How might strong advocates of community masking – who happen to occupy positions within the hierarchy that provide opportunities to influence research activity – go about achieving their aims? I suggest it would include some combination of discouraging the undertaking of robust research about mask effectiveness and potential harms, impeding and delaying the publication of unfavourable findings, and undermining the value of rigorous empirical science. A look at the history of the Cochrane mask reviews seems to offer an illuminating case study of these insidious forces in action.
Cochrane reviews are widely recognised to provide the most authoritative and comprehensive evaluation of the scientific evidence regarding specific healthcare interventions, and their raison d’être is to inform the decision-making process. On January 30th 2023, the latest version of the Cochrane review of the effectiveness of physical interventions (including masks) in reducing the spread of respiratory viruses was published. In keeping with their earlier reviews, the overarching conclusion of the authors confirmed what we already knew: masks achieve no appreciable reduction in viral transmission. Arguably of more interest are the indications that powerful forces within the academic world were at work to obstruct the dissemination of this inconvenient truth.