Several places across the world are experiencing a steep surge in COVID-19 infections. Face masks have become increasingly accepted as one of the most effective means for combating the spread of the disease when used in combination with social-distancing and frequent hand-washing. However, there is an increasing trend of people substituting regular cloth or surgical masks with clear plastic face shields and with masks equipped with exhalation valves. One of the factors driving this increased adoption is improved comfort compared to regular masks. However, there is a possibility that widespread public use of these alternatives to regular masks could have an adverse effect on mitigation efforts. To help increase public awareness regarding the effectiveness of these alternative options, we use qualitative visualizations to examine the performance of face shields and exhalation valves in impeding the spread of aerosol-sized droplets. The visualizations indicate that although face shields block the initial forward motion of the jet, the expelled droplets can move around the visor with relative ease and spread out over a large area depending on light ambient disturbances. Visualizations for a mask equipped with an exhalation port indicate that a large number of droplets pass through the exhale valve unfiltered, which significantly reduces its effectiveness as a means of source control. Our observations suggest that to minimize the community spread of COVID-19, it may be preferable to use high quality cloth or surgical masks that are of a plain design, instead of face shields and masks equipped with exhale valves.
Several places across the world are experiencing a steep surge in COVID-19infections. Face masks have become increasingly accepted as one of the most effective means for combating the spread of the disease when used in combination with social-distancing and frequent hand-washing. However, there is an increasing trend of people substituting regular cloth or surgical masks with clear plastic face shields and with masks equipped with exhalation valves. One of the factors driving this increased adoption is improved comfort compared to regular masks. However, there is a possibility that widespread public use of these alternatives to regular masks could have an adverse effect on mitigation efforts. To help increase public awareness regarding the effectiveness of these alternative options, we use qualitative visualizations to examine the performance of face shields and exhalation valves in impeding the spread of aerosol-sized droplets. The visualizations indicate that although face shields block the initial forward motion of the jet, the expelled droplets can move around the visor with relative ease and spread out over a large area depending on light ambient disturbances. Visualizations for a mask equipped with an exhalation port indicate that a large number of droplets pass through the exhale valve unfiltered, which significantly reduces its effectiveness as a means of source control. Our observations suggest that to minimize the community spread of COVID-19, it may be preferable to use high quality cloth or surgical masks that are of a plain design, instead of face shields and masks equipped with exhale valves.
The COVID-19 pandemic has deeply affected every aspect of daily life worldwide. Several
places across the world, including the United States, Brazil, and India, are experiencing a
steep surge in infections. Healthcare systems in the most severely affected locations have
been stretched to capacity, which also tends to impact urgent care for cases unrelated to
COVID-19. Researchers have reported
steady progress in the development of potential treatments and vaccines; however, it is
estimated that widespread inoculation will not be available until sometime in the year 2021.
It appears that the likelihood of vulnerable individuals struggling with severe health issues
and the debilitating socio-economic ramifications of the pandemic will continue in the
foreseeable future. Furthermore, widespread uncertainty regarding the re-opening of schools
and universities for in-person instruction has created additional cause for concern, since
these institutions have the potential to become focal points for unchecked community spread of
the disease. In light of the acute circumstances, it has become crucial to establish clear and
specific guidelines that can help mitigate the disease’s spread, especially given the high
prevalence of asymptomatic and pre-symptomatic spread. A number of recent studies have contributed to this effort by
significantly improving our understanding of various physical mechanisms involved in the
disease’s transmission.Face masks have become increasingly accepted as one of the most effective means for source
control (i.e., protecting others from a potentially infected wearer) and can help curb the
community spread of the disease when used in combination with social-distancing and frequent
hand-washing. Widespread
mask-use by the general population has now been recommended or mandated in various places and
communities around the world. Several private businesses have also adopted requirements for
customers to use face coverings. Importantly, certain cloth-based masks have been shown to be
effective in blocking the forward spread of aerosolized droplets (supplementary material,
Movie 1). Although they are somewhat less capable than well-fitted medical grade masks,
homemade masks constructed using certain materials can filter out a large proportion of
respiratory droplets and particles. Moreover, cloth masks have the advantage of being readily
available to the wider public in addition to being cost-effective, comfortable, and reusable
when washed and disinfected properly. Additionally, they do not divert away from the supply of
medical grade masks for healthcare workers.While broad acceptance regarding the need for face coverings has risen steadily, there is an
increasing trend of people substituting regular cloth or surgical masks with clear plastic
face shields, and with masks equipped with exhalation valves (Fig. 1). Face shields tend to have noticeable gaps along the bottom and the sides,
and are used in the medical community primarily for protecting the wearer against incoming
sprays and splashes while in close proximity to patients. Moreover, they tend to be used in conjunction with respirators,
surgical masks, or other protective equipment. Masks with exhalation ports include a one-way
valve, which restricts airflow when breathing in, but allows free outflow of air. The inhaled
air gets filtered through the mask material; however, the exhaled breath passes through the
valve unfiltered. There has been limited research on how effective face shields and masks with
exhalation valves are as a means of source control.
