Masks vs shields

With the COVID-19 pandemic, lay people are sometimes a step ahead of medical professionals when it comes to protecting themselves.

This has been clear in the way, early on, Asians in particular insisted on using masks even with health authorities saying they should be used only in hospitals.

The problem was that there was a shortage of the medically-approved masks, partly because of hoarding and partly because the supplies were coming from China, which had to face its own needs as the epidemic raged there.

But that didn’t stop Filipinos from improvising, sometimes to the horror of medical people, who saw disposable masks all grimy and dirty from being reused, or masks being worn incorrectly, not quite covering completely the nose and mouth, or people touching the masks constantly to readjust or scratch an itchy nose, among other reasons.

That touching has a fancy medical term, autoinoculation, referring to the danger of contaminated hands introducing the virus to the mask when you touch, and the virus penetrating the cloth and entering your mouth or nose.

As the pandemic worsened, people began making their own masks out of handkerchiefs, bandanas, ski caps, motorcycle masks, and even underwear and undergarments.

Then the medical people relented, the World Health Organization finally advising that cloth masks can help when you’re outdoors; but save the surgical masks and the N95 masks for hospital personnel, it said. They also warned against touching your mask.

These days, you’ll find masks of all kinds being sold even on sidewalks, some with quite nice, sometimes wacky, designs. They’re cheap, too, ranging from P30 to P50 each, compared to P28 minimum for the medical 3-ply masks and more than P100 each for the N95.

Advice for do-it-yourself masks has exploded as well on the internet, even in staid newspapers like the New York Times.

Meanwhile, too, I began to notice people wearing face shields, which was initially part of the personal protective equipment (PPE) for hospital staff. Because they were associated with hospitals, I used to think they were technologically sophisticated stuff like those astronauts’ headgear.

Turns out the shield is a simple contraption, using plastic (or acetate) to protect your face completely, with a headpiece or headband to keep it in place.

Again, lay people caught on quickly. I first saw them being used by supermarket checkers, then shoppers themselves. The internet now has many sites offering programs so you can produce them using 3D printers.

UP Diliman fine arts students, very early on, were producing them for our own health staff and security personnel, and have posted their own guide for 3D printing. (Do a search of “UP CFA Fablab COVID 19 face shields”.)

The medical people have been silent about the face shields being used outside of hospitals, but in the latest issue of the online journal of the American Medical Association, an opinion piece by three physicians from the University of Iowa (Perencevich, Diekema, and Edmond) proposes that these face shields could probably be introduced for community use because, for several reasons, they are even more effective than masks.

First, they cover not just the nose and the mouth, as masks do, but also the eyes, which are potential entry points for the virus.

Second, the face shields are more comfortable to use, especially when it comes to breathing.

People complain all the time about the difficulty with breathing for masks, and in fact the N95 masks have warnings not to use for prolonged periods because the pores are so small and could affect respiration.

With face shields, you breathe easy because there’s space between the shield and your face.

Third, the face shields prevent autoinoculation, or the contamination from the hands that I described earlier. If your hands reach up toward your face, you only touch the plastic, which the virus can’t penetrate.

Fourth, the face shields can be quickly cleaned with soap and water and reused indefinitely.

Finally, the face shields are much better for communication. You don’t have to remove a shield to speak up and because your whole face can be seen, communication is much better because you can see each other’s facial expressions and lip movements.

Back to nonmedical wisdom: Here’s a video from lawyer Marichu Lambino of our College of Mass Communications demonstrating an instant face shield using a cap and any piece of plastic or acetate: https://youtu.be/oMNkPrn2Yxg

Announcement: This evening at 6:30, church bells will ring out to protest the closure of ABS-CBN. Not masks, not shields, but a muzzling of press freedom.

mtan@inquirer.com.ph