Sorry, But This Is Not How Air Works

Photo: ERIC BARADAT/AFP via Getty Images.
As Americans anticipate the first vice presidential debate tonight, many health experts are metaphorically raising their eyebrows at the plexiglass barriers being used to protect the vice presidential nominees from one another. That's how they're separating Senator Kamala Harris and Vice President Mike Pence (who we assume has spent a fair amount of time around Donald Trump, U.S. President and COVID-19 patient, in the past few weeks)? A slim, semi-circle of plastic, surrounded by... nothing?
Sure, Harris and Pence will be seated with more than 12 feet between them. But... a free-standing sheet of plastic? In the middle of a wide-open room? During a pandemic caused by a virus that the CDC just confirmed is airborne? The picture of the setup was enough to make Linsey Marr, PhD, a professor at Virginia Tech and an expert in airborne viruses, laugh out loud, according to The New York Times.
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In a desperate bid to make it make sense, I reached out to some experts to ask how effective this setup could possibly be.
The truth is that the plexiglass isn't a bad idea — as long as it's combined with other precautions, according to Robert Korn, MD, vice president of emergency medicine at Northwell Health and the co-founder of Back To Work Experts
He offers this analogy: “Imagine you’re trying to flick a toothpick through a piece of Swiss cheese." Hold up one slice of cheese, and you have a good shot of getting the toothpick through a hole. But if you stack several slices of Swiss, the holes probably won't line up perfectly, making it harder to find a toothpick-sized gap.
Similarly, if the VP candidates are only using the plexiglass to protect themselves, they’re more likely to contract COVID-19. The more precautions taken — including socially distancing, wearing masks, and setting up a good air filtration system — the safer everyone will be. “Having plexiglass is certainly better than not having it, because it’s another layer of protection,” Dr. Korn says. But, ideally, it should be one layer of many. 
“The big unknown is the likelihood of airborne transmission and Pence's last potential exposure,” says Khawar Siddique, MD, the CEO of DOCS in Beverly Hills. “We are now learning that COVID-19 can travel more than six feet through smaller, microscopic particles that are airborne. We don’t know how far they can travel, but we do know that there is a higher risk in areas with poor ventilation, such as small rooms.” 
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That's why the flat sheets of plexiglass seem so ridiculous. Sure, they'll stop droplets that hit them directly. But what if either nominee turns their head? If Pence and Harris end up raising their voices like Trump and Biden did during their debate, droplets could be more likely to travel further, especially if the VP nominees are facing away from the barrier, Dr. Korn says. "I assume Pence won’t be encased in a plexiglass box, so there’s still some risk,” says Jill Grimes, MD, a family physician in Texas.
Dr. Siddique says he’s even more concerned for the politicians’ team members, including the Secret Service, who likely will be interacting without glass, and who won’t be regulated as closely. “To assess that risk, we would need to know all of the test results of Vice President Pence and his entourage,” Dr. Siddique says. “Their last test date, the number of tests they've taken recently. We'd also need to know: When was Pence’s last contact with anyone who has tested positive, including those that attended the Rose Garden event in late September?” 
Dr. Grimes notes that the incubation period for COVID-19 can be between two and 14 days, and that’s why the CDC asks folks to quarantine for two weeks if they’ve been potentially exposed. She adds that just because Pence tested negative for coronavirus on Tuesday, it doesn’t mean he couldn’t test positive later on. 
Dr. Korn says the safest option for everyone involved would have been to hold the debate virtually, and he would have liked to see the politicians lead by example. “It’s important to note that when influential people don’t follow the guidelines, people without medical [training] might see it as an indication that the behavior is acceptable,” Dr. Korn says. “It’s not.” 

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