As face shields continue to steadily grow in popularity and visibility, many people are wondering what’s better: face shield? Face mask? Both?
Donning a face mask as a preventative measure for COVID-19 has become the norm in South Africa and many other parts of the world. But we’ve all heard the face mask complaints: “I wish I could breathe more comfortably”, “my glasses always fog up”, “people can’t see my face”, “it hurts my ears” – the list goes on. Could there be another option that doesn’t come with these irritations?
What about face shields?
Chances are you’ve already seen one, but a face shield is essentially a rigid piece of clear plastic that’s attached to a headband with the plastic piece covering your face to below your chin. For the medical community, face shields are nothing new – they have, for the longest time, been an essential part of personal protective equipment (PPE). Often, medical professionals wear face shields together with medical face masks – sometimes they use goggles instead of face shields – but the recommendation is not necessarily the same for the public.
Could a face shield offer the same, or even better protection, without all the discomfort that comes with a face mask? Three medical experts from the University of Iowa wrote an opinion piece in the journal JAMA offering their expert insights on the matter.
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“Face shields offer a number of advantages. While medical masks have limited durability and little potential for reprocessing, face shields can be reused indefinitely and are easily cleaned with soap and water, or common household disinfectants,” the paper said.
“They are comfortable to wear, protect the portals of viral entry, and reduce the potential for autoinoculation by preventing the wearer from touching their face. People wearing medical masks must often remove them to communicate with others around them; this is not necessary with face shields. The use of a face shield is also a reminder to maintain social distancing, but allows visibility of facial expressions and lip movements for speech perception.”
Is a face shield effective?
How COVID-19 is transmitted remains an inconclusive matter, but the majority of the evidence points to the suggestion that COVID-19 is spread through infected droplets emitted in close proximity (below 1.8 metres) to one’s eyes, mouth or nose or through direct contact with those droplets with your hand(s) and then touching your eyes, mouth or nose – just like most other respiratory viruses. The way that the virus has played out so far makes it unlikely that it is airborne.
“This implies that simple and easy-to-use barriers to respiratory droplets, along with hand hygiene and avoidance of touching the face, could help prevent community transmission when physical distancing and stay-at-home measures are relaxed or no longer possible – the major options for such barriers are face masks and face shields,” the paper says.
The key shortfall of masks is the fact that they don’t protect your eyes as well – and this is a great selling point for face shields.
Led by infectious disease expert Dr. Eli Perencevich, the paper strongly advocates for the use of face shields and uses a 2014 simulation study’s findings to drive their suggestion forward.
A repeated version of the study using the recommended social distancing of 1.8 metres concluded that face shields could reduce one’s immediate viral exposure by 92%.
Face shield worn during a one-hour walk in 13mph sustained winds with 35mph gusts. No problem – actually no watery eyes, which was nice. Ball cap did blow off once #faceshields pic.twitter.com/zScHp0Kvom
— 𝙀𝙡𝙞 𝙋𝙚𝙧𝙚𝙣𝙘𝙚𝙫𝙞𝙘𝙝 🤚 🧼 (@eliowa) April 19, 2020
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One of the primary benefits of wearing a mask is that it protects both the wearer and the person that the wearer is interacting with, but there isn’t enough evidence to suggest that a face shield can offer this kind of two-way protection. In other words, even though it would seem that you’re protected when you wear a face shield, it’s not yet clear if a face shield can protect someone else when you sneeze or cough when wearing it.
This is why Hopkins Medicine recommends wearing a face shield if you’re in close contact with someone that isn’t wearing a mask.
“If you maintain social or physical distancing of at least six feet [1.8m] between you and other people when in public places, you will not necessarily need a face shield,” the statement says. “A face shield may provide some additional protection if you must be in close contact with someone who is not wearing a mask.”
So, what should you do?
At the end of the day, it’s clear that, more than anything, there are fewer opportunities to wear a face shield incorrectly versus a mask and face shields are more comfortable. But the jury is still out on face shields, and the recommendation hasn’t yet been provided by the CDC, the World Health Organization, or the SA Department of Health for the public.
Chances are that you won’t be let into supermarkets, clothing stores, shopping centres hospitals and so on if you’re not wearing a mask. So, while a face shield might be an option for you, maybe you should see it more as an additional measure rather than a primary one because you’ll still have to wear a mask when you go out for essential services during the lockdown.
Remember that none of these measures are as effective as they can be if they’re not accompanied by the general COVID-19 prevention guidelines such as maintaining social distancing, washing (with soap) or sanitising your hands often and making sure you don’t touch your face.
Gauteng’s COVID-19 numbers double in a week
South Africa has now completed over 1 million COVID-19 tests (1 028 399) as of 12 June 2020. The total number of confirmed cases stands at 58 568 with 33 252 recoveries, 24 032 active cases and 1 284 deaths.
The country’s recovery rate, 56.78%, is higher than the global recovery rate, which is currently 50.44%.
Gauteng premier David Makhura came out to say that “Gauteng has entered a new period in the battle against the COVID-19 pandemic” after the province’s cases doubled over seven days. Gauteng now has 7 953 confirmed cases of the virus – 4 948 of those cases are active and 57 people have died. Public servants, including public health workers and teachers, account for 335 of the identified cases.
“Cumulatively, 1 033 patients were admitted in hospital, 476 of whom were discharged and 57 succumbed to the infection. Currently, 493 patients are admitted in hospital, 22 of whom are ventilated and 124 on oxygen,” Makhura said in a statement.
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In the same media briefing, Makhura also said that the sale of alcohol under alert level 3 has led to a direct increase in trauma-related cases in hospitals. The provincial government is yet to decide whether the sale of alcohol will continue under alert level 3.
“The cumulative impact is something we can see, especially in the wards,” Makhura said.
“We were happy that some of the wards were empty, [but] some are now filling up. We will say that we are deeply concerned [but] we have not yet come to the decision as the Provincial Command Council that says alcohol should be completely banned; we have been dealing with the effect of it.”
Earlier this week, the minister of police, Bheki Cele, said that the lifting of the alcohol ban has also led to higher levels of crime and believes that it should be banned again.
“I have said it all the time that if I were given the opportunity to run and decide alone, my first prize would be to ban the alcohol because I believe there is a lot of evidence that it is not doing anything good,” Cele said.
