December 3, 2021

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Should the use of the mask be permanent in children outside the infection?

Jose Gomes Real

No one doubts that the use of the mask and social distance are the two best measures to try to control the infection, while the vaccines do not reach the entire population. There is no doubt that the number of deaths prevented by this double health measure is incalculable.

In addition, in the child population, we saw a drastic decrease in the number of regular viral infections during that period. Now, as these infections decrease, should the use of masks during the period of high cycle of respiratory germs (autumn-winter) persist in the child population? What will be the impact of that decision on the health of children?

Hygiene Hypothesis: A Controversial Theory

There is a controversial theory of Hygiene hypothesis It contributes to the normal development of the immune system by exposing various pathogens in childhood and prevents various diseases related to immune deficiency such as allergic processes and diseases called autoimmune diseases.

According to its author, epidemiologist David Strachan, the absence of this expression may lead to defects in the normal tolerance of harmless antigens. In other words, if we overprotect children from regular contact with childhood infections, we will “rudely” ruin our immune system.

This theory was published in 1989 with many followers, such as protesters. At the time it sought to explain the rise of allergies in the 20th century as the reason for abandoning the rural environment and reducing family size. A child), excessive hygiene or antibiotic abuse with other factors.

The question of balance

This theory is being revised and updated over time Explored the causal mechanism. Lack of exposure to infections creates an imbalance between people with two main effects: Th1 / Th2 cells. The two functional branches of our immune system must function in balance. Inadequate processing of the Th1 branch (which is usually active in infections) in particular can lead to over-activation of the Th2 branch, which is primarily responsible for allergic processes.

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I do not consider myself a serious defender of this hypothesis because it has great limitations as it cannot be used by all people and does not even take into account the genetic burden of the individual. However, I believe that the child’s immune system should develop its normal maturation process. Continuous interventions (such as permanent masks) over time can alter the normal development of the immune response.

After all, our immune system Gradually matures in childhood, Especially in the first years of life. At that time, contact with the environment, infections and vaccines build up the immune system until it reaches its full maturity.

Also, we will never forget it One reason children do not develop severe Govt-19 disease This is precisely the plasticity of the immune response and the ability of the child’s immune system to constantly confront new infectious agents.

If we continue to use the mask to avoid routine infections at this stage, there is a risk of losing plasticity in the immune response. There may even be problems related to deficiency in controlling the immune system.

Immune credit

The effect of continuous use of the mask during the epidemic phase is called “immune credit”. Newborns who do not develop immunity to other viruses due to birth and other social distances are more likely to become infected with these viruses late and with more virus.

This is true Seen in New Zealand With respiratory syncytial virus (RSV), it is most common in late autumn and early spring and can often be followed by bronchitis. During the period of severe captivity established by the New Zealand government, children were unable to express the full set of environmental variables and pathogens that naturally shape their immune system.

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After the easing of operations in this country, the proliferation of so-called “anti-debt repayment” cases was seen with concern.

Adaptation of protocols to an epidemiological situation

With all of this, I do not mean that the mask should be removed immediately, because I consider premature removal for both adults and children in closed or less ventilated environments.

What I consider completely irrelevant in view of the current epidemiological situation is the use of children’s masks in outdoor activities. Its current use is not justified as withdrawn in the adult population.

I think ethics should be reviewed and updated for all population groups depending on the evolution of the epidemic, always weighing the risks against the benefits of the measures used. And considering the child population.

Jose Gomes Real, Immunology Specialist. Galician Health Service (SERGAS). University Hospital Campus of Santiago de Compostela (CHUS)

This article was originally published Conversation. Read on Original.