transmission of SARS-CoV-2. Science 2020 Jun 26;368(6498):1422-1424.
  10. Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Devine J, Erhart M, Napp AK, Becker M, Blanck-Stellmacher U, Löffler C, Schlack R, Hurrelmann K (2020) Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Ärztebl Int 2020; 117: (in press).
  11. Regli A, Sommerfield A, vonUngern-Sternberg BC (2020) The role of fit testing N95/FFP2/FFP3 masks: a narrative review. Anaesthesia doi: 10.1111/anae.15261
  12. Samannan R, Holt G, Calderon-Candelario R, Mirsaeidi M, Campos M (2020) Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD. Ann Am Thor Soc doi: 10.1513/AnnalsATS.202007-812RL
  13. Scheid JL, Lupien SP, Ford GS, West SL (2020) Commentary: physiological impact of face mask usage during the COVID-19 pandemic. Int J Environ Res Public Health 17:6655
  14. Shack AR, Arkush L, Reingold S, Weiser G (2020) J Paediatr Child Health 56:1475-1476
  15. Singh I, Pavarini G, Juma D, Farmer M (2020). Multidisciplinary research priorities for the COVID-19 pandemic. Lancet Psychiatry 7(7): e36, doi: 10.1016/S2215-0366(20)30228-5
  16. Smart NR, Horwell CJ, Smart TS, Galea KS (2020) Assessment of the wearability of facemasks against air pollution in primary school-aged children in London. Int J Environ Res Public Health 17:3935
  17. Spitzer M (2020) Masked education? The benefits and burdens of wearing face masks in schools during the current Corona pandemic. Trends Neurosci Edu doi 10.1016/j.2020.100138
Source: dgpi.de
Article image: Shutterstock / By Maridav

In line with this topic:

Sign up for the Mimikama newsletter

Notes:
1) This content reflects the current state of affairs at the time of publication. The reproduction of individual images, screenshots, embeds or video sequences serves to discuss the topic. 2) Individual contributions were created through the use of machine assistance and were carefully checked by the Mimikama editorial team before publication. ( Reason )