The increased infection risks from omicron raise a pressing question: What more can we do to prevent Covid-19 infection, especially during air travel?
According to experts, there is a vulnerability many people overlook: our eyes.
As early as 1919, research showed that eyes are a route for respiratory viral infection. This connection was confirmed during the SARS1 outbreak in Singapore and Canada, where healthcare workers without eye protection were at higher risk for infection.
More recently, researchers showed that face shields, as part of a set of preventive measures, prevented the spread of infections in nursing homes early in the pandemic.
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According to Dr. Eli Perencevich, professor of internal medicine at the University of Iowa and one of the authors of the nursing home study, eye protection is an important safeguard in high-risk situations.
“All high-risk people (immunocompromised) should consider eye protection since not everyone responds to the vaccine,” Perencevich wrote in an email.
Eye protection, with face shields or goggles, is particularly important if you can’t maintain three to six feet of distance in high-risk situations, especially if you’re not vaccinated, according to Perencevich. He says eyes are likely to be infected by larger respiratory droplets, making distance especially important.
But among the general public, there appears to be confusion or even disagreement about the scientific evidence on face shields.
According to Hootsuite, a social media management platform with millions of users, face shields aren’t a big part of the social media conversation. Since December 8, only 43 mentions turned up in Hootsuite’s analysis of “omicron” or “covid” and “face shields” or “eye coverings.”
Some people, though, are embracing this extra protection.
Alvin Dy, cofounder of All Home Robotics, said he’s added plastic face coverings to his holiday travel precautions. He also cut his two-week family vacation down to one and got all family members vaccinated to reduce their risks.
Axel Hernborg, self-proclaimed wanderer and CEO of Swedish-based Tripplo.com, is also using face shields on flights during his holiday travels. He’s been avoiding crowded places and only staying in hotels that follow strict Covid-19 protocols.
Andre Flynn, founder of Gadnets.com, didn’t want to give up his “big trip” for Christmas—from California to St. Lucia—despite the rising risks due to omicron. Flynn is vaccinated. He has also upgraded his masks to N95s and added face coverings to use on the long flight and in crowded areas at his destination.
These layered precautions make sense to the experts.
“If you want to think about decreasing risk, the most important thing is to get vaccinated and then boosted if you haven’t already,” said Dr. Megan Ranney, a practicing emergency physician and academic dean of public health at Brown University. “Step two is a really high-quality mask—an N95 or KF94 or KN95.”
After that, Ranney said, face shields can’t hurt.
“Particularly if you are someone who is higher risk or if you’re going to be on a really long flight, you are not wrong to use [a face shield],” Ranney said.
But Ranney says, because the data showing face shields reduce Covid-19 spread is based largely on unvaccinated populations, face shields may not dramatically change your risk if you’re vaccinated and also taking other precautions like using high-quality, well-fitting masks.
On the myCOVIDRisk app put out by the Brown University Center for Digital Health, which Ranney founded and leads, Ranney says you can see how face shields could change your level of risk in certain situations or environments.
Even if the impact is minimal, face shields have another benefit, according to Ranney.
“What I love about face shields in the emergency department is that it protects my mask,” Ranney said. “With the face shield on, it means that then when I touch the outside of my mask, I’m not touching all those Covid particles.”
Not everyone is convinced that this extra layer of protection is necessary.
Tracy Lamourie, a celebrity publicist and travel blogger, has been looking forward to a trip to Malta with her mother. Though she’s worried omicron will lead to new travel restrictions and cancellations, she isn’t especially worried about getting sick herself. She is vaccinated and vigilant about sanitizing her hands and wearing a mask.
“In addition, I hide under my coat, using it as a blanket so I am effectively on my own little bubble for the flight,” Lamourie said.
That layered approach may be enough to keep a low-risk person safe.
“For most people, the primary protection should remain a high-quality mask since the virus is spread by respiratory droplet aerosols in the air,” Perencevich said.
In high-risk situations where you can’t afford to catch even a mild covid infection, such as when visiting an older parent or immunocompromised person, Perencevich recommends eye protection, especially if you can’t maintain three to six feet of distance, such as when flying.
For most people, vaccination with booster and well-fitting, high-quality masks are good protection.
But, Perencevich cautions, “Nothing is 100%.”