The COVID-19 pandemic has had enormous effects on health, wellbeing, and economies worldwide. Governments have responded with rapid and sometimes radical public health interventions. As nations grapple with the question of how to regain normality without unnecessarily endangering lives or healthcare systems, some scientists have argued for policies to encourage or compel the use of face coverings in community (nonclinical) settings, despite acknowledged gaps in the evidence base for the effectiveness of such a measure. This commentary has two objectives. First, in the face of strong arguments that face coverings are a commonsense intervention, with negligible downsides, that can only do good, we make the case for caution in changing policy. Many seemingly benign public health interventions have the potential to cause harm, and that harm is often socially differentiated. We present five arguments for caution in policy change. Second, we reflect on the wider implications of the increasingly overt approaches to policy advocacy taken by some scientists. Drawing from the theory of post-normal science, we argue that the science-policy interface in the case of face coverings has taken a surprisingly traditional form, falling short of interdisciplinary integration and failing to incorporate insights of the full range of relevant experts and affected stakeholders. We sketch a vision for an alternative, more mature, relationship between science and society that accepts uncertainty, embraces deliberation, and rises to the challenge of developing knowledge to improve public health.

Distinction is critical for good healthcare

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BACKGROUNDThe rise of non-communicable diseases, many of which share common risk factors of smoking, alcohol, poor diet, and physical inactivity, has resulted in calls to develop and expand lifestyle medicine, giving 'hope to those suffering from chronic illness' (https://bslm.org.uk/). It has been argued that lifestyle medicine should be recognised as a new medical specialty, 1 with primary care leading.There are numerous drivers for lifestyle medicine (Box 1). Our analysis does not aim to argue against the importance of these drivers as many of them are well informed. Instead we seek to balance existing discussions with aspects that, in our opinion, have been less well considered. With this in mind, we focus on the unintended consequences of uncritical endorsement and application of lifestyle medicine including the infiltration of pseudoscience, profiteering, and the potential for widening health inequalities by a continued focus on the 'individual'. We stress the need for greater attention to public health and community-level interventions and a more critical approach to current practice. WHAT IS 'LIFESTYLE MEDICINE'?Medical practice guidelines often advise on 'lifestyle factors'. These are usually in the form of individual behaviours that impact on health, framed as modifiable, often related to smoking, alcohol intake, physical activity, diet, and, to a lesser degree, sleep quality, stress, and social factors. However, translation of guidelines into achievable real-world benefits outside clinical trials is challenging.The British Society of Lifestyle Medicine (BSLM) describes lifestyle medicine as 'an established approach that focuses on improving the health and wellbeing of individuals and populations … It requires an understanding and acknowledgement of the physical, emotional, environmental and social determinants of disease.' (https:// bslm.org.uk/). Society membership is open to registered health professionals, who can take a diploma, and associate membership is available to others, such as reflexologists, homeopaths, herbalists, and naturopaths. Some have called for greater inclusion of lifestyle medicine education in professional training, including medical curricula, 2 based on evidence that knowledge of

The pause in appraisal and revalidation during the covid pandemic offers an opportunity to reflect on their value and consider their future argue Victoria Tzortziou Brown and colleagues