[roenxi]

> It's not about the money. PPE like face shields are specifically used during procedures that involve...

There is currently a global pandemic afoot that is spread by droplets expelled from people's mouth and nose. What a tool was being used for 2 months ago isn't relevant; the situation is different now.

> Everybody stocking a "handful" of PPE isn't a scalable solution to maintain a national supply.

If masks or face-shields could be cleaned fairly easily then it probably is a scalable supply. Particularly if medical professionals are allowed to supply their own work tools.

[mbreese]

> What a tool was being used for 2 months ago isn't relevant

It is very relevant. These face shields wouldn't protect anyone from airborne/aerosol pathogens or viruses. They have a very specific purpose and that isn't one of them.

If you're talking about adapting construction grade shields (like used for painting, etc) for medical use -- sure. But you aren't going to use a face shield as a replacement for a face mask, which is what it seems like you're arguing for.

If you're saying that you should wear a face shield in public to protect yourself from aerosolized virus -- that's not the point of a face shield. The particles can travel around the sides of the mask too easily. If you want to protect from small, airborne particles, you need a mask.

[dillonmckay]

Nobody is advocating for a face-shield as a replacement for an N-95 mask, but using them together, would reduce the odds of infection.

According to the MIT paper, a typical sneeze will travel over 20 feet.

Additionally, there is mention of the velocity of the particles may be able to penetrate the mask, so a face-shield could help with that, too.

[awaythrower]

Yes. Defense-in-depth. In China, most hospital red zones required 3 layers of PPE, whether that's two masks and a face shield or such. One layer alone is not very good, and a face shield alone is no good. A mask and a face shield are very good, especially for confined spaces like subways and busses where there are jerks coughing and sneezing all over without hygiene or manners.

[woofie11]

What if I want to protect myself and my facemask from large droplets. I also want to protect myself from accidentally touching my face. Is a face shield okay then?

And if so, why not drop $300 million to get one for everyone in the US? They're cheap, wash easily, and that's less than 0.02% of the last stimulus.

[roenxi]

If someone is facing me and a stream of airborne particles hits a plastic shield instead of streaming out to me, it seems pretty likely that I will be protected.

I'm certainly open to the idea that fluid mechanics are complicated and somehow air currents are going to do unhelpful things, but until I find someone with a paper on the topic I'd much rather be talking to someone wearing a face shield than not.

Plus obviously wearing a face shield will protect against self-inflicted infections from a contaminated finger.

[mbreese]

> it seems pretty likely that I will be protected

And you'd be wrong. Sure, a face shield will protect you from liquid streaming out at you (partially). However, it isn't a liquid that you need to protect yourself from in this instance... it is aerosolized particles. And those travel in the air. So when you breathe in, that air can and will move around the face shield.

The sibling comment about smoke moving is exactly right. Smoke is a great example of how small particles can move and travel in the air. If you think that a face shield will protect you from something in the air, you'd be wrong.

Side note: this is how N95 masks are actually fit. (Well, not using smoke, but similar test). If you can smell the chemical used in the test, the fit is wrong.

If you really want to protect yourself from other people sneezing -- stay away from other people. That's why social distancing is still the primary, and best, recommendation.

[BalinKing]

Isn't the recommendations by many countries to wear even cloth masks (e.g. the recent reversal by the CDC) _because_ there's a good chance COVID-19 can spread via large (i.e. non-aerosolized) respiratory droplets? (Not that it doesn't also spread in other ways, but removing even one vector would be better in this case than not doing so.)

[mbreese]

I'm not sure why there is a recommendation to wear cloth masks in other countries (not discounting it, I just haven't looked). However, I believe that the primary rationale for the CDC switching their recommendation that everyone should wear masks has to do with the great numbers of asymptomatic carriers. In this scenario, wearing a mask is not designed to protect the wearer from others. Wearing an ill-fitting mask is not protective to the individual. Instead, wearing a mask is designed to protect others from the wearer. Because people are carriers before they exhibit symptoms (if they ever have symptoms), you can't know if you are infected or not. If you are wearing a mask, you are limiting the potential spread of virus from you. This way, you are keeping any potential virus closer to you so that others are more protected. This goes hand in hand with social distancing. If you use a mask and don't distance yourself, you aren't helping at all. I'm looking for a CDC reference, but this was also the rationale presented in local media reports.

