What is face shield?

Face shields are clear plastic barrier that cover the face.

Face shields are available in various forms, but all provide a transparent plastic barrier that
covers the face. For optimal protection, the shield should extend below the chin anteriorly, to
the ears laterally, and therefore there should be no exposed gap between the forehead and
the shield’s headpiece. Face shields require no special materials for fabrication and
production lines are often repurposed fairly rapidly. Numerous companies, including Apple,
Nike, GM, and Deere , have all started producing face shields. These shields are often made
up of materials found in craft or office supply stores. Thus, availability of face shields is
currently greater than that of medical masks.

Face shields offer variety of benefits . While medical masks have limited durability and
tiny potential for reprocessing, face shields are often reused indefinitely and are easily
cleaned with soap and water, or common household disinfectants. they're comfortable to
wear, protect the portals of viral entry, and reduce the potential for autoinoculation by
preventing the wearer from touching their face. People wearing medical masks often need
to remove them to speak with others around them; this is often not necessary with face
shields. the utilization of a face shield is additionally a reminder to take care of social
distancing, but allows visibility of facial expressions and lip movements for auditory
perception .

Most important, face shields appear to significantly reduce the quantity of inhalation

exposure to influenza virus, another droplet-spread respiratory virus. during a simulation
study, face shields were shown to scale back immediate viral exposure by 96% when worn
by a simulated health care worker within 18 inches of a cough.10 Even after half-hour , the
protective effect exceeded 80% and face shields blocked 68% of small particle aerosols,10
which aren't thought to be a dominant mode of transmission of SARS-CoV-2. When the
study was repeated at the currently recommended physical distancing distance of 6 feet,
face shields reduced inhaled virus by 92%,10 almost like distancing alone, which reinforces
the importance of physical distancing in preventing viral respiratory infections. Of note, no
studies have evaluated the consequences or potential benefits of face shields on source
control, ie, containing a sneeze or cough, when worn by asymptomatic or symptomatic
infected persons. However, with efficacy ranges of 68% to 96% for one face shield, it's likely
that adding source control would only improve efficacy, and studies should be completed
quickly to guage this.
Major policy recommendations should be evaluated using clinical studies.

However, it's unlikely that a randomized trial of face shields might be completed in time to

verify efficacy. No clinical test has been conducted to assess the efficacy of widespread
testing and get in touch with tracing, but that approach is predicated on years of experience.
Taken as a bundle, the effectiveness of adding face shields as a community intervention to
the currently proposed containment strategies should be evaluated using existing
mathematical models. The implicit goal of face shields alone or together with other
interventions should be to interrupt transmission by reducing the R0 to but 1. Notably,
effective control of even the foremost infectious pathogens, like measles, doesn't require a
vaccine with 100% efficacy. No burden of 100% efficacy should be placed on face shields or
any containment policy because this level of control is both impossible to realize and
unnecessary to drive SARS-CoV-2 infection levels into a manageable range.

In the wake of scarcity of face shields during the COVID-19 pandemic, consideration of
innovating newer methods of manufacturing must be considered to overcome the present
day scarcity without jeopardising the safety of front line Heath care workers.

All safety precautions and guidelines for use and disposal and sterilisation must be
considered to get maximum benefits out of such simple innovations. Hence we thought of
putting down simple guidelines for new emerged face shield use:

1. Snug fitting.
* The face shield must be tightly fitting around head without any gaps between forehead and
shield
* All 3D printed or readymade plastic bands don't achieve this
* A simple solution is to tie the shield firmly with an elastic band (which may give headache
due to pressure if used for long time) or simple ribbon gauge

2. Tight fitting
* All 3D printed or readymade plastic used for holding is best for single use. With repeated
use, the face shield may fall while working
* Using a sponge in between the forehead and face shield gives good comfort as well as a
snug fit, but such face shields should be considered disposable because sterilisation of all
material is incomplete

3. Disposable/Reusable
* If you are using the face shield as disposable then it’s best use it once and with utmost
care remove it after use and dispose it properly. See sterilisation
* Reusable Face Shields: if you plan to reuse the face shield, utmost care should be taken
while removing the shield after use and then sterilise it before reuse. See sterilisation
* Reusable face shields must be very simple prepared based on above points and must be
free from any sponges or sticking material or stapler pins to achieve good sterilisation
* Minimum 5 reusable face shields must be kept in reserve to use it alternately with
sterilisation

4. Quality of Material for face shield

* No plastic or OHP sheet < 50 micron should be used for face shield due to possibility of
crimping and movement due to air flow
* Best thickness is OHP of 150 to 200 micron (for repeated sterilisation and handling and
avoiding crimping )

5. Methods of Handling
* Never touch the front side of OHP/ face shield
* Never hold face shields by touching plastic of OHP sheets
* after complete use, with hand in gloves 🧤removing face shields from behind by untying the
ribbon knot or releasing the visor or lifting the readymade plastic head band over ear
* If you are disposing the face shield , dispose it along with your gloves
* If you are reusing the face shield, follow the methods of sterilisation

6. Methods of sterilisation
* The removed face shields must be kept in 1% Sodium Hypochlorite solution (see how to
prepare it) for 10 minutes
* Dry it in sunlight
* after complete drying, Clean it with Sanitisers (very crude method) (see how to make
sanitiser by yourself) (everything must be done with hand in gloves)
* Or keep face shields in 2% Glutaraldehyde for 10 min, wash it with normal saline, again dry
it
* Best way of sterilisation is ETO

7. Considering all above points, it’s prudent to avoid all supplementary materials like sponge,
stapler pins, sticking materials, adhesives and any other fancy materials for aesthetic appeal
(if you are reusing the face shields)

8. The simplest way of preparing the face shields is

a. Take an A4 size OHP sheet of 150 to 200 micron thickness
b. With an office punching machine, make 8 holes across length of the OHP sheet, leaving a
2 cm margin
c. Thread cotton ribbon gauze of 60 cm alternately through created holes for tying around
head
d. Your simple face shield is ready