To wear or not to wear a mask in the COVID-19 era? The broken bridge between recommendations and implementation in Lebanon

At the beginning of the COVID-19 pandemic, the scientific community has been debating the use of face masks amongst the general public, sending conflicting recommendations. On one side, the World Health Organization (WHO) did not recommend using face masks as a preventive measure [1], in the absence of extensive scientific evidence on the matter. Till May 2020, there were no high quality controlled trials addressing the question of wearing masks by the general population as a protective measure to contain COVID-19. In the absence of evidence related explicitly to COVID-19, analogies were made with similar types of viruses with high transmission rates, such as influenza or SARS. A recent meta-analysis looking into the effectiveness of the public’s use of non-pharmaceutical interventions in the transmission of influenza did not report supporting evidence for the use of face masks [2]. With the lack of strong evidence, the absence of supportive recommendations became more meaningful when considering the shortages of personal protective equipment, including face masks needed for health care workers worldwide.