This is what the health authority recommends for children younger than 18.


Resource details:

Publication title: Advice on the use of masks for children in the community in the context of COVID-19
Author(s): World Health Organisation (WHO) and the United Nations Children’s Fund (‎‎‎‎UNICEF)
Publication date: 21 August 2020

What the guidelines are about:

These guidelines represent the latest evidence on how children (younger than 18) should wear masks to curb the spread of SARS-CoV-2, the virus that causes COVID-19. Experts from the World Health Organisation (WHO) and the United Nations Children’s Fund (‎‎‎‎Unicef) compiled the recommendations with inputs from specialists in organisations such as Infection Prevention and Control (IPC), the Guidance Development Group (GDG) and the International Paediatric Association (IPA). These organisations reviewed the latest available information on the spread of COVID-19 in children and the risks and benefits of kids wearing masks to prevent the transmission of other respiratory diseases.

The WHO will update the guidelines as new evidence develops.  

Key take-aways from the guidelines:

  • Evidence on the effectiveness of children using masks for COVID-19 and other respiratory diseases is limited. 
  • Countries developing policies on mask-use for children should uphold the interest of the child, protect their developmental and learning outcomes and take into account the country’s specific context, including any resource limitations.
  • Countries that decide to use masks for children should also monitor the effects of this decision on children’s health, mental health and whether it reduces SARS-CoV-2  infection. 
  • The use of face coverings, such as masks and face shields, should be one part of a comprehensive COVID-19 prevention plan

Cloth masks

  • Children younger than five years of age shouldn’t wear masks. The rationale for this recommendation includes the developmental milestones of children in this age group. By the age of five children should have the motor skills to use a mask with minimal assistance
  • For children aged six to 11 years the need for mask usage should be based on how much community transmission there is. Other considerations include whether the child lives with elderly relatives and the child’s capacity to comply with mask-wearing rules. 
  • Children between the ages of 12 and 18 should follow the guidelines for adults using masks. These advise that medical masks be reserved for healthcare workers and the use of nonmedical masks be coupled with other preventative strategies such as social distancing and hand washing.  
  • There is little evidence on the use of masks for children. The WHO recommends countries do what is best for the child and which does not interfere with developmental and learning goals. Other considerations should include what is practical and affordable especially in settings where children have disabilities, for example. 

Medical masks

  • For children with weakened immune systems, or those suffering from diseases such as cystic fibrosis or cancer, the use of medical masks is usually recommended. A medical mask is a mask that efficiently filters out small, potentially infectious particles from the air. The use of these masks should be discussed with the child’s doctor. 

Mask exemptions

  • Children younger than five years who have severe cognitive or respiratory impairments and struggle with masks should not be required to wear the face coverings. 
  • Mask wearing should be assessed on a case by case basis for children of any age with health conditions that would inhibit the use of masks. In these cases wearing masks should not be compulsory. 
  • Children should not wear masks while playing sports. 

Face shields or visors

  • Face shields protect the eyes from bodily fluids.
  • There isn’t a lot of research to show how effective face shields are to curb the spread of the new coronavirus. The shield design allows for droplets being exhaled or inhaled in the gaps between the visor and face. It doesn’t provide the same filtration that a cloth mask does. 
  • Face shields may be a beneficial alternative to cloth masks for children with hearing or auditory impairments. The use of cloth masks could hinder the learning outcomes of children who require speech signaling and lip reading.    
  • Face shields should cover the entire face and extend below the chin. 
  • Reusable shields should be cleaned with soap and water and disinfected with sanitiser each time they are used.

South African regulations

Find and download the World Health Organisation’s guidelines.
Download South Africa’s guidelines

[Please note: Information on the new coronavirus is rapidly changing. Please refer to the World Health Organisation website for the latest information. Visit www.sacoronavirus.co.za for updates on South Africa’s coronavirus response.]