Gina Ferazzi / Los Angeles Times through Getty Images
Week by week, we answer “frequently asked questions” about life during the coronavirus crisis. If you have a question you would like to consider, email us at firstname.lastname@example.org with the topic line: “Weekly coronavirus questions”.
Between face shields, neck nuts and goggles, protection options are becoming more complex. What configuration for the face mask offers the best protection against the virus?
There has been a lot of news covering the face this week. A study by Duke looked at the effectiveness of a variety of coverages and resulted in titles like this from Washington Post“Wearing a garage neck can be worse than no mask, researchers find.”
Neck guitar lovers – those fabric tubes that slide over your head and pull over your nose and mouth – were on the side.
The Philippines then decided that you should wear a plastic face shield when you go out.
One thing is clear from the research: Wearing a covered face can save lives.
But there is still much we do not know.
The debate over neck collection illustrates why there is still confusion.
Outdoors practitioners often like guters – they are easy to pull up and down and there are no ear loops that can catch the ears or just slip.
But this week, a study by Duke seems to have concluded that wearing a jacket is worse than no mask at all when it came to protection. (The researcher hypothesized that the porous texture of the bagpipe was likely to spread large COVID-19 particles into much smaller ones, which could then stay in the air for longer.) And the media was quick to launch into the market.
Dr. Michael Edmond, infectious disease specialist at the University of Iowa, has some points to make about the study.
“One thing to understand is that they [tested only] a guitar, made of neck shear – which is a very thin fur, “says Edmond. This is a synthetic material. He says:” I would be interested to know if the proven guitar was made of a different fabric with multiple layers if it will be more protective “.
In other words, he would like to see more data before he knew if he was going to come down all gaiters.
And this is generally true for face masks that seek to protect others from every viral particle released by the wearer – and even protect the face mask.
Dr. Vicente Diaz, who specializes in inflammatory and infectious eye diseases at Yale Medical School, agrees. He says that while Duke’s study provides a good starting point, there are many other factors to consider in assessing gaiters – such as test circumstances and specific gaiter used.
“What they found was that when the topics talked for ten minutes, [gaiters] seemed to allow particles [spewed by the wearer] to explode and even spread faster, “he says.” But it can be a function of the material used as well as the design of the face mask. “
Moreover, outdoor practitioners are … outside … where transmission risks are lower than inside. And runners can also follow social distancing guidelines, which will further reduce the risks to others – which is why some reports have said you should not be in such a hurry to ruin your pair.
A ScienceNews story, by Jonathan Lambert, acknowledges that there is indeed much to learn about the role of masks in helping prevent the spread of COVID-19. But according to Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, quoted in the story, “the prevalence of evidence for both COVID-19 and previous viruses suggests that cloth face masks, and that includes properly dressed neck gaiters, filtered most of the viral particles and provide a protection for an individual “.
Then the question of plastic face shields arises.
Edmond thinks they are quite delightful.
When it comes to the biggest viral spots, he says, a face shield is likely more protective than a face mask.
Moreover, a face shield covers the eyes – a possible entry point for the virus – he points out. This is something no guitar or mask can do.
And while it’s easy to wear a mask the wrong way – letting it slide down your nose or hang from your chin – it won’t happen with a face shield.
The shields are also easy to clean with spray disinfectant, or just soap and water, says Edmond.
Then again, facial shields are not 100% effective either.
“Weaknesses [with face shields] is that we do not know how well they work for source control, “says Edmond – in other words, limiting your viral particle transmission if you are infected.” This is another thing we are waiting for in the data to really give us answers for “
As such, Edmond says the safest approach combines a mask and a face shield to provide maximum protection from viral particles for oneself and others. He notes that when a face shield is worn over a mask, it can offer the advantage of protecting the mask itself – by keeping it from getting virus particles.
Diaz points out that the eyes are another area to protect, if you have the opportunity to do so. He says studies have found that when eye protection was included as part of the disease control strategy, it significantly reduced the rate of coronavirus infection.
“When it comes to the eye, we’ve learned that they seem to be involved,” says Diaz. “Of course the virus can be noticeable, and approximately 60% of people who present with COVID infection have been observed to have redness of the eye as a presenting symptom.”
Edmond says it is probably easier for most people to wear face shields than skin-tight glasses when it comes to eye protection. However, it depends on your preference. If you need to protect your eyes and do not want to wear a shield, goggles would work. Just make sure they are actually goggles and not safety goggles, which you can tell by “close enough contact with your face” without a gap.
“If fitted properly, the goggles will be very protective,” he says.
Diaz says eye protection can even start with the simplest choices – even choosing glasses instead of contacts can create an additional hurdle. After all, the best protection is what you will actually wear – so it is a good idea to do as much as you are comfortable with climbing consistently.
As a general rule, Diaz says it is essential to consider your health risk when prescribing a face mask or regimen. If your day-to-day life is particularly dangerous – say, you are a healthcare worker – or you are immunocompromised, “the more protection the better”.
Edmond says he adapts his personal attire to the situation.
“If I go to the grocery store, where I do not anticipate that there will be people very close to me, I will usually wear a shield, unless the store specifically says you should wear a mask,” he says. “But if I had to be in a class where there are a lot of people for square footage – I would probably wear a mask and a shield. And the same thing if I’m on a plane.”
Diaz follows a similar lineup – wearing a surgical mask in public, and an N-95 / face shield combination at work, where he works closely in the eyes of patients. Diaz says the most protective options are respirator masks that filter out viral particles, or N-95 masks, although for most people, they are difficult to use.
But a mask that has a breathing valve or vent – making breathing easier – gets a thumbs up from the Centers for Disease Control and Prevention. In guidelines updated late last week, the CDC explains that one-way air sources allow air (and thus, potentially infected respiratory particles) to be released, so valve masks fail to prevent COVID-19 transmission.
“For the general public, we are in consensus that at least one cotton mask is beneficial,” Diaz says. “Beyond that,” he says, “the more you do to protect yourself, the better.”
Pranav Baskar is a freelance journalist and US citizen born in Mumbai.