FIG. 1.
(a) A face shield, which is similar in design to those used by healthcare workers in
conjunction with masks and other protective equipment. The vertical laser sheet used for
visualizing the expelled droplets is visible in this panel. (b) An N95 mask with an
exhalation valve located at the front. Both cloth-based and N95 masks can be found
equipped with such exhalation ports.
(a) A face shield, which is similar in design to those used by healthcare workers in
conjunction with masks and other protective equipment. The vertical laser sheet used for
visualizing the expelled droplets is visible in this panel. (b) An N95 mask with an
exhalation valve located at the front. Both cloth-based and N95 masks can be found
equipped with such exhalation ports.One of the factors driving the increased adoption of shields and exhalation valves is
improved comfort compared to regular surgical or cloth masks. Exhale valves allow for improved
breathability, and reduce humidity and fogging when wearing prescription glasses. Face shields
also offer these benefits, in addition to protecting the eyes from splashes and sprays of
infected droplets. Shields have
also been credited with other advantages such as ease of cleaning and disinfecting, long-term
reusability (which is also true for well-constructed cloth masks), and allowing visual
communication of facial expressions for people who may be hearing-impaired.Notably, a recent opinion-based article by Perencevich et al. suggested that shields may be a better
alternative to regular masks for combating the COVID-19 crisis. The authors’ opinion is based
on the premise that ejecta from the mouth and nose hit the visor, and their forward motion is
arrested completely. While this is true for relatively large respiratory droplets, the effect
on the smaller aerosol-sized droplets (diameter less than approximately 5
µm–10 µm) is markedly different, since they act as tracers
and have a higher tendency to follow airflow patterns more faithfully. We note that one of the
primary studies cited by Perencevich et al. expressly indicates that face
shields did not serve as primary respiratory protection for the wearer in experimental tests,
since suspended aerosols could flow around the visor and enter the respiratory tract. Over an exposure duration of 1 min–30 min,
the shield was only 23% effective in reducing inhalation of droplets that were 3.4
µm on average. Although this study by Lindsley et al. did not consider face shields as source
control methods, they are likely to suffer the same disadvantage in this role, since smaller
outgoing droplets will flow around the bottom and the sides of the visor. While the opinion
article by Perencevich et al. is based on the presumption that transmission of COVID-19 occurs
primarily through larger respiratory droplets, recent studies support the possibility of
airborne transmission via aerosol-sized droplets.Current CDC guidelines discourage the use of face shields as a sole means of source
control, and mention that masks equipped
with exhalation valves should not be used when a sterile environment is required. At the same time, there are broad variations
in recommendations made by states and counties across the US, with some allowing the use of
face shields as alternatives to masks, whereas many others do not address the issue at all. There is a
possibility that widespread public adoption of these alternatives to regular masks could have
an adverse effect on mitigation efforts. To help increase public awareness regarding the
effectiveness of these alternative options, we use qualitative visualizations to examine the
performance of face shields and exhale valves in impeding droplet spread.The visualization setup used here is similar to the arrangement used in a prior study, which examined the effectiveness of various
facemasks in stopping the spread of respiratory jets. The setup consists of a hollow manikin
head, where a cough/sneeze is emulated via a pressure impulse applied using a manual pump. The
air capacity of the pump is 500 ml, which is comparable to the lower end of the total volume
expelled during a cough. Tracers composed
