The agency, however, does advise health care workers to wear them (or some other form of eye protection) along with face masks, especially in areas that are experiencing moderate to substantial spread of COVID-19 -19. “Health care workers wear masks and face shields because it's dangerous in health care, but when you have a pandemic, it's dangerous in the community,” says Perencevich, who coauthored a letter in the Journal of the American Medical Association (JAVA) championing more widespread use of face shields.
Similar findings have been published in The Lancet : Researchers looked at studies evaluating the effectiveness of nonpharmacologic interventions and found that eye protection was associated with a lower risk of virus infection. “Eye protection is typically under considered and can be effective in community settings,” the report's authors write.
The chief reason the CDC recommends face masks is because they serve as a form of “source control,” meaning they help to prevent people who have COVID-19 -19 from transmitting the virus to others by blocking respiratory particles from traveling into the air and on to other people. Face shields also have the ability to block respiratory droplets produced by the wearer from spreading to others, but it's unclear how well, the CDC says.
A new study published in the journal Physics of Fluids highlights a downside of face shields when it comes to controlling droplet spread. “Over time, these droplets can disperse over a wide area in both lateral and longitudinal directions, albeit with decreasing droplet concentration,” study coauthor Manner Diana, a professor at the Florida Atlantic University College of Engineering and Computer Science, said in a statement.
They can also “get steamy and fog up.” As well, people who wear face shields on top of their masks may find they need to speak louder and more clearly when communicating with others. Look for one that is “sealed at the top” onto a visor and wraps around the sides of your face to your ears, Perencevich says.
Shield, a trademarked line of face shields manufactured by Verse, comes with claims of providing protection from the spread of COVID-19 -19 by way of an innovative design that is more comfortable and user-friendly. By wearing one of our Shields, you are helping to shield yourself and those around you, your neighbors, customers, nurses and doctors, grocery store clerks, teachers, hair stylists, restaurant servers and so many others.
In addition to this feature, these shields can easily be pulled down when protection from respiratory viruses is less desirable, such as when drinking coffee at your favorite café. Because I’m the pediatrician on the team, however, I’ll try to mostly stay in my lane and focus on their use by children as personal protective equipment.
But honestly, the issues I’ll raise with using Shield to prevent COVID-19 -19 in kids are pretty generalizable. Customer satisfaction is probably not the best primary metric when designing a medical device aimed at the prevention of an infectious disease.
I need a bit more detail when I’m facing a viral pathogen that might put me or my family on a ventilator. Respiratory droplets that are > 5 micrometers in diameter, once expelled from their source (probably Larry in accounting), are quickly pulled towards the center of the Earth by the gravitational force.
If a person is wearing a face shield that is open at the top, as all Shield products except for the one marketed to healthcare professionals are, they are within roughly 3 feet of the source, and their head is situated below said source, their face shield will inconveniently collect falling infected respiratory droplets and direct them towards the eyes, mouth, and nose. In addition to the fact that it involved a different virus, the most glaring problem with using the study as support for Shield products is that the authors tested classic face shields that attach at the forehead, with no gap between the shield and the skin, and that extended down to the chin, just like the CDC recommends.
There have been a grand total of zero studies looking at face shields that attach at the neck and open to the sky, and there probably never should be. Also left out of the above answer is the fact that the study looked at short term exposures to simulated coughs at 1 and 30 minutes.
This is not generalizable to many situations, especially adults at work, or kids in school, both in indoor environments for hours at a time. This is important because there is growing evidence that SARS-CoV-2 is also spread via airborne particles smaller than 5 microns that can float further and for a much longer period of time.
It did confirm that distance from the source of droplet or airborne particles is an extremely important factor in lowering your risk of infection. For all but the very tall, keeping at a distance from people is probably more effective at avoiding illness from the novel coronavirus than wearing a Shield with the neck attachment and getting within 6 feet of an infected individual.
With so many obvious problems with the design of the Shield face shields being marketed to the public, it’s hard to imagine that they would be approved by the FDA for use. Well, though they probably don’t deserve to be, they might barely make the grade, but only after a relaxation of the approval process during the pandemic.
