N95 Respirators vs Surgical Masks vs Face Shields

From the onset of the Covid-19 pandemic, there was an instant surge in demand for personal protective equipment (PPEs). These PPEs were used by healthcare providers who were in the frontline of the battle against Covid-19 in order to reduce exposure and the spread of the virus. However, ordinary people are also encouraged to wear PPEs, especially in public. Face masks were the most reliable and accessible of them to use in order to protect the public from the potential spread of the virus. In fact, the high level of demand for these masks has created shortage worldwide, forcing manufacturers to produce them in bulk in order to cope with the demand.

Over time, there are various types of face masks that emerged as an option to healthcare providers and the general public. The most common of these were the surgical masks but experts have come into the conclusion that these were not enough to protect the wearer from the virus. Some suggested that the N95 respirators were the best option to ensure protection from Covid-19. After some time, there were recommendations to wear face shields, along with a face mask.

Which of these personal protective equipment offer safety against Covid-19? It’s important to look closely into each type in order to fully understand their features and their capabilities when it comes to preventing the spread of the virus.

N95 Respirators

The N95 mask, also known as N95 respirators, is a protective device for respiratory threats such as the coronavirus. It is considered as the standard of health safety and protection as far as masks are concerned because it offers the most secure facial fit. The design of the N95 respirators feature sealed edges in the nose and mouth area. This in itself is critical in minimizing the filtration of airborne particles that could spread the infection.

According to the National Institute for Occupational Safety and Health, the N95 masks offer more or less 95% filtration efficiency. This means that non-oily particles that are no more than 0.3mm in size are unable to penetrate through this mask. Historically, this type of mask is used by healthcare workers since it is approved by the FDA and offers maximum fluid resistance. It is also equipped with an elastic strap that ensures a tight fit on the user’s face, although some models might require fit testing for a more secure seal.

Since the rise of the Covid-19 pandemic, though, there has been a short supply of these types of masks in the market. Because of this, the Center for Disease Control and Prevention (CDC) has recommended that the general public refrain from the use of N95 respirators. Since this is considered a critical supply, it is only recommended for use by health care workers and first responders, as per latest CDC guidance. You can learn more about other recommendations for its use on the FDA website.

Surgical Masks

The general public has been advised to wear some form of face coverings in order to slow down the spread of the virus. The use of surgical masks is one of the options available, although the CDC would suggest that even face cloth masks will do. They also encouraged observance of minimum health standards such as social distancing (at least 6 feet) and constant hand washing. However, the use of a surgical mask is shown to limit exposure to the virus, and for those who might have it from transmitting it to those around them.

Unlike the N95 respirator, a surgical mask is loose-fitting. This protective respiratory device is also disposable in nature. Hence, health experts advise against reusing surgical masks after users have worn them in public. The use of surgical mask provides a protective physical barrier for your mouth and nose from possible contaminants. There are many other names used to refer to surgical masks although they are all the same, such as dental, medical, or isolation masks.

Surgical masks are available in a variety of thickness, although the 3-ply mask is the current standard in the market for use by the general public. Its main purpose is to limit or prevent exposure to liquids and airborne particles that might contain the virus. At the same time, it also limits the spread of your saliva and other forms of secretions to those around you. However, surgical masks do not offer complete protection especially when compared to the protective capabilities of the N95 mask.

Face Shields

With the global shortage and increased demand for face masks, the general public is forced to look for alternative options to protect against the virus. Face shields provided another option for face covering in order to prohibit exposure to the virus. In some parts of the world, the use of face shields on top of a face mask is recommended.

A face shield is not a form of respiratory protective device. Hence, experts suggest that it should not be used as a replacement for wearing a mask. Instead, it is used to enhance the protective capabilities of wearing a mask, especially if you are using a surgical mask (and not the industry standard N95 masks). When no medical masks are available, the general public is encouraged to use a face shield.

In most cases, though, face shields only offer eye protection. Since masks are able to provide protection to the mouth and nose, the eyes become vulnerable to being exposed to the virus. As such, the recommendation to wear a face shield came about in order to prevent respiratory droplets from entering through the eyes. However, there is lack of evidence from the CDC or WHO that would suggest the effectiveness of face shields in curtailing the spread of the virus. It should, therefore, not be used as a substitute but rather an additional form of protection.

The use of face shields is accepted on those instances wherein wearing a mask is not possible. A good example for that concern those who are deaf or those with hearing impairment. They may use a face shield instead of a mask in order to communicate non-verbally (which wearing a mask would prohibit).

Due to the widespread use of face shields all over the world, the WHO and CDC are looking to standardize its use. This will ensure that all face shields meet the satisfactory requirements set by these organizations to ensure that they can perform their jobs. For instance, reusable face shields must be thoroughly cleaned and sanitized after every use. The CDC has detailed some cleaning measures for face shields to ensure that contamination does not happen through its surfaces. In addition, those who opt to use face shields must also dispose of the items properly by following the manufacturer instructions.

For best results, health experts recommend using the medical masks in combination with a face shield. This will ensure that the mouth, nose, and eyes are all protected from airborne particles and respiratory droplets.

Detailed Comparison

In order to make an objective comparison, it is important to look at a few factors as points of comparison. These factors are the following: Testing and Approval, Intended Purpose and Usage, Filtration, and Limitations in Use.

In terms of testing and approval, the N95 respirator is the best option there is when it comes to protecting against Covid-19. In fact, it has earned the recommendation of the National Institute for Occupational Safety and Health (NIOSH). However, this is only recommended for use by healthcare workers and first responders so the general public should resort to using a surgical-grade mask. While there are many individuals who have opted for the use of fabric masks, the 3-ply surgical mask is still recommended because it offers better filtration capabilities.

As for face shields, the testing and approval is still ongoing in order to standardize their use. The WHO and CDC are in agreement, however, that face shields are not as effective as medical masks are. It should be looked at as a supplement source of protection rather than the main protective device.

When it comes to intended use and purpose, N95 respirators help to reduce the wearer from exposure to minute particles and droplets. On the other hand, surgical masks are fluid resistant and can provide protection against large droplets only. It is also best for the wearer to contain their respiratory emissions so as to stop contributing to the spread of the virus and other airborne particles. For face shields, they do not offer the same level of protection because they are not as tight-fitting as N95 masks are. Of these three devices, only the N95 masks undergo the fit testing requirement.

The filtration protection offered by a surgical mask is lower than the N95 mask. Whereas the latter offers 95% filtration efficiency from smaller particles, a surgical mask does not provide the wearer with a reliable level of protection from respiratory droplets. In terms of leakage, the N95 mask is also superior to surgical masks and face shields. It is properly fitted around the edges to provide minimal leakage unlike that of a surgical mask.

As per disposal after use, the N95 mask should be completely discarded after exposure to possible contaminants. Any deformity on its shape or form would warrant for it to be discarded, too, as it is no longer as effective as it is designed. The same is true with surgical masks – they are also disposable in nature. Meanwhile, face shields can be reused (depending on the material) provided that strict sanitation and cleaning procedures are followed after every use.