LAUSR

During the COVID-19 pandemic, international organizations, institutions, and experts firstly recommended face masks for the population only in symptomatic subjects, but today various countries recommend or require their use even outdoor. In Italy, there was an obligation in closed places accessible to the public, including means of transport, and always if the safety distance was not continuously guaranteed. Various regions have long imposed obligations everywhere but at one's own home, and now the mandate has become national. This contribution critically analyses the randomised controlled trials (RCTs) on the effectiveness of medical masks in preventing respiratory infections in university/community contexts and outdoor gatherings, with questions and answers based on reasoning where possible based on evidence. It discusses whether the evidence supporting the WHO positions is weak compared to more stringent policies; it considers some underestimated adverse effects of the prolonged use of masks in the community and especially outdoors, not only by persons doing physical activity. This paper discusses some differences between SARS and COVID-19 in the potential impact of the masks and proposes to consider the most valid evidence available, avoiding prolonged/continuous use without valid needs for face masks, especially outdoors, waiting for others pragmatic RCTs that clarify conclusively a net balance between expected benefits and possible damages. KEYWORDS: facemasks effectiveness; medical masks safety - side effects; medical masks and SARS-CoV-2.