Little evidence for facemask use in children against COVID‐19

In a Perspective paper in Acta Paediatrica, Xu argues that the pressure on paediatric respiratory departments Chinese hospitals decreased early 2020 because children were wearing face masks during COVID-19 pandemic.1 He concluded doctors and parents should ask to wear whenever there was high incidence of infections, including COVID-19. I feel challenge those statements. Most countries seem have noted reductions number visiting start global phase pandemic spring 2020. Decreases been emergency departments,2 asthma wards3 and, particular, for cases influenza A.4 But these decreases took place stages pandemic, when few recommended used masks. From personal experience, fewer visited Sweden, despite fact nobody outside health care advised masks.5 The decrease also China does not support suggestion using explained reduction child hospital visits reasons unrelated Although acknowledge abundance studies suggest mask protective effect, evidence may be as rock-solid suggested by some supporters. One most cited papers so far is Chu et al systematic review meta-analysis Lancet.6 this study has important limitations. included looked at other pathogens, rather than did include very undertaken settings. addition, community them are different. It worth noting supplementary material provided al6 indicated presence publication bias, since showed effect more likely published negative studies. Asking potential advantages disadvantages. clearly risk child, well transmission disease. However, it take into account rarely become sick from COVID-19,7 while so-called multi-inflammatory syndrome8 potentially ‘long covid’ occur children,9 complications rare. Face disadvantages, such hindering verbal non-verbal communication. There will keep touching their actually increase viral load hands. Using risks replacing social distancing, tempted send school or daycare if they minor symptoms keeping home. Finally, commercially made currently available, especially N95 said offer greater protection, fit children. Hence use might lead false sense safety, leaking viruses due poor fit. drawback could reduce focus measures important, hand washing, distancing staying home sick. A PubMed search carried out 10 November 2020, which focused masks, virus causes it, identified no offered any guidance That said, an absence same lack effect. If future research suggests morbidity, considered now, do we can recommend with get symptoms7 drive mortality pandemic.10 None.