Public Health’s Truth Problem: Throughout the pandemic, medical and scientific institutions have disseminated dubious advice, flawed studies, and even outright falsehoods.

Throughout the pandemic, public-health officials have omitted uncomfortable truths, made misleading statements, and advanced demonstrably false assertions. In the information era, where what one says is easily accessible and anyone may read primary literature, these falsehoods will be increasingly recognized and severely damage the field’s credibility. No doubt, officials and organizations promulgating them had a range of motivations—including honorable ones, such as wanting to encourage salutary choices. Yet the subsequent loss of institutional trust may result in harm that far outweighs any short-term policy objectives.

Consider some messages the field has promoted to the public over the last two years and their shaky relationship with the truth.

Any mask is better than no mask. Last week, CDC director Rochelle Walensky asserted that “any mask is better than no mask.” This statement was factually incorrect when she said it. The only published cluster randomized trial of community cloth masking during Covid-19—performed in rural Bangladesh—found that surgical masks reduced the spread of Covid-19 among villages assigned to wear them, while cloth masks were no better than no masks at all regarding the primary endpoint of blood-test-confirmed Covid-19. In an umbrella review of masking that I coauthored, we found no good evidence to support cloth masking. Two days after Walensky’s statement, the CDC conceded that cloth masking was inferior to other masks. Notably, however, this is still misleading because cloth masking is not just less effective—it is entirely ineffective.

You should wear an N95 mask. Now the CDC has endorsed the use of N95 or equivalent masks in community settings, which it presents as the superior choice. Here, too, the evidence is misleading. First, a masking policy involves more than just the filtration properties of the material; it should consider both filtration and human behavior. Will people wear the mask appropriately? Will there be gaps around the nose? Will they cheat to scratch or drink? Will it cause discomfort and lead to discontinuation? Will they feel invulnerable and seek out higher risk settings? Simply put, the CDC does not know that advising the public to wear N95 is good policy. It could have run a cluster randomized trial, as was done for cloth and surgical masks in Bangladesh; it did not. In fact, the agency has run no randomized trials of masking this entire pandemic.

The virus changes, but our policies remain the same. Masking—even if it works—is not a permanent solution. It cannot work when you stop doing it. Recently, in a striking admission, Anthony Fauci confirmed not only that the virus will not be eliminated, but also that it will eventually infect us all. Even vaccination is not enough to entirely halt omicron breakthroughs. Thus, even if N95 masking delays the time to infection, we will eventually be infected. The question becomes: Is it worth it? We aren’t getting any younger, and at some point we will have to trust our immune systems (helped by vaccination) to fight off the virus. Is it worth it for a young person to delay exposure with an inconvenient and intrusive mask?