The choice of various respiratory protection mechanisms, including face masks and respirators, has been a vexed issue, from the 2009 H1N1 pandemic to the west African Ebola epidemic of 2014,1  to the current COVID-19 pandemic. COVID-19 guidelines issued by WHO, the US Centers for Disease Control and Prevention, and other agencies have been consistent about the need for physical distancing of 1–2 m but conflicting on the issue of respiratory protection with a face mask or a respirator. This discrepancy reflects uncertain evidence and no consensus about the transmission mode of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For eye protection, data are even less certain. Therefore, the systematic review and meta-analysis by Derek Chu and colleagues in The Lancet  is an important milestone in our understanding of the use of personal protective equipment (PPE) and physical distancing for COVID-19.


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