Today, the American Academy of Pediatrics (AAP), drawing from the latest evidence, issued three new interim guidance documents on the care of children during the COVID-19 pandemic. New recommendations address:

In the guidance on cloth face coverings, the AAP advises they can be safely worn by all children age 2 years and older, including the vast majority of children with underlying health conditions, with rare exception.

“Children are incredibly adaptable and resilient. Just like children understand that they must wear bicycle helmets and buckle into their car seats, they will come to learn to wear masks routinely when necessary,” said AAP President Sally Goza, MD, FAAP.  “This virus is going to be with us for some time, and face coverings are a proven, effective way to prevent the spread of COVID-19. As parents prepare to send their children to school and into childcare settings, cloth face coverings should be part of their new normal.”

The guidance also advises that in addition to protecting the child, cloth face coverings significantly reduce the spread of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and other respiratory infections within schools and other community settings, as well as in the home.  For more advice for parents on cloth face coverings and children, see this article on

In the testing guidance, the AAP offers recommendations to help pediatric practices determine when to test patients for COVID-19. Scenarios that indicate the need for a test include a child who is showing symptoms of the disease, a child who has been in close contact with a person confirmed to have the infection, or patients scheduled for elective surgery.

Because the symptoms of influenza and COVID-19 are similar, testing may be needed to confirm a diagnosis in communities with moderate to high community spread of COVID-19.

The guidance also discusses:

  • The types of tests available
  • The feasibility of testing in the office
  • Processes to consider in scheduling tests, including use of PPE
  • Counseling families on test results
  • Reporting results to public health authorities

In the PPE guidance, AAP outlines strategies to protect pediatric health care providers in ambulatory care settings such as offices, urgent care centers, school-based clinics and homes.  AAP recommends all practices have written protocols for PPE, hand hygiene, disinfection of equipment and physical facilities, and efforts to promote physical distancing.  Higher levels of PPE are necessary during procedures that could generate smaller respiratory droplets at higher concentrations, and to protect staff who are at increased risk of severe illness.