Episode Eight: Face Masks 101
You voiced your questions and concerns about the ASD School Start 2020 plan, and the District heard. Starting this week, ASD will air a twice weekly, pre-recorded Q&A session with a variety of ASD and community member hosts and guests who will take a deep dive into the details of what school will look like this fall. Videos will post by the end of day every Tuesday and Thursday leading up to the start of the school year. Topics will dig into everything from teacher tricks to encourage social distancing among young students (airplane arms!)? to how will my senior be best prepared for post-graduation life during a pandemic?
Send us your questions here! The District wants to hear your thoughts and comments to be considered for inclusion in the interview.
Jen Patronas- Thank you for tuning in to "Airplane Arms: Navigating Back to School." I'm Jen Patronas, the director of Health Services for the Anchorage School District, and today we're gonna be talking about masking and what that looks like when we return to in-person learning. With me today, I have Dr. Patricia Clay, pediatrician of Southcentral Foundation and also the school health liaison for the American Academy of Pediatrics Alaska Chapter. I also have Kathy Bell, pediatric intensive care nurse, charge nurse at Providence Hospital, and also school nurse of Goldenview Middle School. Thank you for being here with us today.
Dr. Patricia Clay - Thanks for having us.
Kathy Bell -Thank you.
Jen Patronas - Dr. Clay, one of the most common comments and questions that I get from parents and community members is the fear that their child can't breathe while wearing a mask. Can you talk to us a little bit about that?
Dr. Clay - Yeah, of course. That's a really common concern right now that a lot of parents are asking us as well and, unfortunately, there's a lot of false information floating around about masks and oxygen levels. The purpose of wearing a cloth face mask is to create a barrier to prevent the spray of respiratory droplets, or spit or saliva, when we cough or laugh or sneeze or just even talking. These respiratory droplets can carry the virus that causes COVID-19, which is why we're worried, and we're especially worried in people who have the virus but don't show any symptoms, which means they don't know that they should stay at home and not be in the group setting. So while cloth face masks can prevent the spray of respiratory droplets or at least help decrease it, it easily allows oxygen in and carbon dioxide out because those are really tiny molecules and they easily pass back and forth. For people who wear masks all day at baseline, that could be people in healthcare such as surgeons or nurses or respiratory therapists, they have been wearing masks all day, 12 hours a day, for years and years without any decreases in their oxygen level or increases in their carbon dioxide level. I do think there's an adjustment period for kids to get used to masks, which I think we'll talk about in a minute, but I think what most kids are experiencing is this kind of new sensation or difficulty having something on their face and with practice and parental support, they can definitely adjust.
Jen Patronas - So it doesn't cause you to lose oxygen level or breathe in more carbon dioxide?
Dr. Clay - No, it doesn't. When you think about a cloth face mask, it's really just a piece of fabric or two pieces of fabric. And you think about even the clothes that you're wearing and air easily comes in and out all the time and that's all breathing is, is moving air in and out. So oxygen's coming in and carbon dioxide is coming out just like it is normally.
Jen Patronas - Okay, well, who shouldn't be wearing a face mask?
Dr. Clay - That's a good question too. The vast majority of children can wear a face mask easily and safely. The only exceptions are children under the age of two, children with cognitive or developmental delays or disabilities that would prevent them from safely removing a mask on their own, and then the last group would be people with very severe asthma or severe chronic lung conditions. But I would argue that if someone has severe asthma that they're having daily symptoms, things like that, they probably shouldn't be going to school in the first place and they also should really touch base with their pediatrician. For those with more chronic lung conditions, I would encourage parents to reach out either to their pulmonologist or their pediatrician for more guidance.
Jen Patronas - All right, thank you. Kathy, Dr. Clay mentioned that a good way to get children used to wearing a face mask is to practice. Can you talk to us about some good ways to help children get used to wearing a mask?
Kathy Bell - Well, most children, I hope, have gotten used to it a little bit now because when they're going out in public, if they're greater than three years of age, then they should be wearing them when they go to the store, when they go any place with their parents, go to any social events, along with staying six feet back. But they can also practice wearing it at home. So we're starting this year off with school online, virtual, and children can practice wearing the mask during their school time, also, or during different times at home. Like if they're watching a family movie together, they could practice wearing their mask. I also think it's important to practice taking the mask off and which way to place it on the table and also practice putting it on and off if you wanna have something to drink or have food.
Jen Patronas - Well, when you do take it off, then how are you supposed to place it on the table?
Kathy Bell - Well, you wanna make sure that you're placing, I'm gonna show you with this mask, actually. If this is the outside of your mask, you wanna make sure that the clean side is facing up, and it's best to put it on something like some type of barrier, like maybe a paper towel or a piece of paper that you're using just for that. And then the part that you're putting close to your face, you wanna make sure that that's not touching any other surfaces that may be dirty.
Jen Patronas - Oh, okay. Well, Kathy, I have a second grader and he's extremely active and gets very sweaty. How often should he be changing his mask and how many masks should I be bringing to school with him?