of droplets of distilled water and glycerin are expelled through the mouth opening, and are
visualized using laser sheets to observe the spatial and temporal development of the ejected
flow. Up to two laser sheets are used in the visualizations presented here, to provide a
better indication of the volumetric spread of the expelled jet. The tracer droplets’ diameter
was estimated to be less than 10 µm based on Stokes’ law, and the observation
that they could remain suspended in a quiescent environment for between 2 min and 3 min
without significant settling. The settling velocity for spheres in Stokes flow (i.e., at very
low Reynolds numbers) is given as follows:where
ρ is the density of the spherical particle,
ρ is the density of the ambient fluid (air),
μ is the dynamic viscosity, g is the acceleration due to
gravity, and d is the diameter of the sphere. Using the density of water as
an approximation for ρ, and d =
1e − 5m, we get a settling speed of 0.003 m/s. Thus, a
droplet of diameter 10 µm would fall a distance of 0.45 m in 150 s, i.e., in
2.5 min. From our observations in a minimally disturbed environment, the droplets did not
display significant downward gravity-driven settling within this time-frame. The droplets
eventually disappeared from view, either because they moved laterally off the laser sheet, or
because they experienced further evaporation. Additional details regarding the visualization
setup may be found in Ref. 13. We remark that all of
the flows described in this work are inherently three-dimensional in nature, but the
visualizations only depict plane two-dimensional cross sections. For instance, the uncovered
emulated cough shown in the supplementary material, Movie 1, displays three-dimensional behavior, such as
the motion of the leading plume, which resembles the formation of a vortex ring. The lateral
(sideways) motion of the jets is also evident at times when the visible droplet patches
disappear or re-appear in the laser sheet.Figure 2 (Multimedia view) shows the evolution of a
cough/sneeze when a face shield is used to impede the expelled jet. As expected, the visor
initially deflects the expelled droplets downward [Fig.
2(b) (Multimedia view)]. However, the aerosol-sized droplets do not fall to the
ground, but stay suspended beneath the bottom opening of the shield [Fig. 2(c) (Multimedia view)]. These droplets rise upward after a few seconds
since they are warmer than the ambient air owing to the vaporized glycerin–water mixture, and
also because they might undergo further evaporation once released into the environment. A
horizontal laser sheet has been used in addition to a vertical sheet, and the lateral spread
of the droplets becomes visible as they cross the horizontal plane in Figs. 2(c) and 2(d) (Multimedia view).
Although the case depicted here shows droplets spreading in the forward direction, slight
variations in ambient disturbances were observed to reverse the direction of spread, i.e.,
toward the manikin’s back. The time evolution of the droplet spread from an additional run
with a face shield can be seen in the supplementary material,
Movie 2.
FIG. 2.
Near-field view of the droplet spread when a face shield is used to impede the emerging
jet. (a) Prior to emulating a cough/sneeze, (b) 0.57 s after the initiation of the
emulated cough, (c) after 3.83 s, and (d) after 16.57 s. The ejected plume is illuminated
by both a vertical and a horizontal laser sheet. Droplets illuminated by the horizontal
laser sheet can be observed in (c) and (d). Multimedia view: https://doi.org/10.1063/5.0022968.1
Near-field view of the droplet spread when a face shield is used to impede the emerging
jet. (a) Prior to emulating a cough/sneeze, (b) 0.57 s after the initiation of the
emulated cough, (c) after 3.83 s, and (d) after 16.57 s. The ejected plume is illuminated
by both a vertical and a horizontal laser sheet. Droplets illuminated by the horizontal
laser sheet can be observed in (c) and (d). Multimedia view: https://doi.org/10.1063/5.0022968.1To observe the lateral and longitudinal spread of the suspended droplets over a large area,
we examine a far-field view in Fig. 3 (Multimedia view).
The manikin’s position is shown as an overlay in Fig.
