Face shield nation

The COVID-19 pandemic may be global in scope, and the practices it has engendered can be found around the world: mask wearing, social distancing, PCR testing, working from home. Nonetheless, every country has its own unique way of responding to the ongoing health crisis.

One example is the Philippines and its wide embrace of face shields. Today, you cannot enter most buildings—from the largest mall to the smallest convenience store—without one. Even in outdoor spaces, you can see people donning face shields while walking on the streets, albeit some with “face shields up,” ready to be lowered once they enter their office building, or see a law enforcer.

Of course, face shields are used in other countries, too, but nowhere else to my knowledge has it been as ubiquitous beyond the hospital setting. During the inauguration of Joe Biden, for instance, it was notable that everyone wore masks—a notable departure from the Trump administration’s cavalier attitude—but I saw no one wearing face shields. Neither the Centers for Disease Control and Prevention nor the World Health Organization has endorsed the universal use of face shields, while Dr. Anthony Fauci only said back in August that “it certainly can’t hurt.”

In contrast, face shield use in the Philippines is reflected not just in practice but in a wide range of policies: At one point the government even required people who are cycling to wear it, before thankfully making a volte-face amid commonsensical pushback. And unique among nations, the Philippines’ civil aviation rules require air travelers “to wear both face shields as well as face masks” inside airports and inflight, “except during meals.”

As a medical doctor, I am a big supporter of using face shields indoors, as well as in outdoor spaces where physical distancing cannot be practiced. Although the evidence is sparse beyond hospital settings, there’s little harm in continuing the practice, especially since the pandemic remains largely misunderstood, and for all we know face shields may have had a significant protective effect in the country.

But leaving aside questions of efficacy, what can explain the appeal of face shields particularly in the country?

To recap, face shields became in vogue in the country in the first few months of the pandemic, at the height of ECQ and MECQ, first by individuals then by commercial establishments. As Michael Tan observed in his May 8, 2020 column, referring to the then-novel face shields, “lay people are sometimes a step ahead of medical professionals when it comes to protecting themselves.” He referenced a Journal of the American Medical Association article that endorsed face shields (Perencevich et al. 2020), which would likewise be cited by public health experts in the country in recommending their use.

The government, for its part, increasingly embraced face shields, requiring them in commercial and government buildings as well as public transport in August and expanding their use to “whenever persons go out of their residences” in December: A blanket rule that it had toyed with since July.

In that latter resolution, the Inter-Agency Task Force for the Management of Emerging Infectious Diseases cited the face shields’ low cost, availability, and “effectiveness in reducing the risk of transmission.” But beyond the science, which remains equivocal even today, we can see how the political milieu is favorable for face shield mandates, given how, as with the rest of the pandemic, the government’s response is characterized by “one size fits all” interventions that place the burden on the public. As I observed back in August, “They are quick to impose requirements on individuals (e.g., face shields, quarantine passes, curfews), but slow to pursue steps that require government itself to act (e.g., contact tracing, mass testing).”

Moreover, unlike in the United States, there is no strong libertarian tradition here that considers such requirements an affront to one’s “individual freedom.”

At the popular level, meanwhile, the uptake of face shields is equally understandable, given its tangibleness as a visible barrier against an invisible virus, as well as its consistency with local notions of hawa (contagion). Just like with masks, people “negotiate” their use of shields depending on where they are and who they are with—and it is easy to see how the poor end up bearing most of the brunt in terms of policing.

As with all other aspects of the pandemic, face shields illustrate that an interplay between science, politics, and culture informs how we respond to COVID-19, and how people experience it differently depending on who and where they are.

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