Should You Buy a Face Shield? – Slate

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Heres a charming face shield that will run you $16.50 onEtsy. Designed for teachers, it has an adjustable band, a sheet of clear plastic to cover your face, and a customizable black board on the forehead, where the vendor will print your name in a calligraphic font. Heres another face shield from the same seller that features a unicorn horn and ears across the forehead, with the wearers name below the chin in pink. Here are some face shields for kids with bears and sharks and mermaids. Here are some plain clear face shields with 11 color options for the headband.
Were well past the point of the pandemic where face masks can be fashionableand now face shields are, too. While the headgear has been a regular sight in medical settings since the spring, theyre beginning to appear more in public spaces as states reopen (even as the virus shows no sign of slowing down). So, should you get one?
Some doctors and teachers have suggested that plastic face shields could be a good substitute for masksafter all, they appear to offer protection while not hiding facial expressions. You probably shouldnt do that. Instead, health experts are urging people to consider face masks as an additional piece of protection on top of a mask (a point that some sellers are careful to make through images and disclaimers). Theoretically, you should protect all the mucosal surfaces, Anthony Fauci told ABC recently. So if you have goggles or an eye shield, you should use it.
Heres what we know, and what we dont, about how face shields can protect us from contracting the coronavirus. Right now, the published research on them consists of one paper from 2014: Efficacy of Face Shields Against Cough Aerosol Droplets From a Cough Simulator. Researchers put a face shield on a head form encasing a breathing machine, and placed it a few feet from another head form spewing droplets of influenza. They measured how much influenza made it behind the face shield, into the mouth of the head form, and down the breathing machine. The face shield did a good job of blocking the cough at first, catching the big droplets. But as the minutes went on, smaller dropletsaerosolsmade their way behind the shield. You put on a face shield and I squirt you in the face with a squirt gunin that case, the face shield works great, William Lindsley, a bioengineer at the Centers for Disease Control and Prevention and the first author of that paper, told me. If I blow cigarette smoke in your face, the smoke lingers in the air. After five minutes, youre still breathing in the smoke. Its also not clear how well face masks work as source controlthat is, as a barrier to particles as they leave someones mouth, as masks are intended to do. (On source control, were trying frantically to get some experiments going to see what we can find out, Lindsley said.) Since shields do block some stuff from reaching the wearer, the 2014 paper concluded that in a health care setting a face shield could be a worthwhile addition to a mask.
You put on a face shield and I squirt you in the face with a squirt gunin that case, the face shield works great.
William Lindsley, bioengineer at the CDC
In addition to offering a little extra protection from splashes of virus, and keeping a mask a little cleaner in particularly germy places, face shields offer some eye protection. Our eyes are connected to our noses via the nasolacrimal duct. The importance of eye protection in the prevention of COVID-19 and other coronaviruses is underappreciated, an article in the journalInfection Control & Hospital Epidemiology argues. Theres evidence that eye infections are possible: Two monkeys were successfully infected with the coronavirus via their eyes, according to a paper that hasnt yet been peer-reviewed. Another paper, also not yet peer-reviewed, describes a study of 72 patients with COVID-19 in which researchers found a virus in the eyes of one patient. We suspect the incidence of SARS-COV-2 infection through the ocular surface is extremely low, the paper says, though they also note their sampling method may have failed to catch some instances of eye-virus, and since their work supports that it can happen, they urge health care workers to use eye protection. After all, even if infection via the eyes is on the rarer side, theyre interacting with many people who are or could be shedding the viruspeople who, in order to receive tests and care, might not be wearing masks constantly while in contact with health care workers.

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Its the leap from health care professionals to everyday people needing this extra step of protection that makes the custom masks with apple and flower illustrations so striking to mewere so deep into this now that cutesy PPE has become reasonable and smart. If youre an essential worker, you absolutely have to wear a mask and face shield, Eli Perencevich, an infectious disease doctor at the University of Iowa, and an author of the Infection Controlarticle, told me. Especially if youre an older teacher, I think I wouldnt feel safe with one or the other, said Perencevich. Hes also in favor of people in low-risk situations being able to choose between a face shield, particularly one that bends around the face like this, or a mask (a position that goes against current CDC recommendations). He cited Lindsleys 2014 paper as evidence that the shields do block the immediate spew of particles, which, epidemiologically, he considered enough. Pushing back, leading aerosol expert Linsey Marr emphasized that face shields do almost nothing against those really tiny particles that people can inhale, whereas masks offer far more protection. Still, she sympathized with the idea that one might want to communicate with other people and not have cloth over ones mouth. Im going to have my group look into a face shield with a hood or a towel on it, she told me. (What does that look like? It looks like this.)
One of the big reasons extra protectionwhether from a mask and a shield, or possibly some kind of beekeeper-eqsue contraptioncan be useful isnt eye protection. Its additional protection, on your whole face, from other people. That includes people who outright refuse to wear masks, and also children who have trouble keeping them on throughout the day. Having not just some eye protection, but extra protection overall, stands to cut down on the viral load wearers might receive. Of course, Perncevich offers the caveat that schools in areas with high case counts shouldnt be opening at all; the PPE is meant to be a backstop, not a permission slip. But if youre obligated to go to work under risky circumstances, protecting yourself as much as possible is wise. With a face shield, says Perencevich, youre less dependent on other people.

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