3(a) (Multimedia view), where the ejected droplets are visible in a horizontal and a
vertical laser sheet, which help convey the spread of the droplets in the lateral and
longitudinal directions. The positioning of the laser planes is depicted in Fig. 3(b) (Multimedia view). After 10 s [Fig. 3(c) (Multimedia view)], the droplets were observed to have spread
approximately 3 feet in both the forward and lateral directions. We note that the intensity of
the scattered light has decreased noticeably at this point, which is indicative of a decrease
in droplet concentration due to spreading over a large volume. Most of the droplets visible in
Fig. 3(c) (Multimedia view) are illuminated by the
horizontal sheet shown in Fig. 3(b) (Multimedia view),
which is aligned with the bottom opening of the face shield. Very few droplets are visible in
the vertical laser sheet, since most of them have advected forward of the sheet’s position by
this time. We remark that both the longitudinal and lateral spreads depend on a combination of
the initial momentum of the cough and advection by very light ambient disturbances. While the
specific case discussed here depicts forward spread, we observed that it was equally likely
that the droplets could spread in the reverse direction, i.e., behind the manikin. We do not
expect diffusion to play a dominant role at the time scales discussed here. Overall, we can
surmise that the face shield blocks the initial forward motion of the jet; however, the
aerosolized droplets that are expelled can disperse over a wide area over time, albeit with
decreasing droplet concentration.
FIG. 3.
Far-field view of droplet spread when a face shield is used to impede the jet. (a) 2.97 s
after the initiation of the emulated cough, (b) after 6.98 s, and (c) 10.77 s. Multimedia
view: https://doi.org/10.1063/5.0022968.2
Far-field view of droplet spread when a face shield is used to impede the jet. (a) 2.97 s
after the initiation of the emulated cough, (b) after 6.98 s, and (c) 10.77 s. Multimedia
view: https://doi.org/10.1063/5.0022968.2We now consider the effectiveness of masks equipped with exhalation valves in restricting the
spread of respiratory droplets. Figure 4 (Multimedia
view) shows the spatial and temporal evolution of the jets that emerge from an N95 mask, which
has a single exhalation port located at the front. Apart from the design used here, certain
cloth-based masks that are available commercially also come equipped with one to two exhale
ports, located on either side of the facemask. In Figs.
4(b) and 4(c) (Multimedia view), we observe that
a small amount of the exhaled droplets escape from the gap between the top of the mask and the
bridge of the nose. However, a majority of the exhaled air passes through the exhale port
unhindered. The resulting jet is deflected downward in the current case, which reduces the
initial forward spread of the droplets. However, the aerosolized droplets will eventually
disperse over a large area depending on the ambient disturbances and airflow patterns, as in
the case of the face shield [Fig. 3 (Multimedia
view)].
FIG. 4.
Visualization of the droplet spread when an N95 mask equipped with an exhalation port is
used to impede the emerging jet. (a) Prior to emulating a cough/sneeze, (b) 0.2 s after
the initiation of the emulated cough, (c) after 0.63 s, and (d) after 1.67 s. Multimedia
view: https://doi.org/10.1063/5.0022968.3
Visualization of the droplet spread when an N95 mask equipped with an exhalation port is
used to impede the emerging jet. (a) Prior to emulating a cough/sneeze, (b) 0.2 s after
the initiation of the emulated cough, (c) after 0.63 s, and (d) after 1.67 s. Multimedia
view: https://doi.org/10.1063/5.0022968.3We now examine the droplet dispersal pattern when using a regular N95-rated mask in Fig. 5 (Multimedia view). Once again, we observe droplets
escaping from the gap between the mask and the nose; however, the intensity of light scattered
by the escaped droplets is lower than that for the valved N95 mask [Fig. 4(d) (Multimedia view)]. We note that the droplets that escape from the
regular mask will also get dispersed by ambient disturbances; however, the extent of exposure
will be lower compared to that for either face shields or masks with valves. While the two
masks shown in Figs. 4 and 5 (Multimedia views) are N95-rated, we expect the observations described here (with
regard to valves) to hold true even for cloth/surgical masks that are of a plain functional
design vs those equipped with exhale valves.
FIG. 5.
Visualization of droplet spread when a regular N95-rated mask is used to impede the jet.
(a) Prior to emulating a cough/sneeze, (b) 0.13 s after the initiation of the emulated
cough, (c) after 0.33 s, and (d) after 0.83 s. Multimedia view: https://doi.org/10.1063/5.0022968.4
Visualization of droplet spread when a regular N95-rated mask is used to impede the jet.
