Face shield debate

Healthcare workers assigned in COVID wards are required to wear medical grade goggles. They fit snugly with enough room for eyeglasses, and provide a 180-degree field of view.

The top-of-the-line safety goggles, which can cost about $20 online, are made of materials with special coating that don’t fog, are scratch-resistant and block ultraviolet light. They can keep out splashes, droplets, chemicals, pollen, and to a certain extent gases and air-borne aerosol particles.

The face shield requirement, according to pediatric infectious disease doctor Anna Lisa Ong-Lim, is meant to protect the eyes from droplets that may carry the COVID-causing SARS-CoV-2. The eyes, she says, are scientifically proven entry points for viruses and other pathogens – perhaps not as much as the nose and mouth, in the case of a respiratory disease like COVID-19, but the eyes can still let in SARS-CoV-2.

This is the reason why we are warned against touching our eyes – and any part of the face, for that matter – unless we have washed or disinfected our hands.

And eye protection is one of the reasons why the health professionals in the country’s pandemic response team are still recommending the continued wearing of face shields together with face masks in crowded public places, enclosed areas and close-contact settings.

In separate interviews with “The Chiefs” on One News, Lim, a member of the Department of Health’s Technical Advisory Group, and DOH Undersecretary Maria Rosario Vergeire said that while there is no definitive study on the usefulness of face shields, there is also no study showing the shields are useless. Meanwhile, they say you can see how the shield can protect the face from biological fluids, for example when someone nearby sneezes.

The two doctors stress that with masks, the face shield provides additional protection.

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I’m no health expert, but I agree. I have seen too many people wearing their face mask below their nose or even just around their chin because they say the mask impedes breathing.

And I’ve seen too many people, even in the time of COVID, not practicing cough and sneeze hygiene while not wearing their mask properly.

Infected people can spew out the virus even by singing, talking and breathing. This is the reason for masking requirements.

But even under Alert Levels 4 and 3, I already saw a lot of people not wearing masks at all, including those manning carinderias and wet market stalls. Their ranks keep growing under Alert Level 2.

Such complacency is a major concern for health professionals, who are the ones at highest risk of exposure to infection and who become overwhelmed when there is a COVID surge.

With weak enforcement of COVID safety protocols, people think they can now do as they please.

Taking off masks is being incentivized by the government itself. While epidemiologists have warned that the virus can be spread through singing, the government has approved the reopening of videoke bars and the resumption of caroling. You think people will wear masks while belting out “My Way” in a karaoke bar or “Joy to the World” during caroling?

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If you run into such people as they are spewing their droplets, surely a face shield can provide some protection especially for your eyes even as a mask protects your mouth and nose. The droplets may of course be spread like aerosol spray and enter through the space around the shield, but at least the chances of a direct hit to the eyes are minimized.

Also, the shield prevents reflexive touching of the face. In that brief moment when you have to take off the shield to scratch your cheek, for example, you might remember that you haven’t washed or disinfected your hands yet. So you keep the shield on.

Wearing the face shield is without doubt uncomfortable. I don’t think I can wear it on a long-haul flight. Outdoors in the tropical heat, even with a strong breeze, my face becomes all sweaty with the shield on. But my eyes are protected from wind-blown dust, and saliva from people who inadvertently spew spit while talking.

Similar arguments were raised by several regular commuters who were interviewed last Monday, as the Metro Manila Council (MMC) recommended the lifting of mandatory face shield use outside the home, except in medical facilities, public transport and similar places.

Manila Mayor Isko Moreno jumped the gun on the national government and issued an executive order to immediately carry out the recommendation of the MMC in the city.

He wasn’t the first to do so; the cities of Cebu, Davao and Iloilo had previously issued similar orders.

Malacañang has said all local government units must follow guidelines set by the Inter-Agency Task Force for the Management of Emerging Infectious Diseases. Moreno, invoking the autonomy of LGUs, brushed off the Palace statement.

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Opponents of the use of face shields describe the requirement as silly, saying germs can even be trapped in the interior of the plastic. They also point out that the Philippines is the only country with a face shield mandate.

The controversy over the multibillion-peso deals bagged by Pharmally Pharmaceuticals has aggravated the undesirability of face shields. It has bred the perception that every time we buy a face shield, we are enriching administration cronies.

With all the activities now being allowed to resume, a face shield might in fact not be enough to protect the eyes. It might be better to get yourself medical goggles, for use in high-risk environments such as public transport.

All health experts have stressed that the pandemic is far from over. People are still dying of the virus. Yesterday, 46 more COVID deaths were recorded in the country, bringing the total to 44,567.

The number does not include deaths after COVID recovery, which I think is not that rare – it happened to several people I know. The virus weakens the immune system and people who have tested negative after a bout with COVID succumb days or weeks later to pneunomia or heart attack.

Vaccination is great, but as we keep seeing, breakthrough infections are possible especially as vaccine efficacy wanes (regardless of the brand). With infection, deaths have also been recorded.

The eyes, like the nose and mouth, need special protection against the entry of the COVID virus. You’ve been warned.