The new normal, forced by the COVID-19 pandemic, includes the use of face masks: either medical grade or fabric made. But some experts advise those with access to face shields to use them instead because they are better than masks.
The advantages of face shields over face masks were unveiled by the American Association of Retired Persons (AARP), a US-based interest group. Certain experts recommended face shields for those who could obtain them. The primary advantage of these shields was the capability to block the whole face, including the eyes, from biologics that could reach mucus membranes. At the same time, face shields could be disinfected and reused, compared to surgical masks.
Contagiousness of COVID-19 Compared to Other Communicable Diseases
Like some communicable diseases, COVID-19 has no cure or specific treatment. Clinicians often apply supportive care to prevent patients' health from declining, while letting their immune system develop the necessary antibodies against the SARS-CoV-2 virus. However, other known communicable diseases have vaccines that can protect communities. This clear difference between COVID-19 and other contagious diseases makes the former a big threat.
As such, health experts are always reminding the public to take preventive measures, such as physical distancing, proper handwashing, and wearing face masks, to reduce the chance of contracting the novel disease. If augmented with proper hygiene and not touching the face, the reduction will be significantly greater. For the masses, there are several items they can use to avoid the virus. Face masks, face shields, and gloves are some that can form a barrier between them and the pathogen. Though, gloves are the least advised because they can act as a petri dish and spread microbes from one surface to another.
According to Statista, a German portal for statistics, the contagiousness of COVID-19, as of January 23, 2020, was found to be lower than other communicable diseases. Its basic reproduction rate or R naught was between 1.4 and 2.5, meaning a carrier of SARS-CoV-2 could infect more than two people on average. Measles remained with the highest R naught between 12 and 18. A person infected with measles could infect up to 18 other individuals. It is followed by the eradicated smallpox from five to seven and polio from five to seven as well. Mumps came next with R naught between four and seven, HIV from two to five, SARS-CoV-1 of the severe acute respiratory syndrome from two to five, and influenza from two to three. Ebola virus disease had the least R naught from 1.5 to 2.5 in this list.
But Ebola has a higher fatality rate of between 25% and 90% or 50% on average. Based on the details from Our World in Data, an online source of research data, the fatality rate of COVID-19 was significantly higher in the early months of 2020. Across China, as of February 20, 2020, the recorded fatality rate of the novel disease was up to 17.3%. In Wuhan, it was over 20% and when the cases declined weeks later, the rates dropped to as low as 5.8% in that city while 0.7% throughout China.
Face Shields vs. Face Masks
Recently, experts explained why face shields could be better than face masks. In areas where the availability of these items might be high, people are advised to use them more often than face masks. Several advantages could be gained in using shields instead of masks. Simultaneously, specific disadvantages from using masks would be eliminated in using shields. These pros and cons were the factors detailed by the experts.
"There's a lot of at least biological possibility to suspect that [shields] are definitely better than homemade face masks, and maybe even better than other types of masks as well, because they not only prevent you from spreading it … [and] because it also covers your eyes, it provides more protection to the mucus membranes of your face where you might be getting infected," said Dr. Amesh Adalja, a pandemic preparedness expert at Johns Hopkins Center for Health Security, quoted AARP.
First, face shields cover the whole face of the wearer. This blocks the majority of elements from the front side. So, when someone coughs, sneezes, or spits, the shield hinders the liquid droplets and prevents it from reaching the wearer's mucous membranes. Second, the wearer may no longer depend on homemade face masks if they have shields. This removes the burden on the lungs. Wearing face masks for an extended period can be detrimental to breathing.
Third, standard face shields are transparent. These items protect people from liquid droplets without obscuring faces. Even with physical distancing, face shield wearers can still spread their beautiful smiles, in spite of this pandemic. Fourth, face shields enable clear verbal communications between individuals. Face masks, regardless of material, can decrease voice quality and impact those with hearing problems. But with face shields, people can talk as normal without worrying too much about exchanging saliva or liquid droplets while conversing. If a wearer coughs or sneezes, their own droplets are blocked by their face shield.
And finally, likely an important factor in some regions, face shields are reusable. Wearers can simply disinfect them using soap and water, alcohol, and sanitizers. Once disinfected, the shields do not lose their potential to block liquid droplets. The only time face shields are no longer viable is when some parts have been damaged. A single crack on the surface is enough to call for a replacement.
If face shields are sufficient against COVID-19, why do people use it with face masks? In clinical settings and specific workplaces, there is another danger that people must be aware of: aerosols. Healthcare workers are often seen wearing both face masks and face shields if not the full medical suit. The face shields are intended to block particulate matter while the face masks are for filtering aerosols and the virus. Since SARS-CoV-2 can be transmitted via aerosols, wearing a mask in definitive settings is a must. However, not all settings have hazardous encounters with aerosols.
The bottom line is: wearing a face shield is enough for the average person. Kristi Carnahan, a registered nurse in the Emergency Department at Stanford Hospital, said the average person cannot gain more benefits in combining both face masks and face shields. Although particles can still go upwards under the shield, someone intentionally sneezing from that direction is a very rare circumstance. As long as social distancing is practiced, the wearer has a high chance of avoiding the virus.