Understanding The Cochrane Mask RCT Review
How Can You Trust?
It is September & we are once again talking about the Jan. 30th, 2023, Cochrane meta-analysis of RCTs for PPE (masking). Many insist this is the "definitive" evidence that PPE does not work to prevent transmission of airborne viruses such as SARS-CoV-2.
You are entitled to a critical understanding of the publication & its authors, instead of cheap soundbites and misleading headlines. This is what you need to know about the Cochrane Meta-Analysis:
I. BIASED AUTHORSHIP - TOM JEFFERSON
The lead author, Tom Jefferson, is a former researcher for the Nordic Cochrane Center, and is paid to write articles for The Brownstone Institute - owned by neo-Confederate billionaire and child labor & smoking enthusiast Jeffrey Tucker, who funds all sorts of right-wing, heavily biased propaganda. Jefferson is not a legitimate or unbiased source of credibility. Jefferson’s biggest defender, Vinay Prasad of the University of California San Francisco, has never disclosed that both of them are paid by Tucker via the Brownstone Institute - a blatant conflict of interest.
Tom Jefferson has also long been a crusader against flu vaccines and the H1N1 swine flu, even accepting an award for his fringe anti-vax crankery. Amazing how much trust everyone is putting on a self-proclaimed expert on not only vaccine development, but PPE engineering as well - medical science & engineering science are very, very difference fields of practice.
“…Do not call me an expert.” -Tom Jefferson, Feb. 2023
How can you trust an author who has a long history of peddling anti-scientific nonsense for personal gain, accepting “Courage in Science” awards for quack publishing on a topic which he has zero qualifications to opine about?
II. FUTHER BIASED AUTHORSHIP - JOHN CONLY
Another author on the Cochrane mask review, John Conly, previously campaigned against airborne PPE for Canadian nurses, fearmongering about acne in the face of a deadly & disabling virus. Sadly, Conly was successful & many Canadian healthcare workers died or were disabled by SARS-CoV-2. Conly also engineered a corrupt, unethical & illegitimate study to attempt to disprove the effectiveness of N95 respirators against airborne transmission.
How can you trust an author who so clearly has an overwhelming bias, seeking to construct evidence that retroactively proves their desired conclusions?
III. CONCEALED AUTHORSHIP - CARL HENEGHAN
Carl Heneghan is a hidden co-author on the Cochrane mask review & member of the libertarian thinktank Collateral Global, a Great Barrington Declaration adjacent front which insists rapid, mass infection would magically end the pandemic. Children on their third and fourth COVID-19 reinfections would obviously disagree with this absurd evidence-free claim.
How can you trust a publication which has to conceal their authors in order to circumvent reporting standards on blatant conflicts of interest?
IV. SCIENTIFICALLY ILLITERATE AUTHORSHIP
In interviews, Tom Jefferson proves he is scientifically illiterate about many, many fields, and very clearly has far too many obvious biases to be taken seriously. Jefferson also has zero experience or credentials in the field of PPE engineering, which typically does not employ RCTs to develop & evaluate tools such as N95 respirators.
Even worse, in a post-publication interview, Tom Jefferson reveals he does not believe the scientific fact that SARS-CoV-2 is an airborne virus. Co-author John Conly once claimed an N95 respirator, engineered to filter particles 300nm in size with 95% efficacy, retains CO2 (0.33nm) and blocks oxygen (0.29) whilst failing to prevent inhalation of airborne viruses - a common refrain of pro-viral contrarians.
How can you trust that an author, who is utterly delusional about objective reality, is somehow qualified to talk about PPE engineering?
V. PPE ENGINEERING & RANDOMIZED CONTROL TRIALS
Contrary to the elaborate fictions of dishonest social media cranks like UCSF's Vinay Prasad, a Randomized Control Trial is not the end-all, be-all of scientific research. While RCTs have their uses in the medical science field, engineering science typically does not employ RCTs - not even in parachutes!
This has long been a running joke - in 2003, BMJ published a satirical study titled “Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials” which concludes:
”As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.”
How can you trust a publication that fails to respect interdisciplinary expertise and ignores decades of material on understanding the ethics & challenges of conducting a Randomized Control Trial?
VI. DENIAL OF AIRBORNE SARS-CoV-2 TRANSMISSION
In a response to the Cochrane mask review written by respiratory protection & infectious disease expert Dr. Lisa M. Brosseau, alongside Center for Infectious Disease Research & Policy (CIDRAP) director Michael T. Osterholm for CIDRAP, they found upon reviewing the Cochrane publication that:
There is no mention of airborne or aerosol transmission, the former being defined as inhalation of "droplet nuclei" at long distances from a source, and the latter representing a more up-to-date understanding of infectious particle inhalation both near and far from a source. An RCT by MacIntyre et al showed that even for infections assumed to be droplet transmitted, N95 FFRs prevent infection, while surgical masks do not.32 This again points to the droplet paradigm being incorrect.
How can you trust a publication about a virus that fails to understand the basic mechanics of the SARS-CoV-2 virus & how it’s transmitted?
The Cochrane review has a number of serious methodological flaws, as well.
The Cochrane review authors incorrectly combined studies where people wore masks or respirators infrequently with those where they were worn all the time. A careful examination of the studies where healthcare workers were required to wear the intervention throughout the day shows that respirators are more effective than surgical masks at preventing infection from respiratory viruses.
How can you trust a publication that poorly bundles entirely different study methods together to manufacture a desired conclusion?
