The use of masks is not recommended for children under the age of five, the Union health ministry said on Thursday. The ministry released a revised set of guidelines for the treatment of Covid-19 in children and adolescents.

Those aged six to 11, may wear a mask depending on the their ability to use it safely under direct supervision of parents, the ministry said. Those aged 12 and above should wear masks under the same conditions as adults, according to the guideline.

The health ministry also said that the use of antivirals or monoclonal antibodies was not recommended for coronavirus patients under the age of 18, irrespective of the severity of infection.

Monoclonal antibodies are laboratory-made proteins that mimic an antibody to evoke a faster immune response in the body against the coronavirus and prevent severe disease. They target the spike proteins on the surface of the virus to stop it from entering human cells and multiplying.

As for the use of steroids to treat coronavirus patients under the age of 18, the health ministry guidelines said that they should be given “at the right time, in right dose and for the right duration”.

Steroids should be avoided in the first three to five days since onset of symptoms, the guidelines stated. Even after they are used, the dosage should be tapered over 10 to 14 days, subject to clinical improvement, according to the health ministry.

The ministry has also recommended separate modes of treatment for asymptomatic, mild, moderate and severe infections.

For post-Covid care, the guidelines suggested that children with asymptomatic infection or mild disease should receive routine childcare, vaccination if they are eligible, nutrition counselling and psychological support.

In case of moderate and severe infections, the parents or caregivers of the children should be counselled during their discharge from hospitals, regarding monitoring for persistence or worsening respiratory difficulty and explained the indications for bringing the child back to the health facility, the health ministry said.