Rebecca A. Housel Ph.D.

Survive Anything

Face Shields and COVID-19

How wearing PPE can keep you safe if restrictions are lifted for summer.

Posted May 01, 2020

 Dr. Rebecca Housel
"Wherever the art of medicine is loved, there is also a love of humanity." –Hippocrates
Source: Dr. Rebecca Housel

Thinking Outside of the Box Saved My Life ... and May Help Save Yours, Too

When diagnosed with high-grade brain cancer 29 years ago, I did what doctors told me to do. But when it came back a decade later, I decided to flip the narrative. Instead of being reactive, I got proactive. If I wanted to survive beyond the two-year prognosis doctors predicted, I’d have to take matters into my own hands. So, I researched volumes upon volumes of medical studies. It wasn’t as though I relied on unconventional methods. What I did do, however, was attempt to calculate how much of which conventional treatments were needed to not only effectively treat the cancer but improve my overall longevity.

The criticism I received for taking charge of my own treatment plan was surprising, given how sick I was. Everyone from doctors to family and friends put pressure on me to conform to “publicly accepted standards.” And yet, today I’m one of the longest-living known survivors of high-grade brain cancer alive in the United States, and very possibly, the world. The “U.K.’s longest-living brain cancer survivor,” according to Brain Tumour Research, had lived 12 years after his diagnosis in an article dated October 2017.[i] In 2017, my survival after brain cancer was at 26 years—14 years longer than U.K.’s “longest living” survivor. So, when I say I’m a longevity expert, I’m not just talking down to you from some impossibly high ivory tower. I’ve put my proverbial money where my mouth is, so to speak. As a result, the reader can trust that I know what I’m talking about when it comes to surviving things that appear unsurvivable. 

Knowledge Is Power

To me, COVID-19 is just another puzzle to solve. While it’s true that we're in somewhat uncharted territory, there is still research available on how to potentially avoid contracting and spreading COVID-19 before a vaccine is created. 

In the last month or so, I’ve taken a series of postgraduate continuing education courses through Harvard Medical School on COVID-19. If you want to stay healthy until a vaccine comes out (projected for summer 2021, according to the National Institute of Health’s website), read on! But if you’re more interested in things like a perceived infringement of your political rights, this may not be the article for you.

First and foremost, it’s important to recognize that COVID-19 is unlike any other virus our species has encountered. Like other viruses, COVID-19 is delivered through droplets. But unlike other viruses, “aerosol” droplets (or droplets so small, you can’t see them) can hang in the air for hours, especially indoors.[ii] There’s also new evidence that pets, including dogs and cats, can contract COVID-19.[iii]

What does all that mean?

The Infectious Diseases Society of America made policy recommendations for public health and safety when easing COVID-19 distancing restrictions this summer. These recommendations include the use of not just mouth-masks in public spaces, but face shields as well.

Think of the world under the COVID-19 pandemic as one giant hospital. Would you walk into any hospital today without the use of PPE (personal protective equipment)? I hope the answer is “no.”

According to a Journal of the American Medical Association article dated 29 April 2020, face shields were “shown to reduce immediate viral exposure by 96%.”[iv] That’s pretty significant, especially given that the study parameters included the face shield wearer being within 18 inches of an actively coughing person. There was no mouth-mask involved either. Even after 30 minutes of exposure to the cough at less than two-feet of distance, the protective effect was well beyond the 80% mark. Nearly 70% of the particles blocked were aerosol particles. Now, when paired with social distancing of at least 6 feet, the study concluded that face shields (without the use of mouth-masks) reduced inhaled viral particles by 92%. That’s a big deal.

The Reality of Hospital Care During a Pandemic

According to the Harvard Medical School course I took on Ethics and Psychosocial Issues in Management of COVID-19, a big problem for healthcare workers has been the allocation of things like ventilators for the treatment of patients. Some hospitals claim they have enough now, but most people do not realize that if you have to be hospitalized for COVID-19, your family will not be with you. Cannot be with you. And doctors have a right to make treatment decisions for you. Yes, though we’re all used to having a myriad of options and time for sensitive, thoughtful conversations, that’s not how things work in a crisis—you may not have a choice. And, things would be happening very fast, too. Your treatment options will be based on something called your “triage score,” taking a number of factors into account, including if a younger or healthier patient than you also needs the limited equipment available at the time of your admittance.

