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Are face shields better than masks for COVID-19?

6 Comments on Are face shields better than masks for COVID-19?
Image by Engin Akyurt

Health care workers and restaurant servers seem to be wearing face shields to avoid contracting COVID-19. So should we all be wearing them, too?

The bottom line: face shields add extra protection for people who need it—but only if worn and cleaned correctly.

SARS-CoV-2, the virus that causes COVID-19, spreads most commonly through droplets that hang in the air for a short time and then fall to the ground and onto nearby surfaces. They are most concentrated within six feet of the infected person emitting them. There’s some debate about the degree to which these droplets remain airborne, so let’s begin by making it clear that mask-wearing and hand washing are of primary importance in preventing or decreasing transmission of the pandemic virus.

Is it time for a face shield?

Face shields may add an additional layer of protection and are most useful if you have to be in close contact with infected people (less than six feet). It makes the most sense for frontline healthcare workers to wear them, but you’ll also see shields being used by restaurant staff, for example. There’s probably an argument for teachers and professors to wear them as schools open up, as there will be times when educators need to step inside that 6-foot radius to help a student.

Face shields are most protective if worn over a mask, and not in place of a mask.

If you’re caring for a sick family member or frequently find yourself in situations where social distancing is compromised, a face shield could be useful to you. It may also be useful for those who have trouble keeping their hands off their face when wearing a mask. When I’m working in the hospital, I prefer face shields for eye protection. I find that goggles and safety glasses fog up with mask-wearing.

Which shields work against COVID-19?

I don’t recommend buying disposable shields and trying to reuse them. Many disposable shields have foam around the headband, and that foam can’t be thoroughly disinfected. The disposable shields I’ve come across are not made of robust enough plastic to survive heat treatment as a means of disinfection, either.

I recommend getting a durable, reusable face shield. More durable shields can be properly cleaned with disinfectant wipes or solutions. They can also be used for safety when crafting or doing other projects around the house.

Uvex Bionic Face Shield

Uvex Bionic Face Shield

Sturdy, reusable, and easy to disinfect. Works when in close contact with people who might be carrying SARS-CoV-2, but also does double duty when I make cold-process soap.

If you have a full facepiece air-purifying respirator, like one from our guide, Best gas masks and respirators for survival, that will also work.

In the face of supply chain woes, face shields can now be hard to come by. So people are getting creative. 3D printing is becoming common, and so is the use of very simple and very common household items:

https://www.instagram.com/p/B-w9K2mn2mH/?igshid=ly898x67d8q7

I don’t see anything wrong with using homemade shields if needed. A headband can be laundered, and the binder sleeves can be tossed and replaced. It’s not stupid if it works! (But maybe don’t try to reuse those page protectors later.)

Practical tips

For general information and especially if you plan to make your own face shield, follow JAMA’s advice. Make sure the shield:

  1. extends below the chin,
  2. extends to the ears on each side,
  3. does not have a gap that exposes the forehead between the headband and the shield, and
  4. is made of smooth, solid materials (this is what allows it to be disinfected) if you plan to reuse them.

Avoid alcohol and ammonia as disinfectants on flimsier materials, as they may damage the material and make it less protective. Don’t use acetone on plastic or rubber. Use approved disinfectant wipes or cleaning solutions, and allow shields to dry before reuse. To avoid respiratory irritation, disinfect outside or in a well-ventilated area. Allow some time before reuse so traces of disinfectant can dissipate—I’ve heard complaints from shield-wearers that constant exposure to disinfectants on the mask is irritating. If you have a reactive airway, disinfecting and reusing shields without drying time may not be ideal.

Whether you have a commercial shield or a homemade one, it’s probably wise to spot-test your disinfectant to make sure it doesn’t corrode the material or warp it. Warping could make the surface porous and harder to disinfect. Corrosion could cause the clear plastic portion of your shield to become cloudy and unusable.

Stephanie Arnold | cosmicpixle

Stephanie Arnold is an advanced practice psychiatric nurse and a doctoral candidate in UA Tuscaloosa’s DNP program. Stephanie moonlights from time to time at UCLA teaching mental health nursing. She also likes making cold-process soap.

  • 6 Comments
    • Hardened July 11, 2020

      Good point that foam can’t be thoroughly disinfected!

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    • Hardened September 13, 2020

      The recommended face shield in this article requires a hard hat to work and I don’t have a hard hat.  I wish I’d read the description more carefully (or that The Prepared had warned me about this) before purchase.

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    • CamilleContributor September 29, 2020

      Recently people have been getting very lax about wearing masks where I live so I’ve been considering acquiring a face shield to wear overtop my mask when I have to leave the house. 

      https://www.etsy.com/listing/794834349/face-shield-face-mask-adults-face-mask?ga_order=most_relevant&ga_search_type=all&ga_view_type=gallery&ga_search_query=gizda+face+shield&ref=sr_gallery-1-1&organic_search_click=1&bes=1&col=1 

      I found this one which has a lot of good reviews (including some from people like hairdressers who have routinely disinfected it in between each client for months on end) and it seems sturdy. I like that it’s a hood and not something that sits tightly like a headband which could dig in or cause a headache after having it on for a while. Any thoughts on this? It seems to hit the JAMA requirements you outlined…but it’s definitely not medical grade/industrial as it comes from Etsy. 

