Clear face masks and face coverings – what to look forPublished Date: 26 Jul 2021
An introduction to face masks and coverings in health and care settings and in use by the public.
UK governments make a distinction between face coverings and masks.
Face coverings are recommended as a protection against community transmission of COVID-19 by passing on any infection that the wearer may have but be unaware of (known as being asymptomatic). Face coverings are not designed to protect the wearer although there may be some limited protection offered. Face coverings may be purchased in the high street as disposable or reusable products, or can be made at home. Face coverings act as a physical barrier blocking any virus transmission from the wearer to people around them while talking or coughing etc. Unless marked as a disposable product, face coverings can be re-used multiple times with regular washing in between uses.
Face coverings must cover the mouth and nose to be effective and the wearer should wash their hands before and after removing their mask. The covering should be kept in a clean plastic bag when not in use. Wearers should avoid touching their face when wearing a face covering and should avoid pulling it on and off regularly because any virus on another part of their face or neck could be transferred to their mouth and nose.
Face masks are classified as Personal Protective Equipment (PPE) which is designed to meet a higher standard of both protecting the wearer and preventing the risk of community transmission.
NHS and Social Care settings
Face masks worn by staff in the NHS and Social Care settings are part of a package (including gloves, aprons, face shields etc.) known as PPE or Personal Protective Equipment.
PPE is designed to protect both the wearer from picking up any infection, as well as to prevent the member of staff from passing on any infection that they may have but be unaware of (known as being asymptomatic). PPE is always single-use and has to be changed regularly to prevent transfer of infection between individuals. It has to be taken on and off in a very careful way to avoid any infection on the PPE from coming into contact with the wearer. PPE face masks have to be fitted to ensure that they fit the individuals face well, with no gaps around them to allow virus transmission in and out. A good summary of different levels of PPE masks is available here and the full NHS guidelines on PPE is available here.
We have been campaigning to have clear face masks widely available in the NHS to help improve communication with deaf children without the need to remove masks to allow lip-reading and see facial expressions.
The Department for Health and Social Care (in England) purchased 250,000 clear face masks from the USA for a pilot to see how useful they were for improving communication with hearing loss. We are now working with the NHS Supply Chain PPE group who have been working with over 70 manufacturers worldwide on innovative new products. New standards have been developed for transparent face masks for use in clinical settings. So far, none of the tested products have met this specification but a number are very close and a trial of these new products will be introduced in the NHS supply chain soon. In the meantime we have been advised by the NHS Supply Chain PPE group that transparent face masks can be purchased by NHS Trusts for use in lower risk environments following risk assessment and approval of local infection control teams. They currently cannot be used in higher risk environments. Low and high risk will remain relative and depends on factors such as the level of Covid infection locally etc. but a low risk setting might be an outpatients clinic and a high risk setting a surgical ward. The easement on use of the ClearMask product also remains in place.
You can see an update on the work of the NHS Supply Chain PPE group here.
Our education blog sets out the latest rules and advice on face coverings in education. The best way to prevent virus transmission in public is by physical spacing between individuals (social distancing) and regular hand washing, but when physical distancing is not possible then a face covering helps prevent virus transmission.
Home-made clear face coverings are unlikely to provide the same degree of reduction in virus transmission as a three layer fabric face covering (as recommended by WHO). However, there are a few manufacturers of clear face masks which are available to the public to buy which are designed as alternatives to the Type II and IIR face masks (Surgical masks EN14683). The surgical mask standard (EN14683) is not appropriate for transparent face masks because the tests (such as breathability and bacteria filtration) that are carried out on fabric masks have to be omitted when testing a mask with a plastic panel. However, these could be used safely as an alternative in environments requiring face coverings such as education settings.
PPE is manufactured to standards that cover the materials used and manufacturing methods. The NHS uses PPE that has been certified by CE marking which shows the product complies with British and European safety, health and environmental standards .
There are currently no UK product standards for face coverings and the government has advised that home-made face coverings are suitable for use by the public and has information here. The World Health Organisation and Welsh Government recommends that face masks and coverings are made of three layers of fabric.
However, the British Standards Institution (BSI) have recently introduced a new BSI Kitemark for face coverings which aims to provide consumers with confidence that their face covering provides meets standards in bacterial filtration and breathability. The certification scheme has been developed for manufacturers of face coverings who wish to demonstrate that their products have been independently assessed to perform as intended. Achieving a BSI Kitemark for a product is voluntary. We are currently working with the BSI in the development of standards that will include clear face coverings also.