Kathy Bell - Well, you should probably send some extra masks in his backpack because a lot of second graders are probably gonna be experiencing that. They also could be drinking something and spill something on their mask. So if their mask is moist or feeling uncomfortable, it's a good time to change it and the best thing is probably to make sure they put it away, like in a baggie or something in their backpack, and get out a clean one, which means you'll probably have to be washing more masks at home at night to send in. We also provide masks at the school district for emergencies if a kid didn't have enough masks with them and they got all three of them soiled or they felt too moist to be wearing them. The ones that are provided will be looking this and they can use these type of masks. There's some made just for kids and some of them that even have cartoon characters on them, so they will like wearing them, most of them. And so they're welcome to use those too.
Jen Patronas - So what type of mask do you suggest that children wear? Is there one that's better than the other? Can you kinda go over that with us?
Kathy Bell - Yeah, there's lots of different type masks. There's this type, which is a surgical mask, and they make a children's form of this. The one that I've seen most commonly at the hospital has little Disney characters on it and it's really cute, kids love wearing it, and this is probably really good protection. But, also, this cloth mask made just for children, and there's one that have loops like this that go behind your ears, which for some people can be a little irritating. So there's also these type that you can just tie and you can tie them like this and then tie the other part down like this, so all the ties are in the back and they don't have any movement around the ear part. 'Cause I do find myself, if I have to wear one for 12 hours, it's a little bit irritating. They can also wear some different type, there's lots of different type of face shields out here. Here's just one of them. And they can put the face shield on also to wear like this. And this one doesn't have all the pieces to it but it does usually have a piece of foam right here so that it's resting on the head. And they're all very comfortable.
Jen Patronas - So, looks like there's a lot of options out there for different types of face mask. Well, how many face mask do you recommend that I bring with my son again?
Kathy Bell - So, I would bring, he'd wear one, of course, to school and I would send two or three extras. And then if he goes through that many, we'll try to figure out why he's going through so many to begin with, and then we also have some available at school for emergencies.
Jen Patronas - Okay. So, for emergencies, if my son needs to get one, who does he see to get that from, or how does he get one?
Kathy Bell - Well, we'll probably have a limited amount in the classroom for the teacher to give out because we don't want any children walking around the halls without a mask. Or the teacher can always call me and say, "So-and-so has a mask on. "It's the third one today and it's now really moist "and it's irritating to them. "Could you bring me a mask?" But I suspect we'll have a limited amount in each classroom.
Jen Patronas - All right, thank you. Dr. Clay, if I have a parent that's just really concerned about their child wearing a mask and is fearful, where should I direct them or who can they talk to to help calm their fears or maybe even provide some education on that?
Dr. Clay - Yeah, I would really encourage parents to reach out to their child's doctor's office. I know our team has been fielding a lot of questions about masks in the past couple weeks, couple months, really. We're lucky enough in our office to have behavioral health consultants too who've done a lot of work with families and with kids in particular. I do think that even just having parents reach out to their pediatrician's office so we can also check on any other chronic medical concerns and why are they so worried about their kids wearing masks, what are the pros and cons, and making sure that their well visits are up to date and immunizations are up to date. I'd really encourage parents to reach out. We're there to hear from you and this is a really uncertain time, so I would use the medical home for your kids as much as you can.
Jen Patronas - All right. Can they also reach out to their school nurse, Kathy-
Kathy Bell - Sure, they can.
- If they wanna talk about that?
Kathy Bell - For sure, they can. That's what we're there for, to help children get through their day, and sometimes all we need to do is talk for a couple minutes to the child and they feel comfortable then. And many of the schools have social workers or middle school or high school counselors and those people can also help with that and I know I'll be providing some education to my counselors too to help in case I'm busy with assessing sick children. They can help them with their mask concerns. But, for sure, that's what we're there for. I hope they come and I can offer them help and, also, I hope parents will call me.
Jen Patronas - Okay, is there anything else that you wanna add that I missed today?
Dr. Clay - I mean, I would like to emphasize that I think one of the best ways to get kids used to wearing masks, and like you said, I hope they're already kind of used to it, but is really modeling from parents, right? So every time kids are leaving the house, parents should be wearing masks, kids should be wearing masks, and even in the house, I think, with kids who are home with parents, with guardians, during the day, if they're gonna practice during the day, I mean, have the guardian or the parent practice with them. I think that it's much easier for them to learn by seeing it and so making it normal, 'cause that's what's normal right now.
Jen Patronas - Yeah, that's a good tip. I know that my children always remind me to bring my mask whenever I leave the house 'cause it's a habit that I'm not used to quite yet. Anything else that I missed, Kathy?
Kathy Bell - No, the modeling is a great idea though because I know if they see us doing it, they'll do it, and they see their friends doing it, you know, peer pressure's the biggest one of all for most school-aged children. If they see their friends doing it, they'll wanna do it too.
Jen Patronas - All right, well, thank you for being here with us today, Dr. Clay and Kathy, and thank you for tuning in.