Analysis Guest article

Senior medic writes: the govt is going to lift lock-down – but the right type of face protection will save lives. No more excuses

Mask or visor – what will best protect when lock-down is relaxed?

Dr Kailash Chand OBE is an award-winning GP and former deputy chair of the British Medical Association. Here, he writes in a personal capacity about recommended type of protection for the public when lock-down is eased – and the government’s duty to provide it:

In next few weeks, it looks certain that the the government will relax the lockdown. Irrespective of the debate for or against wearing face masks, I suspect that mask wearing will become the norm in enclosed public spaces.

But what kind of mask? We need to look at what sort of mask would meet the necessary requirements .

Dr Kailash Chand OBE

In an article in Journal of the American Medical Association, experts led by Dr Eli Perencevich of the university’s department of internal medicine and the Iowa City VA Health Care System advocate the clear plastic face shield or visor already in use by health care personnel. We know the Covid-19 is here to stay for a while, the Face shields might replace masks as a more comfortable and more effective protection against COVID-19.

Laboratory testing suggests that cloth masks provide only partial filtration of virus-sized aerosol particles. According to Perencevich’s group, “face shields may provide a better option.”

“in a simulation study, face shields were shown to reduce immediate viral exposure by 96% when worn by a simulated health care worker within 18 inches of a cough.”

In addition, visors have practical advantages over masks. Firstly, they are endlessly reusable, simply requiring cleaning with soap and water or common disinfectants. Such shields are also usually more comfortable to wear than masks and they form a barrier that keeps people from easily touching their own faces. When speaking, people sometimes pull down a mask to make things easier—but that isn’t necessary with a face shield.

 And “the use of a face shield is also a reminder to maintain social distancing, but allows visibility of facial expressions and lip movements for speech perception,”

 According to the Iowa team:

in a simulation study, face shields were shown to reduce immediate viral exposure by 96% when worn by a simulated health care worker within 18 inches of a cough.

When the study was repeated at the currently recommended physical distancing distance of 6 feet, face shields reduced inhaled virus by 92%

To be most effective in stopping viral spread, a face shield should extend to below the chin. It should also cover the ears and “there should be no exposed gap between the forehead and the shield’s headpiece,”.

Masks are simple, cheap, and potentially effective. Very respectable researchers like  Trisha Greenhalgh  believe that, worn both in the home (particularly by the person showing symptoms) and also outside the home in situations where meeting others is likely (for example, shopping, public transport), they could have a substantial impact on transmission with a relatively small impact on social and economic life.

“Matt Hancock and Boris Johnson can no longer hide behind the ever-changing and conveniently-timed ‘science’ they have used so to delay taking measures.”

We definitely need masks – until  we reach ‘acceptable’ levels of infection, until a vaccine is produced and until  we have sufficient mass testing.

Visors should only be one part of any infection control effort, along with social distancing and hand-washing. A cloth face cover is not a substitute for social distancing.

Matt Hancock and his team must apply the precautionary principle now and encourage people to wear face shields on the grounds that we have little to lose and potentially something to gain from this measure. He and Boris Johnson can no longer hide behind the ever-changing and conveniently-timed ‘science’ they have used so to delay taking measures.

I urge the government to get ready now to quickly produce affordable face shields – and to prepare to distribute them. There can be no repeat of the constant excuses that capabilities are being eternally ‘ramped up‘ and that the government is ‘straining every sinew‘ while sacrificing lives to its failure to actually achieve.

Suitable face shields will save lives. No more excuses.

Dr Kailash Chand OBE
Twitter @kailashchandobe

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  1. The WHO’s research meta-analysis (October 2019) came to the following conclusion :

    “There is a moderate overall quality of evidence that face masks do not have a substantial effect on the transmission of influenza.”

    The overall conclusion is – to summarize – that, since there isn’t much harm in wearing them, it could be given a try, but the key use is by people who have an infection – to guard against coughing and sneezing. It certainly isn’t a proven measure at the back end of an epidemic.

    Kailash Chand isn’t really an authority in this area.

    1. Dr Chand and everyone else are “really authorities” in all areas compared to you RH. OR you RH are the “authority” on everything compared to everyone else. readers will judge.
      Key observations include, how at one you RH are with Tory callousness ➕ how hard you work, night and day, to achieve Tory aims.
      BASIC LOGIC and FORESIGHT – face masks, even a scarf, help, to reduce spread of contagious airborne / aerosol diseases to and from others. All sensible readers of will ignore your toxic RH Tory cheerleading.🌹🌹🌹

      1. “Key observations include, how at one you RH are with Tory callousness”

        Are you really that much of a deluded idiot, windy chimes?

        It’s not *my* opinion – I just take the trouble to go and find evidence instead of just making stuff up – and the WHO meta-analysis is the most thorough-going in this area. Read it.

        There is a clear rationale for medical staff to use face shielding, but beyond that there isn’t much substantive evidence, although people with infections might be advised to wear them to prevent the results of coughing and sneezing spreading too far. But the idea that simple face masks act as a major protection for the normally uninfected is cloud-cuckoo land.

        Your concept of ‘BASIC LOGIC and FORESIGHT’ is otherwise known as ‘ignorance of the evidence’.

        If you want to twitch around pointlessly at Bojo’s ‘Panic!’ command string – that’s up to you – but don’t fool yourself that you’re doing anything constructive.

  2. Visors are essential for health & social care workers – it would be a shame if the public starts buying them and reducing their supply.
    CV-19 ward workers should really have full positive air pressure and cooled hazmat suits but good luck getting the Tories to pay for that.
    You can make an adequate visor for short term use from clear plastic pizza packaging ‘window’ and a hairdryer, a Tesco 5 litre water bottle or any other kind of see-through clear plastic and some gaffer/parcel/sellotape – you’re not going to be wearing it for an 8 or 12 hour shift.
    Use a cloth face mask in conjunction with any visor – no protection is 100% but there’s no point doing less than your best.

  3. Why in the middle of the epidemic are we even thinking about this ,, this Govt is effing nuts !
    Great lets all believe those fiddled Govt figures ,,, just wait for the second wave , an all the wailing and whining to follow .

    End of 5 weeks of relative bliss , no cars , no pollution , cleaner air to breath , silence and birdsong , compassionate folks , better family balance and time with children. Headlong rush back into the insanity of ” the Capitalistic economy ” desperate to get back to normal … yehhhy burn the planet

    1. Great if you can afford to just sit on your arse like we old farts can – even if pension funds are taking a massive hit.

      But even then it’s not very enlivening if you have friends and family elsewhere.

      But what about the effect on the already impoverished, and those without any pension? I bet they’ll love listening to tweety pie chirping from a branch, and will get slim consolation from the bonus of less pollution as they contemplate suicide by other means, as unemployment sky-rockets and a new rationale for austerity and downward pressure on earnings emerges.

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