Face coverings during COVID-19: Answers to common questions

Social distancing and proper hand-washing are critical ways to protect yourself and your family from COVID-19. Cloth face coverings are an additional step to slow the spread of COVID-19. Get answers to your frequently asked questions in this Q&A with CHOC Children’s infectious disease experts.

Do I have to wear a face covering in public?

The Centers for Disease Control and Prevention recommends cloth face coverings in public settings in places like grocery stores and pharmacies where physical distancing measures can be difficult to maintain. These face coverings can slow the spread of COVID-19 and help people who may have the virus and do not know it from transmitting it to others. It is not necessary for children under the age of 2 to wear cloth face coverings.

The governor of California has mandated that face coverings be worn by the general public when outside the home. This applies to high-risk situations such as entering public spaces; obtaining medical attention; riding public transit; certain work settings; and while outdoors in public spaces when maintaining a physical distance of 6 feet from persons who are not members of your household is not feasible. Exemptions include children age 2 and younger; persons with a medical condition, mental health condition or disability that prevents them from wearing a face covering; the hearing impaired or those communicating with them; persons seated at restaurants while eating or drinking, provided they maintain physical distancing; and those engaged in outdoor work or recreation alone or with household members while maintaining physical distancing from others. Read the full order here.

Is there anyone who should not wear a face covering?

Children under age 2, or anyone who has trouble breathing, is unconscious, incapacitated or unable to remove the mask without assistance should not use a cloth face covering.

What’s the right way to wear a face covering?

Wash your hands before putting on your face covering. It should cover your nose and mouth, be secure under your chin, and fit snugly against the sides of your face. Make sure you can breathe easily while wearing your mask.

Don’t put the covering around your neck or up on your forehead. Avoid touching your face covering. If you do, wash your hands.

Here’s a helpful video from Dr. Katherine Williamson, a CHOC Children’s pediatrician, on how to wear a face covering:

Should I wear a surgical mask?

N-95 or surgical masks are not recommended for public use, as supplies are needed by healthcare workers and first responders.

How can I make my own face covering?

The CDC offers tutorials for sewn and non-sewn face coverings.

What’s the best way to remove my face covering?

Untie the stings behind your head or stretch the ear loops. Only hold your face covering by these ties or strings to avoid transferring any germs that may be on your hands onto the portion of the cloth that covers your nose and mouth.

Wash your hands after removing your face mask.

How do I wash my face covering?

Wash your face covering frequently, using one of these methods:

  • In the laundry – It’s OK to include your face covering in your regular laundry. Use your regular laundry detergent and the warmest possible setting for the cloth used in your face covering,
  • By hand – When washing face coverings by hand, the CDC suggests using a bleach solution by mixing 5 tablespoons (or 1/3 cup) of household bleach per gallon of room temperature water OR 4 teaspoons of household bleach per quart of room temperature water. Soak the face covering in the bleach solution for five minutes. Then thoroughly rinse with cool or room temperature water.
    • Always check the label on your bleach before using. Ensure your bleach is intended for disinfection, and that it’s not past its expiration date.
    • Never mix household bleach with ammonia or any other cleanser.

Why should I wear a face covering?

Many people with COVID-19 have no symptoms. Wearing a face covering helps protect others in your community – like those with autoimmune disorders or the elderly – in case you’re infected but don’t have any symptoms.

How can I help my child who is afraid of face masks?

Some children may incorporate mask wearing into their daily lives with ease, while others may find it odd, uncomfortable or even scary. If your child is having trouble wearing a mask, here’s advice from a CHOC pediatric psychologist on how to ease their fears.

Additional resources
The Orange County Health Care Agency has a printable graphic that offers an overview of how to wear and wash your mask available in multiple languages:

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Coronavirus: What parents should know

We know how frightening it may be for parents to hear news reports about the 2019 novel Coronavirus (COVID-19). Get answers to your frequently asked questions – and some peace of mind – in this Q & A with CHOC Children’s infectious disease experts.

