So how does the culture and procedures work for a publication like the Lancet? Are certain members of staff excluded from reading articles and correspondence etc? Genuine questions, not accusatory.
Not excluded, as such, but due to the sheer volume of material The Lancet receives, editors are assigned to certain areas of interest. As a former correspondence copyeditor (ie, fairly junior), I would only ever see letters that had been accepted - but never thought to ask to see what had been rejected. Generally, you are not reading for content anyway at that stage. But it did strike me that it was quite rare for authors to adequately address the criticisms their papers received - which is why I think addressing flaws through journal correspondence sections is relatively ineffective.