If you're really curious, Ars Technica has a really good writeup of all of the relevant studies.

https://arstechnica.com/science/2020/04/should-you-wear-a-fa...

Most of the research above assumed either surgical or N95-style masks. There was one study that looked at use of cloth (non-medical, non N95) masks, and this was the key finding (from Ars, not the paper):

Wearing cloth masks resulted in significantly higher rates of infection, the authors found. They also noted that in their test, the cloth masks were only 3 percent effective at blocking particles.

Regarding everyone wearing (surgical) masks to protect others:

In a study published April 3, 2020 in Nature Medicine, researchers found that surgical masks reduced the detection of respiratory viruses in aerosols generated by infected people breathing or coughing in a breath-collecting machine.

[Dylan16807]

> Wearing cloth masks resulted in significantly higher rates of infection, the authors found. They also noted that in their test, the cloth masks were only 3 percent effective at blocking particles.

Hoo boy that's misleading by itself. The control group was "use what you normally use", and had the following numbers:

> In the control arm, 170/458 (37%) used medical masks, 38/458 (8%) used cloth masks, and 245/458 (53%) used a combination of both medical and cloth masks during the study period.

Given those numbers, it's basically impossible to use this data to tell us anything about the efficacy of cloth mask vs. no mask. The control group did wear their masks less often, but it's still very unhelpful data.

[pmachinery]

>https://arstechnica.com/science/2020/04/should-you-wear-a-fa...

> This may lead some members of the public to be lax about ... washing their hands frequently and thoroughly. Moreover, donning [a] mask may lead some people to touch their faces more, some argued.

> simply touching their mask could contaminate their hands if there are viral particles caught on the outside ... a mask wearer could then transfer virus particles from their mask to their face

"May". "May". "Some argued". "Could". "If". "Could".

> negating any benefit of having the mask.

So even with all the above steps that have to occur, it's still no worse than getting a face-full of Covid directly.

Almost every stupid, pointless, dangerous argument against masks boils down to:

People may not wear a mask properly. People may not wash their hands properly.

The first one is used as an argument against masks, so why is the second not only not used as an argument against hand washing, but also used in arguments against masks?

People don't always practice social distancing. So why don't people argue against that? Oh, because that too is reserved for arguments against masks.

It's fucking ridiculous. Why do some people continue to spend so much time and effort trying to discourage use of potentially life-saving items?

[virgilp]

> I'm not sure why there is a recommendation to wear cloth masks in other countries

You're spreading actively dangerous advice, that has already been proven wrong. DO look up why there is that recommendation.

[Dylan16807]

A cloth mask can capture some sizes of droplet, but a flat wall that the all the air goes around is not really going to do anything.

[roenxi]

You say that with great confidence and a lack of sources; and I'm guessing we are equally ignorant on the actual physics of how small droplets move.

The details aren't clear on how the virus is spreading. The virus might have multiple modes of transmission. Closing 2 of them reliably a great deal. There are important things to do with "catching COVID" that aren't binary; starting doses likely matter as well.

I'd rather not talk to you in person if you aren't going to cover your face, tyvm :)

[ksk]

> starting doses likely matter as well.

That is something that I've been wondering about too. I work in biotech but not as a scientist. These things are tricky to nail down as they seem to be very individual specific. Theoretically, in an exponential growth model, it wouldn't matter if you were inoculated with 20000 or 200000 virons, after the incubation period post-infection, you're going to be generating a huge amount, millions and millions, of virus particles in either case. Certainly, if you keep getting exposed, you're immune system is going to get overwhelmed quickly, but for a single event, I don't think it matters.

[sadfklsjlkjwt]

It could give your immune system an extra day or two to produce antibodies before it get overwhelmed.

[norgie]

Viral dose does indeed matter. https://www.nytimes.com/2020/04/01/opinion/coronavirus-viral...