What is COVID-19?
COVID-19 is a disease caused by a novel strain of coronavirus. Coronaviruses are a large family of viruses and commonly infect people around the world with mild upper respiratory infections. Sometimes coronaviruses that infect animals can evolve and become a new human coronavirus strain. These can cause more severe illness. The current outbreak began in Wuhan, Hubei Province, China and has spread to other countries, including the U.S.

Who is at risk for COVID-19 infection?
Mostly people older than 60 and those with pre-existing health conditions are at greater risk. Additionally, people who have had contact with people confirmed to have COVID-19. Based on available evidence, healthy children do not appear to be at higher risk for COVID-19 related complications compared to adults, according to the CDC.

How do you get COVID-19?
We are still learning exactly how COVID-19 spreads. What we do know though that the virus is spread mainly from person-to-person contact. This can happen when people within 6 feet of each other inhale respiratory droplets produced when someone speaks, coughs or sneezes.

COVID-19 is thought to be spread primarily through inhaling droplets produced when someone coughs or sneezes or by transmission between people in close contact.

Can someone spread the virus without being sick?
The CDC reports that recent studies show a significant portion of individuals with COVID-19 lack symptoms. Even the people who eventually develop symptoms can pass the virus to others before showing symptoms. This means that the virus can spread between people interacting in close proximity — for example, speaking, coughing or sneezing — even if those people are not exhibiting symptoms.

Can I get COVID-19 from touching an object?
This is not thought to be the main way the virus spreads. However, it is possible that someone who touches their nose, mouth or eyes after touching a surface with the virus on it could possibly get the virus.

What are the symptoms of COVID-19 infection?
Symptoms can include fever, cough and shortness of breath. The CDC has identified muscles aches and loss or taste or smell as additional possible symptoms. For an updated list of possible symptoms as reported by the CDC, click here.

Symptoms typically appear two to 14 days after exposure.

According to the CDC, the symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose and cough. Vomiting and diarrhea have also been reported.

How can I protect my family from COVID-19?
With no vaccine currently available, the best way to prevent illness is to avoid being exposed. It’s also important to take preventative steps:

  • The CDC recommends the use of cloth face coverings in public for those over age 2
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing or sneezing. Get more information on hand-washing— and here’s a fun graphic.
  • The CDC recommends laundering items including washable plush toys as appropriate following the manufacturer’s instructions. When possible, use the warmest appropriate water setting for the items and let them dry completely. Laundry from an ill person can be washed with other people’s items.
  • Check out this list of how to prepare your household for a potential COVID-19 outbreak.

Should my children and I wear masks?
The CDC recommends cloth face coverings in public settings in places like grocery stores and pharmacies where physical distancing measures can be difficult to maintain. These face coverings can slow the spread of COVID-19 and help people who may have the virus and do not know it from transmitting it to others. It is not necessary for children under the age of 2 to wear cloth face coverings.

The governor of California has mandated that face coverings be worn by the general public when outside the home. This applies to high-risk situations such as entering public spaces; obtaining medical attention; riding public transit; certain work settings; and while outdoors in public spaces when maintaining a physical distance of 6 feet from persons who are not members of your household is not feasible. Exemptions include children age 2 and younger; persons with a medical condition, mental health condition or disability that prevents them from wearing a face covering; the hearing impaired or those communicating with them; persons seated at restaurants while eating or drinking, provided they maintain physical distancing; and those engaged in outdoor work or recreation alone or with household members while maintaining physical distancing from others. Read the full order here.

Here’s guidance from the CDC on how to properly wear a cloth face covering, as well as tutorials on how to make your own mask.

N-95 or surgical masks are not recommended for public use, as supplies are needed by healthcare workers and first responders.

Practicing proper cough and sneeze etiquette can help prevent the spread of illness.

My family has upcoming travel plans. Should we cancel?
We recommend following the CDC’s guidance for travel, and for using public transportation.

Should we stay away from gatherings like church, sporting events or amusement parks? What about smaller gatherings?
Fluctuating numbers of COVID-19 cases have led to changes in what businesses and organizations may operate. See updated guidelines here.

