What are the best masks for children to wear at school during the omicron surge? | Quick Guide

January 31, 2022

An Oakland Unified student wears a KN95 mask provided to her by the district.

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As the more highly transmissible omicron variant continues to be the country’s dominant Covid strain, health experts are recommending adults and children upgrade from cloth or surgical masks to higher quality masks such as KN95s or KF94s.

Children in California are required to wear masks indoors at all times while at school, but the state doesn’t mandate a specific type of mask. Some school districts, such as Oakland Unified, Berkeley Unified and West Contra Costa Unified, have ordered KN95 masks for children since their return from winter break, and after students, parents and teachers demanded them.

For the most part, though, California parents who want their children wearing the most protective masks have been left to fend for themselves. Parents of children younger than middle and high school-age have the added struggle of finding child-size versions of the masks amid a nationwide shortage.

The state Office of Emergency Services is currently distributing a total of 6 million child-size KN95 masks to county offices of education, which will distribute them to schools.

For students who don’t have access to those masks, California public health officials advise wearing a surgical mask or a surgical mask with a cloth mask on top. Students who wear fabric masks are advised to opt for ones with three or more cloth layers. Any mask worn comfortably by a student is better than no mask at all, public health officials said.

What constitutes a high-quality mask, and why are they better at preventing Covid than cloth or surgical masks?

The California Department of Public Health considers respirator-style KN95s, N95s and KF94s to be the best for preventing Covid. That’s because they are made of synthetic fibers that filter at least 95% of the particles in the air – 94% for KF94s – when worn properly. Though N95s offer the highest level of protection against Covid according to the U.S. Centers for Disease Control and Prevention, they are not intended for children’s use, so the National Institute for Occupational Safety and Health has not approved them for children.

Cloth and surgical masks aren’t as effective at filtering out smaller air particles, experts say, which means it’s easier to inhale aerosol droplets containing the virus.

KN95s are made in China to Chinese standards, and KF94s are made in South Korea to South Korean standards.

What if my child won’t wear a KN95 or KF94 mask?

Though respirator-style masks have better filtration than others, their effectiveness depends on whether they are worn properly and consistently, according to the CDC. If the mask is uncomfortable on a child, causing them to frequently take it off or wear it incorrectly, a respirator-style mask isn’t as beneficial. For this reason, Harvard Medical School professor of pediatrics Dr. Rick Malley said surgical masks may be a more realistic option for children.

Masks typically have a fit guide on the packaging, but generally, masks should completely cover the nose and mouth, fit snugly against the sides of the face and not have any gaps. They should only be handled by the ear loops, cords or head straps and not by the surface of the mask, according to the CDC

Dr. Sten Vermund, dean of the Yale School of Public Health, told New York Magazine that parents should make mask-wearing “fun and gamelike” if their child refuses to put one on.

Can the masks be reused?

Outside of health care settings, experts say it’s safe to use KN95 and KF94 masks more than once, though how many times they can be reused depends on their condition and proper storage.

The virus that causes Covid-19 has an expected survival time of 72 hours, so one should wait at least that amount of time before using the mask again, according to the CDC’s recommendations for health care workers. The CDC recommends storing masks in a “breathable paper bag” in between uses, and other experts say keeping those paper bags in a dry, sunny spot can help deactivate the virus.

There’s no hard-and-fast rule as to how many times a mask can be reused, experts say, though the masks degrade at least a little with every use from the moisture caused by breathing. If it’s damaged or the elastic band is stretched out so that the mask no longer fits snugly, if the material looks dirty or if it becomes hard to breathe through, it’s time to throw it out. Getting the masks wet will degrade them, so experts say don’t try to wash them.

Experts advise throwing the mask out even after one use if it was worn in close contact with someone who is tested positive for Covid.

How do I know I’m getting a real KN95 or KF94 mask?

The growing demand for KN95 and KF94 masks has given rise to the sale of fake, substandard masks, especially on Amazon. The CDC estimated 60% of KN95 masks sold in the U.S. in 2020 and 2021 were counterfeit.

Some online mask listings have obvious signs of fraudulence. Since KN95 and KF94 masks aren’t certified in the U.S., any such mask claiming to be certified by the National Institute for Occupational Safety and Health, or NIOSH, is likely counterfeit. And since NIOSH hasn’t approved N95 masks for children, any mask claiming to be a child-size N95 is also likely fake. The CDC keeps a list of counterfeit respirator products here.

Nonprofit personal protective equipment clearinghouse Project N95 vets its masks, as do U.S.-based distributors Bona Fide Masks and Wellbefore.

Can I use a mask that is past its effectiveness date?

As mask stockpiles are tapped, some families could be provided with masks that are older than the expiration date indicated on the packaging. NIOSH has determined that respirators can still be effective after their expiration date, but only if they are stored correctly in a cool, dark place. Though the masks’ filters generally maintain their functionality past their expiration date, the ear loops or headbands could be degraded by sunlight, according to Bona Fide Masks

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