The CIDRAP response concludes the Cochrane mask review was sloppy work:
The Loeb et al RCT and the Jefferson et al Cochrane review are part of ongoing efforts by physicians and infection-control professionals to promote the droplet transmission dogma, which has been disproved and invalidated by data demonstrating that people generate small inhalable infectious particles all of the time, that these particles remain in the air for long periods, and that respiratory viruses can remain viable in air for many hours.
How can you trust authors that insist upon easily debunked falsehoods, against the overwhelming consensus of the scientific community?
VII. THE WORLD'S EXPERTS AGREE: PPE DOES WORK
Nearly 400 international experts in a major DELPHI study for Nature agree that quality respirators are needed to combat the dominant airborne transmission of the SARS-CoV-2 virus. None of them have been funded by a neo-Confederate billionaire, unlike all of the authors, hidden or not, for the Cochrane review. The Delphi Consensus is a definitive article that outlines how a proper, coordinated response to the ongoing SARS-CoV-2 pandemic must be conducted. They state:
“Wide use of high-filtration & well-fitting facemasks (for example, N95, KF94, KN95, FFP2/3) is important to reduce transmission, particularly in high-risk settings.”
Jefferson & co-authors’ “consensus” is to repeatedly infect unvaccinated children with SARS-CoV-2 - there are zero RCTs proving that repeatedly infecting kids with SARS-CoV-2 is safe or healthy, and countless newly dead & disabled children which immediately disprove this absurd hypothesis.
How can you trust that an anti-vax contrarian magically knows more on complicated technical matters like PPE than 386 experts, at the top of their respective fields, from around the world?
VIII: COCHRANE LIBRARY REBUKED THE AUTHORS
In a February 22, 2023 tweet, unqualified art dealer & misogynistic abuser Eli Klein remarks “You counter a comprehensive study by the (gold standard) Cochrane review of 78 controller trials on masks with a crappy article…and then attack me?” The Editor-in-Chief of “The Gold Standard,” Dr. Karla Soares-Weiser, rebuked Jefferson & other authors in a public statement on March 10th, 2023:
“…accurate to say that the review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses, and that the results were inconclusive. Given the limitations in the primary evidence, the review is not able to address the question of whether mask-wearing itself reduces people's risk of contracting or spreading respiratory viruses.“
The “Gold Standard” Cochrane does not consider the review “Physical interventions to interrupt or reduce the spread of respiratory viruses” to be a conclusive or definitive article about the effectiveness of PPE in the SARS-CoV-2 pandemic. Vinay Prasad, who shares Eli’s enthusiasm for harassing female science professionals online, has publicly campaigned to have Dr. Soares-Weiser fired for challenging Jefferson’s sage wisdom.
Seven months later, Eli Klein smeared epidemiology professor Dr Ellie Murray, claiming the review & meta-analysis “failed to show that mask mandates & recommendations slow the spread of respiratory viruses,” as the unqualified art dealer smeared the professor’s work as “misinformation.” He has never accepted the correction from “Gold Standard” Cochrane’s Editor-in-Chief, also a woman. Gee, sure seems like a pattern is forming here amongst these pro-viral contrarians!
Dr. Soares-Weister’s statement is clear: the Cochrane RCT meta-analysis on masks is inconclusive, and thus does not prove or disprove anything. This is a matter of basic reading comprehension and critical thinking skills, and any critical analysis of Jefferson’s writing reveals he is a dishonest and untrustworthy source for information about the SARS-CoV-2 pandemic and PPE engineering.
How can you trust a publication whose authors are rebuked by the editor-in-chief for blatant dishonesty and manipulation?
IX: MOVING FORWARD FROM JUNK SCIENCE
The scientific method is not rooted in constructing evidence to retroactively prove your conclusion. In fact, this entire Cochrane “meta-analysis” debacle is a textbook example of Confirmation Bias: “the tendency to search for, interpret, favor, and recall information in a way that confirms or supports one's prior beliefs or values.”
What Tom Jefferson is specifically guilty of is the Observer-expectancy effect: “interpreting results incorrectly because of the tendency to look for information that conforms to their hypothesis, and overlook information that argues against it.” Jefferson cherry-picked studies to try and prove his conclusions, as he was tasked by his funder, the neo-Confederate billionaire & child labor fetishist Jeffrey Tucker.
The actual facts & science around PPE engineering & the SARS-CoV-2 virus are not what pro-viral contrarians want to hear - so they disregard reality & immerse themselves in elaborate fantasies, cherry-picking whatever poor-quality “evidence” confirms the desired belief, and use them as a blunt object to harass, insult, and smear respected science professionals with real-world responsibilities. This immature & childish behavior, serving a corrupt political agenda to dismantle public health in its entirety, is to be condemned - there are no “debates” taking place here.
You wouldn't "debate" how to land a rocket on the moon with a spoiled brat smashing cake at their own birthday party. Anyone citing this Cochrane "gold standard" review is either unable to read & think critically, or simply doesn't care & is using the Cochrane name - one they never heard of or cared about previous to 2023 - to mislead you, their audience, and/or the general public to think that there is not effective protection from a deadly & disabling airborne virus. The entire field of PPE engineering disproves this absurd claim - and you don’t see PPE engineers showing up at hospitals to tell oncologists like Prasad how to do their job.
If you find yourself trusting dishonest, manipulative cranks like Jefferson or Vinay Prasad, bankrolled by racist billionaires like Jeffrey Tucker, then maybe “the science” isn’t wrong - and you need to take a long, hard look in the mirror about how you were so easily deceived by these pitiful charlatans.
Excellent, comprehensive article. Dr. Murray is a very, very good epidemiologist who absolutely did not deserve to be attacked by the egregious “contrarian bro” Klein, who has no understanding of the subject matter whatsoever.