When visiting entities that are open, people are encouraged to be mindful that physical distancing and wearing face coverings reduce the likelihood of transmission of COVID-19.

In addition to practicing proper handwashing, people should watch for symptoms and avoid going out if they feel ill. When outside the home, people should physically distance from others whenever possible and wear a face covering.

How can my family stay safe when venturing out?

If you have COVID-19 symptoms or have been exposed to someone with COVID-19, stay home and away from other people. If you choose to leave home, be mindful that the more closely you interact with others and the longer the interaction, the higher the risk of COVID-19 spread.

Before leaving home, the CDC recommends people think about:

  • How many people will you interact with?
    • Being in a group with who people who are not practicing physical distancing or wearing face coverings increases your risk, as does engaging with people who don’t live with you.
  • Can you keep 6 feet of space between yourself and others? Will you be outdoors or indoors?
    • The closer you are to other people who may be infected, increases your risk of getting sick.
    • Indoor spaces are more risky than outdoor spaces where it might be harder to keep people apart and there’s less ventilation.
  • What’s the length of time you will be interacting with people?
    • The more time you spend with others, the higher your risk of becoming infected, as well as their risk of being infected if there’s any chance you have COVID-19.

Before leaving home, consider the following questions to help determine your level of risk:

  • Is COVID-19 spreading in my community? The CDC’s latest COVID-19 information and map of states with reported COVID-19 infections can help you determine your risk.
  • What are the local orders in my community? Check updates from the OC Health Care Agency.
  • Will my activity put me in close contact with others? Practice physical distancing from anyone who doesn’t live in your home by staying 6 feet apart whenever possible. The CDC recommends wearing cloth face coverings in public. Choose outdoor activities and places where it’s easy to physically distance, like parks.
  • Am I, or is someone in my home, at risk for severe illness? If so, take extra precautions. Older adults and anyone with underlying health conditions can be at increased risk for severe illness from COVID-19.
  • Do I practice everyday preventive actions? Continue to monitor for symptoms, staying home if you’re sick, practice proper handwashing and physical distancing, and wear a face covering in public.
  • Will I have to share items or equipment with others? Choose places where there is limited sharing of items and where any shared items are cleaned and disinfected between use.

See the CDC’s full guidance of venturing out safely.

My kids are worried about COVID-19. What can I do?
Check out these tips from a CHOC psychologist about reducing children’s anxiety about COVID-19. This comic book was developed to help kids understand COVID-19 and lessen their fears. The Orange County Health Care Agency has developed some kid-friendly infographics to help children understand what they can do to help stay well: English | Spanish

What should I do if I think my child has COVID-19?
Call your healthcare professional if your child has a fever, in addition to a cough or breathing difficulty, and has had close contact with a person known to have COVID-19, or you live in or have recently traveled to an area with an ongoing spread of the virus.

Do not go to the doctor’s office without calling first. Your provider will work with the local healthcare agency to determine whether testing is necessary.

Speak to a CHOC nurse 24/7 to answer your questions about COVID-19 and your child by calling 1-844-GET-CHOC (1-844-438-2462).

Parents who suspect their child may have COVID-19 should call their healthcare provider before going to the doctor’s office.

Can my child be tested for COVID-19?
If your child has a cough and fever, particularly with underlying health issues, call your doctor to discuss if testing is needed.

How is COVID-19 treated?
There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions.

What is the link between COVID-19 and MIS-C?
Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts become inflamed, and many children with MIS-C have previously been diagnosed with or exposed to COVID-19. Scientists are still studying the correlation, but this Q&A with a CHOC pediatric infectious disease specialist answers parents’ most common MIS-C questions.

Can I transmit COVID-19 to my baby through breastmilk?
Current guidance from the CDC states that a mother who has been confirmed or suspected to have COVID-19 should take all precautions to avoid spreading the virus to her infant. Learn more here.

