– 2006 protocol for the Cochrane review on ‘Physical interventions to interrupt or reduce the spread of respiratory viruses’ drew little interest
– 2009 BMJ version drew 3 comments, 2020 update due to governments mandating masks
– 2023 version was undermined by an op-ed, apology to the world issued without author consultation
The 2006 protocol for the Cochrane review on ‘Physical interventions to interrupt or reduce the spread of respiratory viruses’ drew little interest despite being co-published in the BMJ twice. In 2009, the BMJ version drew three comments. However, for the 2020 update, the situation changed drastically with governments releasing pro-mask-wearing statements and mandating them. Cochrane grandees delayed the publication, added unprecedented layers of scrutiny, demanded the insertion of unnecessary statements, failed to publicise the review and undermined its content with an accompanying Editorial and Feature. This shifted the approach to evidence back to the 1970s.
The situation further escalated when the 2023 version was published and six weeks after, the Editor in Chief, “blindsided” by an op-ed, undermined the credibility of the Cochrane review. An apology was issued for the review findings to the world, blaming the shop window of the A122 review for being badly written and taking responsibility for misquotes of the text.
A costly consulting firm was hired to serve as a mediator, however, there has been no collaboration and considerable duplication of effort. The rapid review topics were duplicates of the interventions assessed since the A122 inception in 2006. The more prolonged the negativity exists, the worse it gets for the authors and for the many working on the other Cochrane reviews.
As the authors have sought clarification of the actions, investigative journalists and other researchers have recognised the mismatch in the power dynamic which has been undermining the publication of the high-quality, evidence-based review.
Despite the negativity, the A122 review has still not been retracted and has the 14th highest attention score of nearly 24.5 million research outputs – showing an enormous amount of interest.
To summarise the story, the 2006 protocol for the Cochrane review on ‘Physical interventions to interrupt or reduce the spread of respiratory viruses‘ – known formally as A122 – and the previous versions drew little interest despite being co-published in the BMJ twice. The 2009 BMJ version drew – all of – three comments.
For the 2020 update, things changed radically: Governments released pro-mask-wearing statements and instigated mandates — the point when our A122 came into conflict with politics.
As we have documented, Cochrane grandees delayed the publication, added unprecedented layers of scrutiny, demanded the insertion of unnecessary statements, failed to publicise the review and undermined its content with an accompanying Editorial and Feature.
Archie Cochrane’s agenda and the precautionary principle were turned on their respective heads. As a consequence, the approach to evidence was shifted back to the 1970s. Following ‘the Science’ meant ditching an evidence-based approach. As the panic spread, policies had to be justified – enter the models and the laboratory studies that followed in the seven-month gap while A122 was delayed.
The rapid review topics were duplicates of the interventions A122 had assessed since its inception in 2006. So far, there has been no collaboration (in fact, completely the opposite), no science and sizeable duplication of effort.
The situation further escalated when the 2023 version was published. Six weeks after publication, the Editor in Chief, “blindsided” by an op-ed, undermined the credibility of the Cochrane review.
Without any consultation with the twelve authors of A122, an apology for the review findings was issued to the world, stating that the shop window of the A122 review had been badly written and effectively took responsibility for other people’s misquotes of the text. Here is the text of the communiqué as a reminder.
The text contains several incorrect and political statements: the review was not and never has been on interventions intended to increase coverage and uptake of physical interventions; it assesses the best available quality evidence of their effects.
To smooth all this, a costly consulting firm has been hired to serve as a mediator. We’ve published hundreds of peer-reviewed publications in probably over 100 journals and hundreds of news articles in the mainstream media; Carl has been an Editor-in-Chief, yet we’ve never seen an editor call in the mediators – have any of our readers?
Such an opposing position to discredit authors and underplay the content is hard to justify. The more prolonged the negativity exists, the worse it gets for the authors and for the many working on the other Cochrane reviews.
A122 dams the flood of poor quality evidence that reigned in the pandemic. It needed to be removed or neutralised as it didn’t fit the narrative, come what may. Yet, it has been the main rallying point of those who either had other views or believed in evidence-guided policy.
One of the immediate consequences of the communiqué and attacks (more later) was the much-publicised misleading statement to the U.S. Congress by Dr. Walensky, then CDC Director, who claimed that the review had been retracted.
Sorry, Dr. Walensky, it still hasn’t been retracted, and there has been no change to the original text – none of the authors agree it needs changing. Nor did the peer reviewers and the editors who gave the publication the green light in the first place.
Another curious aspect concentrates on the shop windows: abstract and plain language summary, never mind the other 293 review pages. It’s almost as though some folk making the decisions haven’t read the full review.
But has the minimising and discrediting strategy worked? This was sent to us this morning by one of our subscribers:
So A122 is number one in Cochrane reviews and currently has the 14th highest attention score of nearly 24.5 million other research outputs.
While attention does not equate with quality, it does show an enormous amount of interest. While the public seems to understand the uncertainties and the need for high-quality evidence, the editorial decisions have lost their way,
We may never get an explanation of the interactions with the New York Times (NYT). We may never know if they were coordinated attacks on the authors. But no author should be singled out for discussing the content of his or her research. The silence of science is a worrying phenomenon, as is the refusal of the NYT to correct past mistakes.
As authors, we have sought clarification of the actions – so far. Organisational implosions can occur when there is a mismatch between the forces acting on those at the lower rungs of the organisation than those at the top.
This mismatch has drawn the attention of investigative journalists and other researchers who recognise the mismatch in the power dynamic undermining the publication of a high-quality, evidence-based review.
Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.