In April, the FDA issued an emergency use authorization that included face shields because of widespread PPE shortages in healthcare settings, making the process extremely simple. Face shields were declared to be exempt from premarket approval and, when marketed for use only in healthcare settings, needed only follow a few general guidelines.
), not have an attached mask component, not burst into flames spontaneously, and cover the front and sides of the face. There is no specific mention of which direction they should point in the FDA emergency use authorization, however it does state that they must be used in accordance with CDC recommendations.
The product is not intended for any use that would create an undue risk in light of the public health emergency; for example, the labeling does not state that use of the authorized face shield alone will prevent infection from microbes or viruses… Not surprisingly, Verse began marketing the new Shield products to the public that same month.
But they took out the part about proscribing labeling that claims that face shield use alone is effective as a prevention of infections and replaced it thus: Yet as I’ve already described above, that kind of language is all over the marketing, which is pretty shady in my humble opinion, particularly given how bad their design is.
If this isn’t undue risk in light of the public health emergency we are experiencing during this pandemic, I don’t know what is. It’s unfortunate that there is nothing in the language of the FDA approval guidance that would require additional protections when such a significant change is made to the form of an existing medical device.
The manufacturers of Shield appear to be choosing comfort and ease of use/customer preference over effectiveness in the design of products that they are selling to the public. It’s dangerous to promote what is essentially an untested medical device with such low likelihood of preventing the spread of COVID-19 -19.
And the degree to which they’ve contorted the available scientific studies and expert recommendations to give the appearance of legitimate protection is wrong. Face masks remain at the core of the CDC’s recommendations for protecting yourself and others against COVID-19 -19.
However, medical experts say a plastic face shield does not provide adequate protection from COVID-19 -19 when used by itself. “Face shields are excellent at preventing droplets from coming into contact with the nose, mouth, and eyes, which are the body sites that the virus enters to establish infection,” Edmond added.
This is why Dr. Joy Jennings, clinical assistant professor, VAMP Section, at the University of Alabama at Birmingham School of Medicine, noted that plastic face shields work best to “protect the wearer from an infected person when used with a mask.” They found that while face shields did block the initial forward motion of a simulated cough or a sneeze, the expelled droplets were still able to move around the visor and spread out over a large area in an environment.
Jennings also pointed to another study that was done following an outbreak of COVID-19 -19 in Switzerland. In this study, none of the people wearing masks tested positive for the virus.
“Face coverings, regular handwashing, physical distancing, and staying home as much as possible are very good tools. Add a face shield to all of those requisite practices, and you go from ‘good’ to ‘great,'” she said.
To get the most benefit from a face shield, Jennings and Edmond recommend these three things: At first glance, it might seem that face shields would be a good alternative for certain populations, such as those who rely on lipreading for communication or those who have difficulty breathing.
“It will be fabulous when high-quality, clear face masks are readily available that permit us to convey the full range of human emotion and assist those who use lipreading in communication,” she said. If you’d like to buy a face shield, there are a wide variety of retailers who sell them.
Edmond suggested that you can also make your own using common items easily obtained in office supply and craft stores. It was updated on June 30, 2021, to reflect new information about this rapidly evolving situation.
What’s the alternative to foggy glasses, dragon breath, a mask that travels all over your face or just being a hot, sweaty mess all the time? Face shields have been used in healthcare settings for a while now, but they’ve become a staple for medical personnel who have to intubate patients with COVID-19 -19.
Face shields are often worn during a wide variety of medical procedures. This includes surgeries or any procedure where bone fragments, blood or other bodily fluids could get into the eyes, nose and mouth.
“Because they extend down from the forehead, shields protect the eyes as well as the nose and mouth,” says pediatric infectious disease specialist Frank Esper, MD. The coverage that face shields offer is ideal since the new coronavirus can enter the body through those points.
A 2014 study showed that when tested against an influenza-infused aerosol from a distance of 18 inches away, a face shield reduced exposure by 96% during the period immediately after a cough. However, some people may choose to use a face shield when they know that they’ll be in sustained close contact with others.
In these cases, it’s best to wear a mask underneath the face shield and maintain physical distancing when possible. This will help minimize the risk of infection since face shields have openings at the bottom.
The CDC does not recommend plastic face shields for newborns or infants. As mentioned earlier, masks absorb droplets when we sneeze or cough.