Can I transmit COVID-19 to my pets?
Until experts learn more about how this virus affects animals, treat pets as you would other human family members to protect them from a possible infection. The CDC offers the following guidance:

  • Do not let pets interact with people or other animals outside the household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash, maintaining at least 6 feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

There is a small number of animals around the world reported to be infected with the virus that causes COVID-19, mostly after having contact with a person with COVID-19. Talk to your veterinarian if your pet gets sick or if you have any concerns about your pet’s health.

If you have a confirmed or suspected case of COVID-19, limit contact with your pets, just like you would with people. If you must care for your pet or be around animals while you are sick, wear a cloth face covering and wash your hands before and after you interact with them.

Call your veterinarian with questions or concerns on your pet’s health before bringing them to the veterinary clinic.

Who can I call for more information about COVID-19?
Speak to a CHOC nurse 24/7 to answer your questions about COVID-19 and your child by calling 1-844-GET-CHOC (1-844-438-2463).

Also, the Orange County Health Care Agency is taking calls from the public about COVID-19. Call 800-564-8448 Monday through Friday from 8 a.m. to 5 p.m.

This article was last updated on July 14, 2020.

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Should My Kids Get the Flu Shot This Year?

Many parents have expressed concern over the last few months that this year’s influenza vaccine may be less effective than in years past and wondering, “Should my kids get the flu shot this year?” These concerns stem from data released after Australia’s flu season, where recent reports indicated low effectiveness of the vaccine.

“We’re using the same vaccine here in the United States, so people think it won’t be effective,” says Dr. Jasjit Singh, a pediatric infectious disease specialist and medical director of infection prevention and control at CHOC Children’s.

dr-jasjit-singh-choc-childrens
Dr. Jasjit Singh, a pediatric infectious disease specialist and medical director of infection prevention and control at CHOC Children’s., addresses parents’ annual concerns over, “Should my kids get the flu shot this year?”

These doubts are misguided, says Singh. Although reports show Australia’s vaccine was only 10 percent effective, that data was specifically looking at the H3N2 strain that had dominated the southern hemisphere this year, she says. Effectiveness against the same strain in the US has been as high as 30-40 percent, and even higher against other strains of influenza in the past.

“We can’t take that one statistic and apply it to all strains of the flu in the US this season,” Singh says.

It’s important for parents to remember that the although the vaccine helps prevent children and adults from getting the flu, physicians are especially concerned with preventing influenza-related hospitalizations or even death.

“People forget that children and adults can die from influenza. So far in the U.S. there have been nine pediatric flu-related deaths this season,” Singh says.

Since the 2004-2005 flu season, flu-related deaths in children have ranged from 37 to 171 each season, according to the Centers for Disease Control.

A recent study published by the American Academy of Pediatrics examined vaccine effectiveness in 291 pediatric influenza-associated pediatric deaths from 2010-2014. Vaccine effectiveness was 51 percent in children with high-risk conditions, compared to 65 percent in children without high-risk conditions.

“This shows that many of our deaths are in otherwise healthy children,” Singh says.

Although it’s best to get vaccinated early in the season, it’s better to be vaccinated later in the winter than not at all.

“Very often, people get vaccinated because someone they know has the flu. It takes two weeks for the vaccine to take effect, so if your child has been exposed to the flu in that time period, they can still get sick,” she says.

Parents should remember that children cannot get from the flu from getting a flu shot.

“The vaccine is not a live vaccine, so it’s impossible to get the flu from getting a flu shot,” Singh says. “the vaccine prevents influenza virus, but during winter months there are many other viruses that cause colds and respiratory viruses, that are usually milder than the flu.”

Those who decline a flu shot because they “never get the flu” still need to be vaccinated, she adds.

“It’s important to remember that some people may have minimal symptoms, but can still pass the virus to others who may be vulnerable to more severe disease.”

The single best way to protect your child from the flu is by getting them vaccinated each year. In addition to receiving an annual influenza vaccine, there are other things parents and caregivers can do to help prevent the flu. Use proper hand-washing techniques, use respiratory etiquette, and stay home from work or school if you are sick with the flu, to prevent spreading it to others.

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