It’s analogous to containing a new virus outbreak before it becomes an exponentially growing pandemic.

[brirec]

> The virus might have multiple modes of transmission. Closing 2 of them reliably a great deal.

Sounds reasonable, but how is a face shield a reliable way to close a mode of transmission if people aren’t spitting liquid in your face?

[woofie11]

It increases the effective time large droplets need to spend in the air to get to me, and decreases the airflow around me. It's about the same reason plexiglass screens help, and keeping a 6-foot distance helps.

Plus, it stops me from touching my face.

No, it doesn't stop everything, but it's a buck.

[brodie]

It’s okay to admit you’re wrong. It’s okay to not understand everything. It’s okay to defer to experts.

So many people on HN and in tech have the same attitude that if they just spend 5 minutes thinking about something then they can intuit an answer and that they must be right. This is a dangerous way of thinking. If anyone took what you’ve been saying as correct they’d be endangering themselves and depriving medical professionals of tools they need.

[roenxi]

But I'm getting my opinions from the experts? See [0]. They recommend covering your face. I agree with them that cloth is more effective than a plastic shield but I'd expect a plastic shield to still be better than nothing. You've got to try and stop droplets from leaving your mouth and reaching other people.

A face shield would be better than failing to create a makeshift covering from a shirt for most people and it'd be resistant to decomposing so it could be stored long term in a home. It'd be a reasonable thing to stockpile.

[0] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...

[pertymcpert]

This is just common sense. Aerosolized particles are not impeded by a shield. A shield is intended to obstruct ballistic projectiles. If those projectiles are aerosolized and are in the air that you breathe, then the shield will offer no protection at all. Even an N95 mask still can let in up to 5% of these particles. What efficacy is a piece of plastic in front of your face going to do against that?

[dlubarov]

> If those projectiles are aerosolized and are in the air that you breathe

It seems like you're imagining that the mucus and saliva particles would behave like a gas, but it's a suspension of liquid particles in the air, which behaves slightly differently. Think of breathing onto glass -- a lot of the aerosol I expel adheres to the glass. Some smaller droplets may move around it, but it's still preferable to receive a smaller dose of the virus.

[seletz]

Stop spreading FUD.

[barry-cotter]

> this is how N95 masks are actually fit. (Well, not using smoke, but similar test). If you can smell the chemical used in the test, the fit is wrong.

And if the smell is less strong than it would be if you weren’t wearing the mask the viral load you’ve been exposed to is smaller. You are less likely to be infected and if you are infected your immune system has more time to ramp up so you’re more likely to fight it off.

[chrischen]

Go light a cigarette or incense and and see if a face shield prevents you from inhaling any smoke.

[ajxs]

Viruses don't diffuse through the air like smoke. Viruses are contained within the aerosolised droplets of your bodily fluids that are ejected through sneezing, coughing, blowing the nose. The survival of the virus outside of the body exposed to the elements is limited. Viruses have limited lifespans and can only reproduce within the medium of the bodily fluid. Every virus has different characteristics, and may have a longer or shorter lifespan. These characteristics are more or less universal for viruses though. It's not impossible for them to travel longer distances through the air. For the most part they are limited to the initial propulsion from the body. A better analogy would be spraying an aerosol can and watching how the droplets settle.

[lancesells]

Light a cigarette and see if you can smell it from six feet away.

[dlubarov]

I think a better comparison would be to try inhaling wet steam (i.e. a suspension of liquid H2O) from behind a face shield. You'll probably inhale some, but a lot of it will adhere to the shield.

[roenxi]

Yeah, that is pretty much what I'm imagining. If someone tried to smoke behind a facemask it seems pretty likely that most of the smoke will be caught behind the mask then drift out behind them like a comet trail, or move up/down. Only small wisps would end up traveling forward to where I'd be standing for conversation. The doses of virus would be diluted very rapidly which is helpful.

Ideal scenario would be most of the smoke gets pushed down in a knee-wards direction, which is well within the realm of the imaginable.

