Universal masking for COVID-19: evidence, ethics and recommendations
Tak Kwong Chan
Abstract
► 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.