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- Page navigation anchor for Lessons learned from Hong Kong's response to COVID-19: Don't just follow the authoritative guidanceLessons learned from Hong Kong's response to COVID-19: Don't just follow the authoritative guidance
I congratulate the authors for writing this inspiring article that shows ways to combat the COVID-19 pandemic.<1> It succeeds in debunking certain myths, such as association of mask wearing with poor hand hygiene and perceived lack of evidence on mask use. However, it fails to detail the events that lead to universal mask wearing by the public in Hong Kong (HK).
HK governor Carrie Lam once advised the public to follow the WHO's guidance to not wear masks, which most HK residents disagree; eventually, Lam herself wears a mask.<2> If HK residents blindly followed Lam's initial guidance to not wear mask, the transmission and death rates in HK could be as bad as the ones in other countries.<1>
Similarly, Canadians should consider taking authoritative guidance with skepticism. On 6 April, Public Health Agency of Canada changed its position from discouraging mask use to encouraging cloth mask use, despite being shown to have inferior effectiveness compared to surgical masks.<3> On 7 April, Public Health Ontario released a literature review that concluded most studies did not demonstrate benefits of face mask use,<3> but appeared to strategically omit two recent systematic reviews which demonstrated effectiveness of masks in prevention of respiratory infection.<4><5>
It is important to note that authorities also have potential conflicts of interest when making guidance. If they advised the public to wear sur...
Show MoreCompeting Interests: I have been paid for working in primary and secondary care settings, but not for writing this letter. Opinions expressed are solely my own and do not express the views of my employer.References
- 1. Samuel Y.S. Wong, Kwok Kin On, Francis K.L. Chan. What can countries learn from Hong Kong's response to the COVID-19 pandemic?. CMAJ 2020;10.1503/cmaj.200563.
- 2. Explainer: 7 reasons hongkongers are angry about the gov’t response to the coronavirus. Hong Kong: Hong Kong Free Press; 2020 Feb 1; cited [Apr 25, 2020]. Available from: https://hongkongfp.com/2020/02/01/explainer-7-reasons-hongkongers-angry-govt-resp
- 3. 2019-nCoV – what we know so far About…Wearing masks in public. . Available from: https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en.
- 4. MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings. BMJ. 2015;350:h694.
- 5. Offeddu V, Yung CF, Low MSF, Tam CC. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clin Infect Dis. 2017;65(11):1934-1942.