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Policy makers must rely on best available evidence rather than awaiting strongest evidence when devising urgent policies that can potentially save human lives.
There is no shortage of mechanistic evidence and observational studies that affirmed the benefits of wearing a face mask in the community, which should drive urgent public health policy while we await the results of further research.
There is no valid scientific evidence to support the assertion that the use of a face mask in the community may impose a higher risk of infection on the ground of improper use or false sense of security.
Rationing offers no moral ground to ignore the evidence about the benefits for the users of lower priorities.
The proper approach to addressing shortage is to formulate stratified recommendations that take full account of the benefits of using face masks in the community and provide viable solutions at different scenarios (see table 3 in the main text).
I urge the WHO and policy makers worldwide to consider my stratified recommendations, or adopting measures to a similar effect, particularly as the authorities are contemplating relaxation of other aggressive measures such as border closure, lockdown and social distancing.
Introduction
This commentary echoes the plea from Greenhalgh et al to encourage people to wear a disposable surgical mask (face mask) in the community.1 There is limited clinical evidence that wearing a disposable face mask, enhancing hand hygiene practice or social distancing can reduce transmission of respiratory viral infections in the community,2 3 although there is mechanistic basis for these measures to work.4 5 For COVID-19, hand hygiene and social distancing are widely recommended, while universal use of face masks in the community is not widely recommended, especially in some Western countries.6–9 Some doubted the effectiveness of wearing a face mask in the …