Amid the storm of US election headlines in recent weeks, a snippet of news began bubbling up on social media that, only a few years ago, would have whipped up a frenzied media hurricane. President Biden had tested positive for Covid and videos posted on X showed him boarding and exiting Airforce One, but without a mask.
“Listen to the scientists, support masks,” Biden said at a campaign rally, four years ago, berating Trump for not wearing a mask after he had caught Covid. “Support a mask mandate nationwide,” Biden thundered to cheers and adulation. His campaign message captured a “follow the science” sentiment among Left-leaning American voters who derided anyone questioning mask effectiveness with the label “anti-mask”. This, despite a smattering of articles in Scientific American, Wired, New York Magazine and The Atlantic reporting that scientific studies found masks didn’t seem to stop viruses.
The debate over mask effectiveness took an odd turn last year when ardent mask advocate, Zeynep Tufekci, wrote a New York Times essay claiming “the science is clear that masks work”. Tufekci’s piece denigrated and belittled a scientific review by the prestigious medical nonprofit, Cochrane, for concluding that the evidence is “uncertain”.
Shortly after Tufekci published her essay, Cochrane’s editor-in-chief, Karla Soares-Weiser, dashed out a statement, to assure mask advocates that Cochrane would update the review’s language. Cochrane reviews are widely considered as the “gold standard” for high‐quality information to inform medicine, and their process is laborious, with multiple rounds of internal checks and expert peer review. Having Cochrane’s head make a personal pronouncement about a published review is unprecedented — akin to having the executive editor of The New York Times write an essay expressing personal opinions about one of the paper’s own deep-dive investigations.
The incident also marked an odd point in the timeline of mask use. Before the pandemic, few, if any, prominent organisations promoted masks to stop influenza or other respiratory viruses. As the WHO concluded in their 2019 pandemic preparedness plan: “There have been a number of high-quality randomised controlled trials (RCTs) demonstrating that personal protective measures such as hand hygiene and face masks have, at best, a small effect on influenza transmission.” So, it was not surprising that both Tufekci’s claims “masks work” and Karla Soares-Weiser’s allegations that something was wrong with the Cochrane mask review were later found themselves to have no real evidence.
Earlier this year, Soares-Weiser issued another statement, this time explaining the mask review was fine and no changes would be made. Despite the 180, damage to Cochrane’s mask review had already been done. Google sends you straight to Tufekci’s New York Times essay alleging problems in the Cochrane review.
But why did Soares-Weiser change her mind?
I have discovered, through hundreds of emails provided to me by freedom of information requests and a Cochrane whistleblower, that Tufekci bumped Soares-Weiser into making the statement against Cochrane’s own mask review — a move that landed like a grenade inside the organisation.
While Soares-Weiser runs Cochrane, scientists with expertise in each specific subject matter write and edit the reviews. When she rushed out her statement complaining about the mask review, the review authors charged that Cochrane had thrown science under the bus by working with “controversial writer” Zeynep Tufekci; meanwhile, the editor of the mask review reminded Cochrane’s leadership that changes were only being considered because of “intense media coverage and criticism”, not because there were any problems in the review’s science. “I had a very challenging meeting with the [governing board] yesterday,” Soares-Weiser wrote a few days afterwards. “I am holding on, stressed, but OK.”
But the story doesn’t end there. Because the attack by Soares-Weiser and Cochrane’s leadership on their own mask review is illustrative of how media and political pressure undermined and suppressed inconvenient scientific conclusions during the pandemic — and are still attempting to do so. The incident also raises questions about media ethics and whether Cochrane’s leadership is still fit for purpose.
When Cochrane published their 2023 mask review, it was the seventh iteration of a process that began 18 years previously. Back in 2006, Cochrane researchers raked through the scientific literature to see if they could determine what interventions could halt the spread of viruses. They found no good evidence that masks work. The scientists then updated their review in 2007, 2009, 2010, 2011, and 2020.
With all six updates, each time scouring any new peer-reviewed studies, Cochrane researchers concluded the same: there is no good scientific evidence that masks work to control viruses. And each time, the scientific community yawned. Because until the Covid pandemic, nobody had conceived of a political movement to advocate for masks. Not even Zeynep Tufekci.
