Saturday, July 24, 2021

Which Masks for Children?

 Nicole and Maggie asked in the comments which masks I would recommend for kids.  So, here's my opinion for schools/ daycares/ non medical settings: 

  • The mask your kid will wear, which is fitted as tightly as the child will tolerate, is the best mask for your child.
  • The objectively best mask is a N95; not only are they very difficult to find, but they are SO uncomfortable for many hours.  (Yes, I have personally worn them for many hours.) Your kid will likely poke at the edges and pull it out for air. 
  • This makes them much less effective, oddly enough. N95 fit also starts to degrade after 5 on/off cycles, and is very poor after >10 in general, so they are probably not a great idea for children
  • Cambridge masks in a size small or medium have excellent filtration and fit parameters (especially with a head strap); they are hand but not machine washable.   
  • Good child-sized KN95s, assuming they were actually tested correctly, are less uncomfortable than N95s, but hard to fit closely to the face.  Again, a KN95 with any air gap is probably no better than a surgical + cloth mask.   (I have also worn KN95s for many hours.  If they're not going in and out when you breathe, they're not tight enough.)
  • A cloth mask + a tied/tucked surgical mask (see here at the very bottom) has very good filtration properties and is relatively comfortable, plus you can swap out the surgical mask in the middle of the day; surgical masks in children's sizes are also widely available.

 What are my kids going to be wearing?  Probably just cloth masks.  Our schools do all require masks for everyone, and transmission in our schools has not been high (though it will certainly be higher in the near future- note that titre and transmission are not linearly related, however).  My concern level is low (if yours is higher that is fine!), and therefore it's not worth it to me to make them miserable.  If new data come out that are concerning, I'll re-evaluate, but that's where we are now.  

Drop your recs in the comments if you want!

P.S. The Wirecutter does recommend one actually machine washable cloth mask for kids.

11 comments:

  1. Thanks for this! We're going to do some testing for fit on her today. I did get a very cute Enro (wirecutter link) earlier that matches an outfit my MIL just bought her but was holding off on giving it to her until her birthday this week, but we'll probably give it to her now so we can check for fit and order more if need be. Most of the masks we have for her that would be fine if other people were masking (because they protect others) are not going to do a great job protecting her.

    DH had a conversation with DC1 yesterday about masking at school for his little sister's sake even though he's vaccinated (did I mention that his high school last year had literally 2x the infections of the other equally sized high school? and his history teacher got covid a week and some change after we saw kids going unmasked in his class via zoom last year). He'll just be using the cheap Old Navy masks that he prefers, but he's much less at risk, so we're ok with that. He said he was fine with masking if it meant he didn't have to shave. (He's at the cannot grow a beard but can get patchy hairs stage of his development.)

    I'm strongly leaning towards staying single masked in class myself until DC2 is fully vaccinated.

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    1. I set a bin up by the door for dirty masks; it didn't catch all of them but it helped (I washed them all in a mesh bag). Maybe you already have something like that! And a good mask that accidentally went through the wash is probably still pretty good.

      Our campus is requiring proof of vaccination for all students and employees. I'm going to wear a mask when I'm indoors with unvaccinated people, but at work I think I'll be fine.

      I'm still not 100% sure what our school district decided but I'm pretty sure masks will be required (my friend on the school board asked me and that was my recommendation, including for my vaccinated 12 year old...)

      Your school district sounds like a bit of a pandemic dumpster fire.

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    2. We are legally not allowed to require vaccinations. Or masks. Because we’re a state school and the state government has a law about it.

      The entire South is a pandemic dumpster fire right now.

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    3. Virginia has kind of stopped being the South! (Many of our state schools are requiring vaccination, mercifully. If you don't like it, you can apparently transfer.) Though the pandemic response here has not been spectacular, I guess it could be worse!

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  2. So after testing, the enro we had (she loved the pattern and was actually wearing the shirt that matched today) and the two kenneth coles we already had fit much better than any combinations of surgical and cloth masks or disposable masks we tried. The childsize KN95 was just too big, though she's keeping some in her backpack in case of emergency.

    I let her pick out 6 more enro masks (which are supposed to be delicate cycle) and then got a couple cambridge masks (handwash only but with the plastic part maybe she'll remember not to throw them in the wash?).

    The Kenneth Coles are also great, but they're 5 layers and thus very hot. Which is fine in the winter, but not so much in a Southern summer.

    I feel a *bit* more relaxed now. I know it's not perfect, but it's something.

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  3. Off-topic, but I was wondering if you had seen the Lancet article about cognitive deficiet resulting from Covid, and what you thought about it if you had.

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    1. Yes, and it's hysterical bullshit in that any ICU stay is associated with significant functional and cognitive decline. Congratulations, you were at death's doorstep, it was not good for you!

      They had 11,000 people who reported any difficulty breathing ever and 386 positive covid tests. The strongest effect was among the hospitalized, especially those on a ventilator. This is a crappy study and the least of the reasons to not.... get sick enough to need a ventilator (overall survival: roughly 30% for all causes!)

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829162/
      https://deliriumnetwork.org/ltci-icu-delirium-blog/
      https://www.nature.com/articles/s41598-020-72109-0
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829162/
      https://www.nejm.org/doi/full/10.1056/nejmoa1301372
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975139/

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    2. That should be 50% survival, sorry. Tablet screen...

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    3. P.S. There is no way all 11,000 of those people had covid AND this study has literally no idea how many did. It's like asking your students who's ever seen a walrus, without specifying picture or in person, and then drawing conclusions about their love for pet fish from that.

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    4. Twenty-ish years ago, my Father-in-Law was on a ventilator for 6 weeks because of a bad bout of pancreatitis. Can confirm that it's been bad for his brain and overall function, and he's still dealing with aftereffects.

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    5. Thank you! I knew you could sort this out.

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