Experts Weigh In on White House Officials' New Face Shields Recommendations

From Good Housekeeping

Americans should always be wearing a face mask while in public during the novel coronavirus pandemic, but White House officials are considering new guidelines around wearing face shields or safety goggles as an added precaution. Earlier this week, two top officials on the White House Coronavirus Task Force — Anthony Fauci and Deborah Birx — both publicly recommended face shields and other eye coverings as a way to encourage Americans to refrain from touching their faces in public.

As Dr. Birx explained on a recent appearance of Fox & Friends, face shields can add an extra layer of protection for Americans who are already wearing masks, which are recommended to prevent asymptomatic individuals from spreading SARS-CoV-2 (the respiratory virus that leads to a COVID-19 diagnosis). "The thing about [the] face shields — we think that they could protect the individuals, and that it would decrease the ability for them to touch their eyes and spread the virus," Dr. Birx, the White House coronavirus response coordinator, told Fox viewers, The Hill reports. "As well as [prevent] those droplets coming towards them. So there are two different technologies for two different reasons."

On Wednesday, Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases, told ABC Health correspondent Jennifer Ashton that he would recommend a face shield or safety goggles for optimal safety. "If you have goggles or an eye shield, you should use it," he explained, adding that eyes aren't addressed by a face mask. "It's not universally recommended, but if you really want to be complete, you should probably use it if you can… Theoretically, you should protect all the mucosal surfaces."

Indeed, the Centers for Disease Control and Prevention maintains that the virus may spread when infectious droplets enter any mucous membrane, a reason why experts have asked Americans to refrain from touching their face as much as possible. The CDC notes that the primary method of COVID-19 transmission is thought to be respiratory droplets that are inhaled when an infected individual coughs, sneezes, or talks in close contact with others, which is why face masks are thought to be crucial. But CDC officials also recommend eye protection for healthcare workers, albeit not for everyday use due to supply concerns. Should you buy a face shield, then? We asked working epidemiologists to answer some of the most commonly asked questions.

Can a face shield be worn instead of a mask?

The short answer: No. You cannot wear a face shield in place of a medical-grade or cloth-based face mask. Why? "A mask contains droplets from being released into the environment… but face shields protect the wearer from splashes and droplets landing on to the face," explains Sherill Brown, M.D., the medical director of infection prevention for Los Angeles-based AltaMed Health Services. "While a face shield may protect the wearer and others around from large infectious droplets, aerosols will not be prevented from going under and around the sides of the face shield to potentially cause infection," adds Dr. Brown, who is also a clinical professor for UCDavis Health.

Does a face shield work as well as a mask does?

During the pandemic, most healthcare workers have been told to put on face shields when they're working for longer than 45 minutes with a patient who hasn't been tested for COVID-19, explains Ghazala Usmani, M.D., the clinical director of pediatric hematology and oncology at the UMass Memorial Medical Center. The prolonged exposure to someone with an unknown COVID-19 health status in close quarters deems it necessary, says Dr. Usmani, who also serves as president of APPNA, especially since hospitals are setting where highly infectious aerosols may be generated due to equipment usage.

"A face shield will protect our skin and the outside of a mask from being sprayed with infectious material that we may then touch later with our hands and rub into our eyes, mouth, or nose," adds Dr. Brown. "We usually use these in the hospital when a patient is sick in their room where they would not typically wear a mask."

A face shield may add extra protection for essential workers or those who are consistently around strangers in public settings for extended periods of time. But, as the pandemic has demonstrated a lack of personal protective equipment for frontline workers nationwide, they may not be necessary for every single American. "Unless you work in a public healthcare setting, there isn't a need for eye protection in routine daily life," Dr. Usmani explains. "That being said, we should avoid touching our face. Goggles and face shields are effective barriers and are recommended only in high risk conditions."

Should I wear a face shield or a pair of goggles?

If you're consistently around strangers or are taking care of someone who is sick, a face shield is a better fit for you in the long run. "Face shields protect all around our eyes and over our entire face, whereas glasses just cover a very small area directly in front of our eyes and are not very protective," Dr. Brown explains.

When selecting a face shield to wear alongside your face mask, consider buying a reusable model that won't put strain on medical-grade PPE supplies for healthcare workers. Many varieties are available online and are made with materials that can be sanitized between uses. You should source a product that completely covers your entire face, wrapping around the sides of your cheeks and extending below your chin, Dr. Usmani says.

If you are concerned about leaving your eyes unprotected while running errands outside, try sourcing a pair of safety goggles — or even a pair of sunglasses in a pinch. These will add some barrier between your eyes and the environment around you, and just like face shields, goggles and glasses may remind you to stop rubbing your eyes while in public.

How do I clean face shields?

Just like face masks, you should avoid touching the front of your face shield while in public or during use, as this could contaminate otherwise clean hands. Disposable face shields are meant to be used only once. Reusable face shields are "considered contaminated after first use," Dr. Brown adds, and should be cleaned in between each use.

Here's how you should clean your face shield at home while wearing clean gloves, according to Dr. Brown's instructions:

  1. Clean from the inside to the outside, as this can help you keep surfaces sanitized while handling, using soap and water.

  2. Remove any dirty or soiled crud or build up on the front of the mask.

  3. Allow to dry.

  4. Use a disinfectant (like Lysol wipes) that you would normally use on a hard, non-porous surface. Apply it to the front and interior of the shield, and let it dry according to manufacturer's directions (on average, keeping it wet for at least 4 minutes).

  5. Let it dry on a hook where it can hang or in a clean paper bag. Be sure to wash your hands after removing your gloves.

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