Are you scared yet? 

Wearing a cloth mouth-mask helps, but it may not be enough to prevent aerosol droplets from infecting you. Once infected, there’s no guarantee you’ll be asymptomatic. This virus has had unpredictable results that are highly individualized. There’s not even any proof that antibodies develop if you are infected. In other words, it's possible you can get COVID-19 again. 

Until a vaccine can be safely developed and a majority of the global population is inoculated, wearing a face shield may be your best defense. And yes, maintain social distancing, even when restrictions are relaxed to help our economy begin its very long road to recovery in what a recent Bloomberg article says will be the worst economic recession in 100 years.[v]

The Bottom Line

When I was lying in a hospital bed, unable to move half my body after surgery to remove a malignant brain tumor left me broken, I had to remember that even though my life had been irreparably altered, it was only temporary. Or would be, as long as I was willing to make some early sacrifices. The nature of my injuries required consistent rehabilitation for several years in order to recover. But, as you can see from my picture today, the efforts were well worth it. Yes, it was a daunting process, but if I wanted my life back, I  couldn't afford to fixate on things beyond my control. There was no room for self-pity. My life would only regain a sense of normalcy if I stayed focused on the future. It’s the same for every single human being on planet Earth today.

This pandemic is scary—no question. But you can survive and thrive. You just have to be willing to make temporary sacrifices to protect yourself and others. Until a vaccine is ready, your job is to stay out of the hospital and help others do the same; one way to do that is by wearing PPE in public spaces. Mouth-masks, too. You can buy a face shield on Etsy made with a 3D-printer for $5.00 (US). No, I’m not kidding. So, for less than the cost of a fancy coffee at Starbucks, you could improve your chances of not getting what can be a debilitating and deadly virus by upwards of 96%—and that’s without a mouth-mask. Or, a vaccine.

I’ll be publishing more of my usual posts on topics related to the biology behind our mental health in May, but as we move into the summer season, and cities across the world begin to relax restrictions, please consider wearing a face shield. You will not only help yourself, but you may also be helping everyone else, too—including beloved pets.

Stay safe!

References

[i] Brain Tumour Research. 17 October 2017. “UK’s Longest Living Brain Cancer Survivor to Attend Brain Tumour Research Symposium in 2017.” <https://www.braintumourresearch.org/media/press-releases/press-release-item/uk-s-longest-brain-cancer-survivor-attends-uk-brain-tumour-symposium-2017> Accessed 30 April 2020.

[ii] Liu, Y, Ning, Z, Chen, Y, et al. "Aerodynamic analysis of SARS-CoV-2 in two Wuhan Hospitals." Nature (2020). <https://doi.org/10.1038/s41586-020-2271-3> Accessed 30 Apr 2020.

[iii] Michael Schultz and Anna Johnson. “Can dogs get coronavirus? Possible first canine case detected in North Carolina." Los Angeles Times. 29 Apr 2020. <https://www.latimes.com/world-nation/story/2020-04-29/can-dogs-get-coronavirus-possible-first-canine-case-is-detected-in-nc-familys-pet> Accessed 30 Apr 2020.

[iv] Eric Martin. “IMF Sees Great Lockdown Recession as Worst Since Depresson. Bloomberg." 14 Apr 2020. <https://www.bloomberg.com/news/articles/2020-04-14/imf-says-great-lockdown-recession-likely-worst-since-depression> Accessed 30 Apr 2020.

[v] Eli N. Perencevich, MD, MS; Daniel J. Diekma, MD, MS; Michael B. Edmond, MD, MPH, MPA. “Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19." JAMA. Published online 29 April 2020. doi: 10.1001/jama.2020.7477. Accessed 30 Apr 2020.