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THE COVID-19 PANDEMIC AND FACE SHIELDS: A REVIEW
  • Jennifer Ha
Jennifer Ha
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Abstract

Introduction The coronavirus disease 2019 (COVID-19) pandemic has placed personal protective equipment (PPE) for healthcare workers (HCW) in the spotlight. HCW’s face has been reported to be the body part most commonly contaminated by body fluids. The aim of this narrative review to examine the current evidence on face shield as a PPE for droplet or aerosol prevention. Methods A literature search was conducted on the PubMed, MedLine, and Embase databases, with the keywords “face shield”, “visor”, and “droplet precaution”. Bibliographic search was also undertaken. Results Respiratory droplet is particle with diameter greater than 5µm, while aerosol are ≤5µm according to the World Health Organisation. However, infection is not neatly separated into the dichotomy of droplet versus airborne transmission route. Modelling and simulation have shown the importance of the conjunctival mucosa as a route of transmission of disease in blood splashes, droplets and aerosols containing virus. The limited reports from SARS, COVID-19 and influenza season supports its use. However, HCW do not routinely use face shield if they consider the procedures to be unlikely to be associated with potential contamination. They also erroneously believe that prescription glasses is adequate protection. The issues associated with eye shield use, may be less of a problem with face shield. Conclusion Transmission of viruses is multimodal, and the conjunctival mucosa presents a real risk for viral transmission. Eye and face protection is important to prevent transmission of COVID-19.