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      • Stephanie ArnoldContributor Camille September 29, 2020

        Hi Camille, I think it would work fine. The biggest rec to follow is that it covers ear to ear and doesn’t have big gaps over the forehead. Just make sure it can be wiped clean without damaging the surface with cleaner–you can do this by spot cleaning a small section to make sure it doesn’t go opaque. 

        6 |
    • Nomore October 31, 2020

      When I was doing influenza pandemic preparation ~10 years ago (I got H1N1 flu when it went around in 2009-10, not fun, I became a pandemic prepper after this, then I had a still living parent with dementia to care for & I was it for his caregiving, also not a good situation) I went to the safety & protection gear section of either Lowes or Home Depot (I forget which) & bought 2 face shields (suitable for using in a home woodshop, maybe for doing some light metalworking as well) for ~$15 each.

      I think AO Safety is no longer making these, but they look a lot like this model (extends down well below my chin, ends about halfway down the length of my neck, covers back to both ears, the cap-like partial helmet covers part of the top of my head as well as my entire forehead, it adjusts like a baseball cap at the back & also to a lesser degree at the top, has a very strong polycarbonate plastic clear shield piece that can be replaced if broken):

      https://www.grainger.com/product/AO-SAFETY-Faceshield-Visor-for-Headgear-8UK71

      Back in 2009-10, people in the know about flu pandemic preparedness were also buying (non-sterile, non medical grade) N95 respirators in the paint or protective gear sections of big box hardware stores, but also back then as there were Tamiflu shortages & other issues, the stocks on the N95s would run out or low from time to time. This was definitely a preparedness problem then as well.

      Remembering that back during the earliest days of the HIV-AIDS pandemic in the 1980s & 1990s, surgeons & surgical teams would wear plastic face shields (they were worried about potentilly virus-infected blood splashing them in the face, i.e. eyes, nose & mouth, though a sterile surgical mask at least covers the last 2), that was when I chose to grab a few face shields for future flu pandemics (well at least I got the respiratory part right, global out of control coronavirus pandemic, who knew?).

      Having the face shield on is *excellent* protection for droplets, less so for aerosols though larger aerosols tend to either sink or hit the face shield & not your face first, it would take some unusual airflow to go down under the bottom end of a sufficiently long face shield & drift up to reach your mouth nose or eyes. My faceshield covering so much of my face & beyond would really make it hard to get infected, but you can add a fabric nose & mouth covering, a surgical mask or a N95 respirator if you have one for far more protection for yourself.

      With just the fabric covering over your nose & mouth, you are more protecting others than yourself & if they cough or sneeze on it, well, yikes!

      What a face shield gives you is the critical EYE protection. Glasses or sunglasses do this a bit, SAFETY glasses or goggles, do this better, but again they don’t cover nearly as much of your face as a face shield would. And that plastic is impervious to virus sized particles (though it is harder to breathe behind, they can get humid & foggy) Even an N95 allows some permeability & they can’t be cleaned or disinfected or reused forever (they were designed to be only for single use protection, I’m so nervous for the health care professionals who are reusing N95s, to me that’s unnecessarily crazy risky, but here we are, sigh.)

      When I was studying for my PhD in an influenza lab, the big thing I had to become aware of is how much people touch their faces around or near their *eyes* (to rub them, to scratch an itch). If you try to touch your eyes & you have a faceshield, safety glasses (they wrap a bit around the sides of your face in the eye area) or safety goggles on, you touch plastic before you touch your infection-vulnerable eyes. It smudges the clear plastic but no virions (virus particles) get through the plastic.

      And I can drink from a straw (have tested this, works fine, you have to hold the cup lower than usual & not bump a straw against the outer surface of the face shield bringing it up to your mouth which like the outer surface of any face covering you should assume is virus exposed & infectious) & possibly eat with a faceshield still on (not with a mask or other cloth face covering on though, that’s impossible)

      Anyway my only issue with my faceshield is that it scrapes/chafes a bit across my forehead but I’m going to experiment with putting moleskin on the hard plastic strap that comes into contace with my forehead it to reduce the forehead scratching/chafing. Moleskin has a sticky side that could be adhered & then peeled off the hard plastic forehead band & replaced when I need to deep clean the face shield.

      I just need to remember to keep Windex & paper towels in my car (more to clean off fingerprints than to disinfect the face shield) so I can see better (I need reading glasses for fine print when grocery shopping etc, it’s a bit awkward for face shield use, but manageable) I really like the EYE protection of the face shield which is something even an N95 doesn’t take into consideration.

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