Covid-19: Face masks should not be compulsory for primary school pupils, Hiqa says

The benefit of wearing face masks in reducing transmission of Covid-19 among younger children in schools is likely to be small, according to new health advice.

The Health Information and Quality Authority (Hiqa) has advised the National Public Health Emergency Team (Nphet) that the minimum age recommended for the mandatory wearing of face coverings in schools should remain at 13.

The State’s health watchdog advised Nphet that there may be “unintended consequences” with the use of face coverings by younger children, particularly among very young children who have difficulty in correctly wearing face coverings.

“More touching of faces may occur, including by those supervising children (eg teachers) where they need to assist a child with a face covering; this may lead to closer contact and potentially touching of high-risk secretions,” said Hiqa in its advisory paper on the issue.

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The regulator said that the current guidance does not intend to advise against face-mask use in children aged under 13, but rather intends to state that it is not required in this age group.

Nphet had asked for advice on whether primary school children should wear face coverings and masks amid concerns about the spread across the country of the more transmissible B117 Covid-19 variant.

Primary school students, from junior infants to second class pupils, returned to school on Monday at the start of a phased return of schools over the coming weeks.

While Hiqa said in its latest advice that evidence points to the benefits of face masks in reducing transmission of Covid-19, there are challenges with younger children wearing face masks.

“Any decision to require or recommend face-mask use in children must be balanced against perceived disadvantages associated with their use, for example, potential effects on communication,” said the regulator.

Several members of a Hiqa expert group found that there was a potential for anxiety or negative impacts on the development of communication and language skills, particularly in younger children, from wearing face masks.

International evidence

Internationally, Hiqa found that the use of face masks among children in schools varied widely, with the minimum recommended age ranging from two to 16 years, with the median being seven years.

Hiqa considered face-mask use for children aged 11 and older for pupils in fifth and sixth classes, which would bring the State in line with many European countries, but thought this “may prove confusing” for children and households if younger classes did not have to wear masks.

Dr Máirín Ryan, Hiqa’s deputy chief executive, gave a presentation to Nphet on the regulator’s latest health advice ahead of the public health team’s regular Thursday meeting.

The best way to ensure schools remain low-risk environments is the continued use of public health measures such as physical distancing, hand hygiene, cough etiquette, increased ventilation and students not attending school if they have a Covid-19 symptom, she said.

“These measures should not be limited to the classroom: high levels of adherence are necessary when students are moving between classrooms, when on school grounds and when travelling to and from school,” said Dr Ryan.

Hiqa stressed that school classrooms appeared to be a “well-controlled, low-risk environment” for Covid-19 transmission, with a higher risk of transmission during transport and travel to and from schools, as well as from mixing of pupils during break times and social interaction.