by Tom Jefferson and Carl Heneghan
Way back in 2006, when Tom and colleagues wrote the protocol for the Cochrane review, Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses ( A122 for short), little did he realise the review would become the centre of a political battle, and he would be personally targeted, too.
The first version of A122 was published in late 2007. Since then, there have been four updates, the most recent in November 202 and January 2023. The BMJ also published two of the updates (see here and here)
The first three versions included randomised and non-randomised comparative studies on various interventions such as personal hygiene, distancing and barriers, gloves, masks, goggles, antiseptics, gargling, etc.
No one took a great deal of notice of the review and its findings. The poor quality of the non-randomised evidence meant it was excluded from 2020 as the number of randomised studies increased.
It was also when the politics started creeping in. First, Cochrane delayed publication by several crucial months, allowing the void to be filled with reviews of poor-quality studies. It then set about discrediting the reputation of the entire Cochrane by including models as “evidence”.
At the same time, a powerful and strident lobby of mask-wearing fanatics made sweeping statements about their effectiveness in controlling the spread of covid, even when the minimal effect was apparent. The fanatics were ardent supporters of cloth masks despite RCT evidence cautioning against their use.
The frenzy was heightened when Anthony Fauci recommended double masking.
A122 became radioactive almost overnight. Overnight experts went on the attack.
However, one of the most egregious attacks came from within Cochrane. A bunch of Cochrane grandees wrote an editorial that they must have thought would undermine A122.
Statements included: “Waiting for strong evidence is a recipe for paralysis” and “Public health officials must, instead, take measured gambles, based on circumstantial evidence from the reviewed studies and other sources. When protecting the public from harm is the objective, public health officials must act in a precautionary manner to take action even when evidence is uncertain (or not of the highest quality), particularly when the harms and costs of such action are likely limited”.
Amid the pandemic, the Cochrane grandees decided it was OK to replace evidence with consensus and fill the void with “rapid reviews” of junk science that included mathematical models. They also allowed the rapid reviews to duplicate the work of A122, avoidance of duplication being one of the pillars of the foundation of the Collaboration.
The attacks from within Cochrane continued with the 2023 publication. Six weeks after publication, the Editor in Chief, “blindsided” by a New York Times op-ed, undermined the review’s credibility.
The op-ed was written by a blogger and mask double-flip lobbyist with no background in respiratory virus research.
Without any consultation with the twelve authors of A122, the Editor-in-Chief of the Cochrane Library issued an apology for the review.
The Cochrane Editor in Chief still needs to explain the rationale for her behaviour. The usual way for an editor to behave is to ask individuals to submit a comment to the review and then allow the authors to address any concerns,
However, a routine Cochrane review had become a political football.
Fauci was back at it: He refuted the Cochrane study, claiming that masks don’t work. On CNN, Fauci’s response highlighted that there’s no need for evidence; you only need to follow the Fauci word.
“When you’re talking about the effect on the epidemic or the pandemic as a whole, the data are less strong, but when you talk about an individual basis of someone protecting themselves or protecting themselves from spreading it to others, there’s no doubt that there are many studies that show that there is an advantage” to wearing masks, he said.
The then Director of the US CDC joined the party in misleading the US Congress by claiming the review had been retracted.
Dr Walensky said: “I think it’s notable that the Editor-in-Chief of the Cochrane actually said that the summary of that…of that review was…(pause) she retracted the summary of that review and said that it was an inaccurate summary…..”
Dr Walensky’s response was factually incorrect. The Editor-in-Chief has neither retracted the study summary nor corrected any part of the study in any way. The article remains completely intact from its original publication on Jan 30 2023.
Some attacks were subtle: A122 is often identified as the “Jefferson Cochrane review” to remove the other eleven authors. Other attacks were more personal. This email is from the US to Tom, dated 10 September 2023:
“Your cochrane report allows people the option to MASK or 100% NOT MASK how can you Tom Jefferson even post this with a straight face its a debunked argument claim there is no evidence for the legitimacy of these randomized controlled trials when you did this exact same thing thats why your study is a False BS Bogus Study , stop lying your ending peoples lives your fake fraudulent cochrane study is nothing compared to CHINA ZERO COVID POLICY everyone 100% wore a mask not like usa 30% masked or denmark 10% masked or any of the countries you reviewed stated that werent evening wearing masks they only had 7780 deaths and 180k cases when they lifted the zero covid policy now they are leading the USA so how do you explain that????”
The role the US CDC played in all this is worth considering: in its advice on all matters ILI CDC is not substantially different from other august public health bodies.
CDC has a consistent record of misquoting, misrepresenting or basing its decisions on poor quality evidence, as we have shown for influenza vaccine policy and antivirals. We have one more blatant and ironic example of this further down.
Recently, a fellow Substacker has exposed that no one is immune to attacks and misrepresentation from the CDC – even their own scientists.
The problem lies in CDC’s championing the superiority of N95 respirators over surgical masks. CDC commissioned their own scientists to systematically review the evidence, presumably to bolster their stand. However, like A122 and several other reviews, the CDC reviewers found no difference across a whole range of agents, known and unknown.
A122 concludes that there is uncertainty about the effects of face masks, and the pooled results of randomised trials did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks during seasonal influenza. There were also no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection.
Contrast this with the certainty of the New York Times article by Tufecki – Here’s Why the Science Is Clear That Masks Work.
This certainty is reiterated by the CDC, which ironically comes from the Introduction of its own self-censored review:
“Medical or surgical masks and N95 respirators, plays a critical role in protecting healthcare personnel from exposures to infectious respiratory illnesses in healthcare facilities. In laboratory settings, N95 respirators have been proven to be more efficacious than surgical or medical masks at filtering particles and challenge viruses in lab settings.[1-5]”
So, if you live in a laboratory setting and spend your time experimenting with respiratory agent transmission, according to the CDC review, it’s a fact that N95 use is critical. This is especially so, as shown by the five citations to published works.
Except that reference 2 is none other than A122.
If any reader of TTE can point to any laboratory studies included in A122 or any text in A122 asserting the superiority of N95 respirators in such circumstances, they will win a giant picture of Matt Hancock.
At the heart of these problems is the fanatics’ approach to bolstering their own opinions on the certainty of the effectiveness of masks.
But as the panic has been negated, we find the flip-floppers are increasingly agreeing with our stance. It’s hard to know when this first started, but in January 2022, the CDC conceded “that cloth masks do not protect against the virus as effectively as other masks.”