Reaffirmed: Masks make 'little to no difference' after 15-month review prompted by NYT columnist

Cochrane's rationale doesn't explain timing: Formal debate between authors, critics ended in December. Pro-mask activists who touted scarlet letter against study, trashed its lead author remain quiet. "The damage has been done," scientist says.

Published: June 14, 2024 11:00pm

Updated: June 15, 2024 12:01pm

Fifteen months after caving to pro-mask public figures by applying a scarlet letter to its research questioning the effectiveness of masks against influenza and COVID-19 – over the strident objections of its authors, whose critics declared victory – a U.K.-based international research collaborative funded by American taxpayers has reached an anticlimactic conclusion.

The collaborative, Cochrane, said it will not require the authors of "Physical interventions to interrupt or reduce the spread of respiratory viruses," an ongoing 18-year systematic review last updated in January 2023, to revise the "plain language summary and abstract" despite Editor-in-Chief Karla Soares-Weiser claiming the study had been "widely misinterpreted" as "masks don't work."

The June update to Soares-Weiser's March 2023 statement, which itself may have violated the Committee on Publication Ethics protocol by unilaterally changing the "interpretation and conclusions" of the authors, raises as many questions as it answers, particularly why the once-celebrated "gold standard" of evidence-based medicine took so long to do nothing.

Cochrane did not respond to Just the News queries for an explanation of the timing or why Soares-Weiser's name isn't on its June 6 response, which is credited to "The Editors."

The collaborative simply cited the "scientific debate" happening in the comment section of the paper, with back-and-forth between commenters and corresponding author John Conly of the University of Calgary medical school on behalf of the authors. The last response, by Conly, is dated Dec. 21, 2023.

Soares-Weiser posted her unilateral statement hours after New York Times columnist and Princeton sociologist Zeynep Tufekci quoted her in the column "Here’s Why the Science Is Clear That Masks Work."

The editor-in-chief criticized the study's initiator and lead, University of Oxford epidemiologist Tom Jefferson, for characterizing the findings in an interview as "no evidence" that masks "make any difference," which Soares-Weiser called "not accurate." YouTube continues to promote Soares-Weiser's view as of Friday.

"I got that highly consequential Cochrane misinterpretation corrected," Tufekci claimed on X and thanked Cochrane for "correcting the record," even though the review's content didn't change. Then-CDC Director Rochelle Walensky falsely told a congressional committee the review had been "redacted" – a factual error the committee fixed in the hearing record.

Tufekci told Just the News in the wake of the controversy she was not bullying or trying to discredit the authors by asking "questions about other people's work[, which] is normal." She does not appear to have addressed the update on her nearly 500,000-follower X account.

"Comments on intervention adherence, combining data from studies conducted against the backdrop of different circulating viruses, and summary versions of the review (including the plain language summary and abstract) have been addressed directly by the authors in their responses," the editors said June 6.

"Following engagement with the authors," the editors decided changing the abstract and summary intended for lay readers — which said masks "probably make little to no difference" – "would not impact the scientific integrity of the content."

Cochrane's shrug after "throw[ing the authors] under the bus," as Jefferson put it at the time, stood out to defenders of the research and its authors.

"No changes made to the plain language summary. Of course media not touching this," epidemiologist Allison Krug wrote on X.

The inaction is "devastating" for Soares-Weiser, University of California San Francisco epidemiologist Vinay Prasad, whose narrower review of community masking research in the law-medicine journal Health Matrix echoed Jefferson's, wrote in his newsletter Tuesday.

Prasad's research team "looked at all Cochrane reviews on topics with negative overall conclusions and wide confidence intervals" – the editor-in-chief's stated basis for changing the authors' interpretation – and found "they were always interpreted as negative except for this one case" in which Soares-Weiser changed it.

Former Senate Finance Committee investigator Paul Thacker, who used a U.K. law to obtain nearly unreadable emails among Cochrane staff on how to respond to his questions after Soares-Weiser's statement, obtained other communications unfavorable to Cochrane.

One author complained to Soares-Weiser that Tufekci had not been "referred to the usual Cochrane process" for journalists, in which they "agree to comply with the Cochrane policy and submit and provide full [conflict of interest] disclosures" that are paired with journalists' comments on papers. 

Thacker detailed Tufekci's alleged conflicts in response to her column, whom he and Heneghan both refer to as a "social media influencer."

Tufekci's column paraphrased Michigan State University emergency medicine department Chairman Michael Brown, who serves on Cochrane's editorial board, as saying the review "couldn’t arrive at a firm conclusion because there weren’t enough high-quality randomized trials with high rates of mask adherence." (The January 2023 update reviewed 78 randomized trials.)

Brown also told her he was "very confident" that mask mandates and other early-pandemic interventions prevented "much higher" deaths in "places like New York City."

But Brown apologized to an author "for how this transpired" because "I stood by the conclusions of the review" and Brown would be "throwing myself under the bus as the sign-off editor" if he contradicted their conclusions, according to Thacker. 

"Very naive to think you" and Soares-Weiser would talk to this "controversial writer" without first informing the authors and "trust them" not to "immediately publish what you said," the author responded, Thacker said.

Brown told Just the News that he thought Tufekci "captured the conclusions of the systematic review" in her paraphrase that it couldn't reach a "firm conclusion" because of too few "high-quality randomized trials with high rates of mask adherence."

But he said the Times did not make "explicit" his other comments, that he was not speaking for Michigan State or Cochrane, and that his apology "for how this transpired" was based on Tufekci apparently not contacting the authors for their thoughts, as he had suggested.

Jefferson and his collaborator Carl Heneghan, director of Oxford's Centre for Evidence-Based Medicine, republished Thacker's essay in their own newsletter. Heneghan's response to the "U-turn" crowed that "Cochrane leaders have recanted" but "the damage has been done," including through Walensky's false testimony and "zero coviders" who used it to "distort reality."

Thacker also created dossiers of medical academics and science journalists who wrote "disparaging stories and social media postings spurred by" Soares-Weiser's statement, documenting their allegedly weak, retracted or fraudulent mask research and false claims.

Tufekci provided Just the News a lengthy statement in response to Cochrane's decision and Thacker's allegations about her.

"Despite Paul Thacker's inexplicable insistence in making false claims about my role in clarifying the findings from the Cochrane review ... nothing has changed regardless of whether or not Cochrane review authors update their summary to prevent widespread misunderstandings of what their review concluded," she wrote in an email, provided in full in the linked PDF. 

"I merely helped clarified this basic misunderstanding after seeing it propagated widely, and multiple co-authors of that review as well as the editor-in-chief of Cochrane agreed with my attempts to correct this misinterpretation, and I quoted two of them in my article," Tufekci said.

"My effort to help correct the misrepresentation ... remains valid and correct, as attested by multiple co-authors of the review, since my clarification was based on the actual review and not whether or not the summary is eventually updated to make it harder to misinterpret it," she said. I've nothing to do with that process which doesn't change the fact that my own clarifications remain correct, valid and supported by multiple co-authors of that very review.

She invited Thacker to point her to other studies or "disagree with various findings ... without making false claims about either my own role in clarifying the findings of the Cochrane review or the actual findings of the review itself."

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