[Talanes]

>If someone tried to smoke behind a facemask it seems pretty likely that most of the smoke will be caught behind the mask then drift out behind them like a comet trail, or move up/down. Only small wisps would end up traveling forward to where I'd be standing for conversation.

You ARE the person in the faceshield (I assume you meant that instead of facemask), you don't control what other people do so assume they uncovered. The smoke is in the air, it can reach you. Will it get around that shield or not?

[roenxi]

How could me wearing a face shield help protect me from catching the virus? It'd be mostly useless; although obviously as mentioned it'd stop me touching my face as much as normal.

This is all about containing the spread.

Although I suppose in hindsight that explains why people were downvoting me.

[rumanator]

> it seems pretty likely that most of the smoke will be caught

If your plan is to only block most of the virus then perhaps you should rethink it.

It's like stating that a hole in the hull is not a problem because the rest of the ship keeps most of the water out.

[ImprovedSilence]

Actually initial viral load seems to be a factor in how severe the disease gets. So keeping any percentage more out of you that you can helps..

[jnbiche]

This is potentially misleading. Viral load is a significant factor in the seriousness of most infectious diseases. This is why you'll likely be ok if you pass a coughing TB patient in the street and inhale a few bacteria, but are much more prone to contract TB if you spend an entire day cooped up in a small room with the same coughing, infected individual.

This is thought to be why an unexpectedly high proportion of young, healthy doctors and nurses are getting seriously ill from Covid-19. Statically, you'd expect almost all of them to get mild disease.

[awaythrower]

Strawman and wrong.

[rumanator]

> There is currently a global pandemic afoot that is spread by droplets expelled from people's mouth and nose.

Do you have any source on how face shields are an effective tool against atomized covid19 viruses? The general guidance is that facial masks are effective at barring infected people from emitting contaminated particles, but not good at stopping healthy people from having contact with the virus. Therefore why would an open face shield, which filters zero, be a better solution?

[woofie11]

That's the general guidance in countries getting overrun by COVID-19. In countries which have stopped it, everyone wears facemasks. Chinese scientists have good data that surgical masks help in both directions.

Face shields reduce flow of air around you. Think of the six foot rule, but add a few more feet. They also reduce projectile sneezes (and "say-it-don't-spray-it" talking, coughs, and even breathing) by quite a bit. Think about sneezing in your elbow, only much better.

[mxcrossb]

I hear mask promoters say the “it’s to protect others from you” line, only to turn around and say “masks are obviously useful, that’s why doctors wear them.” The truth is, mask use is built on incredibly shaky evidence, so it’s no surprise that now face shields will become part of the hype. Both may indeed be useful, but without a clear model of effectiveness, it’s hard to make good assessments.

[blendergeek]

You seem to conflate so many things here. Doctors wear mulitiple types of masks. Surgical masks (as are recommended for the general public) prevent a doctor from spitting on a patient accidentally (just as they prevent an infected individual from expelling virus laden spit droplets). Surgical masks provide limited (if any) protection from airborne droplets. Rather an N95 masks (with a seal and filter) is used. To make this effective to protect the wearer, goggles must also be worn. The general public does not wear goggles. Further,training on putting on and taking off masks is provided to medical professionals. Face shields protect from yet another class of dangers (splashing of contaminated fluid). The general public has little reason to wear these.

[logarhythmic]

I thought the entire point of wearing a mask was precisely because we don't have clear evidence as to it's effectiveness. With such a degree of uncertainty (we are literally in the midst of an epidemic) it's not very practical to wait around for perfect information and evidence before you act

[jrochkind1]

Also, tin foil hats. You can't prove they DON'T work, can you? Even if they only add marginal protection, every bit counts. And they might, so can it hurt? This is why we are recommending tin foil hats to all Americans. That and a nice contribution from the tin foil lobby. We expect all Americans to commence procuring and constructing tin foil hats, and arguing about it on social media, and hope that this distracts them from noticing that their government is practically a failed state.

It turns out that "feeling safe" isn't the same thing as being safe, and feelings of safety will not actually effect infection rates, but Americans can't quite grasp that. And, hey, feelings of safety are about all we've got now, so.