(a) Prior to emulating a cough/sneeze, (b) 0.13 s after the initiation of the emulated
cough, (c) after 0.33 s, and (d) after 0.83 s. Multimedia view: https://doi.org/10.1063/5.0022968.4In order to determine the performance of plain “surgical” masks in comparison to the
N95-rated masks, we examine two different commercially available face masks in Figs. 6 and 7
(Multimedia views). We note that neither of the two “surgical” masks tested here were
recommended for medical use by the manufacturers. Such masks are becoming increasingly
available commercially from a wide range of manufacturers, and they are seeing widespread
adoption by the general population for regular use. We observe in Fig. 6 (Multimedia view) that the first surgical mask tested (brand “A”) is
very effective in stopping the forward progression of the jet. As expected, there is some
leakage from the gap along the top of the mask; however, it is not excessive, and it is
comparable qualitatively to leakage from the regular N95-rated mask shown in Fig. 5 (Multimedia view). On the other hand, the second
surgical mask (brand “B”), which is shown in Fig. 7
(Multimedia view) displays significantly higher leakage of droplets through the mask material,
and does not appear to be as effective as the first surgical mask (brand “A”) in the
restricting droplet spread. This indicates that even among commercially available masks, which
may appear to be similar superficially, there can be significant underlying differences in the
quality and type of materials used for manufacturing the masks.
FIG. 6.
Visualization of the droplet spread when a surgical mask (brand “A”) is used to block the
jet. (a) Prior to emulating a cough/sneeze, (b) 0.37 s after the initiation of the
emulated cough, (c) after 0.62 s, and (d) after 2.33 s. Multimedia view: https://doi.org/10.1063/5.0022968.5
FIG. 7.
Visualization of droplet spread when a surgical mask (brand “B”) is used to block the
jet. (a) Prior to emulating a cough/sneeze, (b) 0.5 s after the initiation of the emulated
cough, (c) after 0.83 s, and (d) after 3.13 s. Multimedia view: https://doi.org/10.1063/5.0022968.6
Visualization of the droplet spread when a surgical mask (brand “A”) is used to block the
jet. (a) Prior to emulating a cough/sneeze, (b) 0.37 s after the initiation of the
emulated cough, (c) after 0.62 s, and (d) after 2.33 s. Multimedia view: https://doi.org/10.1063/5.0022968.5Visualization of droplet spread when a surgical mask (brand “B”) is used to block the
jet. (a) Prior to emulating a cough/sneeze, (b) 0.5 s after the initiation of the emulated
cough, (c) after 0.83 s, and (d) after 3.13 s. Multimedia view: https://doi.org/10.1063/5.0022968.6To summarize, we have examined the effectiveness of face shields and masks equipped with
exhalation ports in mitigating the spread of exhaled respiratory droplets. The aim of the
qualitative visualizations presented here is to help increase public awareness regarding the
effectiveness of these alternatives to regular masks. We observe that face shields are able to
block the initial forward motion of the exhaled jet; however, aerosolized droplets expelled
with the jet are able to move around the visor with relative ease. Over time, these droplets
can disperse over a wide area in both the lateral and longitudinal directions, albeit with
decreasing droplet concentration. We have also compared droplet dispersal from a regular
N95-rated face mask to one equipped with an exhale valve. As expected, the exhalation port
significantly reduces the effectiveness of the mask as a means of source control, as a large
number of droplets pass through the valve unfiltered. Notably, shields impede the forward
motion of the exhaled droplets to some extent, and masks with valves do so to an even lesser
extent. However, once released into the environment, the aerosol-sized droplets get dispersed
widely depending on light ambient disturbances. Overall, the visuals presented here indicate
that face shields and masks with exhale valves may not be as effective as regular face masks
in restricting the spread of aerosolized droplets. Thus, despite the increased comfort that
these alternatives offer, it may be preferable to use well-constructed plain masks. There is a
possibility that widespread public adoption of the alternatives, in lieu of
regular masks, could have an adverse effect on ongoing mitigation efforts against
COVID-19.Please see the supplementary material for additional videos regarding the effectiveness of
various types of facemasks and a face shield.The data that support the findings of this study are available within the article.
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