In the last Coronado Eagle & Journal edition (Aug. 26) a letter restated opinions questioning the use of masks as a preventive measure in the COVID-19 pandemic. In reference to those opinions in a letter to this Journal (Aug. 5), I mentioned the almost disappearance of new COVID-19 cases in South Korea, Malasya, Japan and China following the effective use of social distancing, personal hygienic measures and masks. Indeed, these measures along with a thorough community testing and identification of cases and their contacts have made the difference with the rest of the world in reducing cases and mortality.

Recently published research, like multiple previous ones, continue supporting the rationale for using such measures. A meta-analysis of selected 19 randomized studies that met a strict inclusion criteria from a pool of 852 studies on COVID-19 cases showed masks are effective in “protection for healthcare workers and community members “and that “in the community mask appear to be effective with or without hand hygiene, and both together more protective”

(Int J Nurs Stud 2020Aug.  https://www.ncbi.nlm.nih.gov/sars-cov-2/.).

In some studies that have questioned the effectiveness of masks as a preventive measure in Covid 19, poor or undetermined compliance of subjects in its use has been a significant limitation to validate their results. A recent report in Annals of Internal Medicine also questioning the surgical and cotton mask effectiveness was later on retracted by the authors (https://doi.org/10.7326/L20-0745).

It is well known that at the beginning of the pandemic, when the prevalence of COVID-19 cases in U.S. was still low or simply unknown for lack of testing, and the available supply of masks and other personal protective equipment for health care professionals very limited or even nonexistent in some U.S. regions, CDC officials and other White House infectious disease experts like Dr. Fauci did not recommend the use of masks by the population at large, but later on they reversed their opinion when the evidence of the COVID-19 impact in U.S. changed. Because of this amendment in their recommendations some have accused them of having lied or misled the American people, maybe for not appreciating the difference between defending mistaken or biased policies in contrast to honest, responsible health experts open to change their recommendations facing new evidences.

Finally, the complaint that these well proven effective measures attempting to save lives in US from the COVID-19 “have destroyed the economy” is just a reflection of a personal preference on priorities, luckily different from the ones of our State and National health leaders: “lives first”.

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