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Smart Thinking blog

Insights and expert advice on the key issues facing today’s pharma marketer

Masking the truth

Why a not-so-good editorial piece from The New York Times has me a little vexed

Please wear mask

As you read this column, we are approaching the third anniversary of the SARS-CoV-2 pandemic arriving on our doorstep. March 2020 seems like eons ago. In some respects it was. The world is a very different place today than it was at the end of 2019.

And one of those unmistakable differences is in the esteem with which we hold public health officials. We can all agree to disagree from time to time, particularly when it comes to COVID-19 and public health mandates, restrictions and advice received over the last three years. But let’s be real. Agencies like the CDC and the FDA, along with everyday, run- of-the-mill public health officials have lost some (most?) of that veneer of invincibility they potentially once had. In fact, medicine as a whole has lost that veneer. In what seems like the blink of an eye, a centuries-long slow, methodical building of trust, mutual empathy and shared decision-making has disintegrated.

And there is no shortage of journalists who are ready to point that out. To wit, The New York Times published an Op-Ed on 21 February 2023, entitled ‘The Mask Mandates Did Nothing. Will Any Lessons Be Learned?’ We can forgive the sensational clickbait headline (or at least most of us can). In this piece, the author cites the release of a study ‘for Cochrane, a British non-profit that is widely considered the gold standard for its reviews of healthcare data.’ The columnist goes on to remind us of the sheer breadth of the conclusions reached, which were ‘based on 78 randomised controlled trials, six of them during the COVID-19 pandemic, with a total of 610,872 participants in multiple countries’. And to further drive home the point, The New York Times piece quotes from an interview that the lead author of this Cochrane study gave to a former colleague on her Substack page here.

Suffice to say that the Substack interview reads like a conspiracy theory gone berserk. Tom Jefferson, who is a senior associate tutor at the University of Oxford and the lead author of this Cochrane review, slyly suggests in this interview that the Cochrane reviewers were “pro-mask” and that they may have intentionally held up the publication of his group’s study by seven months on the flimsy grounds of needing “extra peer review”. He goes on to suggest that Cochrane undermined his group’s work by publishing an accompanying editorial stating that, effectively, some action was necessary at the time [2020] when the alternative of sitting on our collective hands would have been deemed unacceptable in the face of this COVID-19 crisis.

But here’s the rub. Or at least one of the many. In this Substack interview, Jefferson concedes the point that “it’s not that masks don’t work, it’s just that there is no evidence they do work”. In fact he goes out of his way to state that “it’s possible they could work in some settings....we’d know if we’d done trials”.

Well, that’s not what The New York Times’ clickbait headline says. At least not the way I read it and not judging by the tone of the author’s point and counterpoint. On page 3 of the 326- page Cochrane review, the authors state that ‘the risk of bias for the RCTs and cluster-RCTs was mostly high or unclear’. They then proceed to tell us that the evidence for comparing medical/ surgical masks versus no masks to prevent the spread of viral respiratory illness was based on 12 studies, of which ten were cluster RCTs.

So there’s that.

And then, still on page 3, the authors conclude that ‘the high risk of bias in the trials, variation in outcome measurement and relatively low adherence with the interventions during the studies hampers drawing firm conclusions’.

Pretty clear, no?

But just in case that’s too ambiguous for the average reader, Cochrane has provided what it calls a ‘plain language summary’. In that plain language summary, there are two key messages. This is the first one: ‘We are uncertain whether wearing masks or N95/P2 respirators helps to slow the spread of respiratory viruses based on the studies we assessed.’

So there’s that. Again.

No one faults the Substack interviewer for conducting an interview and posting the discussion on her page. And nobody faults the interviewee for giving his opinions when asked.

But The New York Times should be ashamed of itself for allowing a columnist to publish a scathing attack on the merits of mask mandates on the basis of a review study that clearly equivocates on the issue.

The only masking issue here is the masking of the truth.

Rohit Khanna, MBA, MSc, MPH is the Managing Director of Catalytic Health, a leading healthcare communication, education & strategy agency. He can be reached at: or you can learn more about him at

30th March 2023

From: Healthcare


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