Achieving Universal Wearing of Face Masks During the COVID-19 Pandemic: A Practical Solution from Shanghai, China

Background: Face masks are basic protective equipment for preventing respiratory infectious diseases. The measures to properly dispose of and allocate face masks during the early stage of an epidemic caused by respiratory infectious diseases deserve worldwide attention. Methods: A qualitative research approach was used to document the practice of a citywide face mask-wearing strategy of the Shanghai Municipal Government (called the "Shanghai solution" in this article). Based on data from government work documents, an online face mask-allocation and sales system was built to offer real-time updates of face-mask appointments and sales information in all designated pharmacies and neighborhood committees in Shanghai. Results: In the Shanghai solution, a total of 24.8 million residents in 6,031 committees were covered, in order to achieve universal wearing of face masks during the COVID-19 crisis. Up to 110 million face masks were dispensed to residents in six rounds of face-mask allocation during February to April. This practical experience in Shanghai solved two key problems (insufficient face-mask capacity, protection of vulnerable population) with the supply of face masks by addressing four essential characteristics: overall coordination, on-demand distribution, efficient distribution, and technical support. Conclusion: The practice of the citywide face mask-supply strategy of Shanghai could provide several pointers for management of a shortage of emergency materials, dispatch, and transport to other countries during the pandemic.