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Masks for All: Exception – Children Under Two Years Old

Author(s): By Donna Hallas PhD, PPCNP-BC, CPNP, PMHS, FAANP

COVID-19 challenges us to ask and answer two questions:
1.) What is the new norm?
2.) Will communities rise to the challenge and accept the new norm?

Masks for All – the only exception being children under two years old truly is the new norm! Are we able to persuade enough individuals, families, community leaders and community members to accept the challenge of living with a new set of norms? One would hypothesize that EVERYONE wants to do their part to stop community spread of COVID-19. Wearing face masks along with social distancing and handwashing are key to preventing the spread of COVID-19. Further, one would hypothesize that these public health measures are the preferred norm rather than individuals throwing “caution to the wind” and placing themselves and many others at-risk for contracting the aggressive COVID-19. So why the resistance to wearing face masks and social distancing?

At this time, we do not know specific reasons for individuals and communities opposing face masks. Perhaps, since some counties and states have only made face masks “a recommendation,” the attitude is “it does not apply to me.” However, some states have mandated the wearing of face masks in public and yet, some remain defiant and refuse to wear them.

What messages can we give to our patients and families? As NPs, APRNs and Midwives, we can help parents understand how to teach their children the reasons for wearing a face mask and the proper way to put on a face mask to be safe. We can also teach our patients how to wear them properly. We have all seen masks being worn on the chin or under the nose. We need to correct that error! We can encourage parents to be role models for their children. Of course, healthcare providers (HCPs) wear masks and other personal protective equipment during in-person office visits, but virtual telehealth visits are an opportunity to role model the wearing of masks that are worn outdoors. In addition, any digital communication with your patients are also opportunities to show your photo wearing an “outdoor mask.”

Yes, we love our freedoms, our spontaneity, our ability to be eating at our favorite restaurants. We love being entertained in crowded arenas, sandwiched in to watch awesome sport events. We are delighted to see our children and grandchildren play freely on playgrounds. We sent our children off to school to be educated without restrictions. But for a while, we must put on-hold many of our freedoms, wear masks, social distance, and maintain the highest levels of personal hygiene to beat COVID-19. We must explain to our patients and families the importance of these measures. Our messages must be loud and clear – we care deeply for the health and well-being of the individuals, families, and communities we serve – but we can only be successful if we can engage the entire community in which we practice to participate, without hesitation, in community health measures that are driven by scientific data. Masks for all is a scientifically driven recommendation!

Donna Hallas PhD, PPCNP-BC, CPNP, PMHS, FAANP, FAAN is a certified as a pediatric nurse practitioner and pediatric primary care mental health specialist. She is a Clinical Professor and Director of the PNP program at New York University Rory Meyers College of Nursing. She has presented nationally and internationally on numerous research and clinical topics with the overall goal of improving health care outcomes for infants, children, adolescents and young adults. 

Her first book, Behavioral pediatric healthcare: A growth and developmental approach to intercepting abnormal behaviors, earned the prestigious American Journal of Nursing 2018 Book of the Year Award earning first place for Psychiatric and Mental Health Nursing and third place for Child Health.

Dr. Hallas is a digital editor for Contemporary Pediatrics and writes a monthly commentary which focuses on applying information in one or more journal articles to pediatric clinical practice. Here is a link to the PNP corner www.contemporarypediatrics.com/pnp-corner.

Dr. Hallas’ most recent research focuses on vaccine hesitancy. She and colleagues designed a web-based intervention study using the concepts of informed decision making and the influence of social media. The study was conducted using two populations: pregnant women  and mothers of newborns and young infants to determine the effectiveness of population-specific web-based interventions to reduce the incidence of vaccine hesitancy (Hallas, Altman, & Fletcher, 2018). The study was statistically significant for prenatal women and approached statistical significance for mothers of newborns and young infants. 

Please click on this link for a brief discussion by Dr. Hallas on vaccine hesitancy and the most recent measles outbreak: https://www.nyu.edu/about/news-publications/news/2019/october/one-question–why-do-some-parents-hesitate-to-vaccinate-their-ch.html.

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