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Act now, wait for perfect evidence later, says ‘high priestess’ of U.K. COVID-19 masking campaign

In May, when several prominent U.K. scientists pushed back against a Royal Society report recommending face masks to help control the spread of COVID-19, Trisha Greenhalgh was furious. The scientists argued there was insufficient support in the scientific literature for the efficacy of masks, and the U.K. government, following their lead, declined to mandate masks for the general public.

“The search for perfect evidence may be the enemy of good policy,” Greenhalgh, a physician and expert in health care delivery at the University of Oxford, fumed in the Boston Review. “As with parachutes for jumping out of airplanes, it is time to act without waiting for randomized controlled trial evidence.”

Greenhalgh is a firm believer in evidence-based medicine. She wrote a best-selling book on the topic, and her research has earned some of her nation’s highest honors. But in recent years, she has grown critical of what she believes is the privileging of randomized controlled studies over clinical experience and close observation. COVID-19, she argues, has revealed the limits of evidence-based medicine—masks being a potent case in point.

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