By Cory Franklin
September 4, 2022
Do facemasks work in preventing COVID transmission? Short answer: I don’t know with certainty and neither does anyone else. The opinions range from absolutely yes to absolutely no, and there are hundreds of scientific studies to pick from to support any position you prefer.
No study can be considered definitive because every study is limited by many confounders – type of mask, type of population, where it is worn, how long it is worn, how long we observe to compare – to name only a few. If pressed on the effectiveness of masks, I would answer that they probably prevent a limited number of infections in certain situations. Many qualified observers would disagree, on both sides of the question, and I wouldn’t press my position too strongly with either side.
But that is not what this piece is about. This is about science in the age of the internet and social media.
MedRxiv is a pre-print server on the internet that is meant to preview new medical studies before they undergo peer review, prior to their publication in medical journals. It is sort of a first pass for scientific literature. Because the science behind COVID changes so quickly, many COVID studies first appear on the internet there.
This month a study from Hofstra University, designed to be a systematic review of facemasks for preventing COVID, was uploaded to MedRxiv. After reviewing 1732 studies on facemasks and COVID, the authors concluded that “across healthcare and community settings, those who wore masks were less likely to contract COVID-19” – medical jargon for masks were effective in preventing COVID transmission.
The response to the study was instantaneous. According to Alasdair Munro, a research fellow specializing in pediatric infectious diseases who follows these things, the study was cited immediately on some of the world’s most important scientific twitter accounts, including those of the head of a translational research laboratory in the US (600,000 followers), a professorial member of a UK based scientific political activist group (200,000 followers), and an ex-director of the World Health Organization (90,000 followers).
The study was additionally cited on twitter by the health minister of a large western European country (1,000,000 followers), a Pulitzer-prize winning science journalist (260,000 followers), and in several news articles attesting to the effectiveness of masks.
There was a huge problem, though: the study methodology was so amateurish that a junior scientist or even a layperson who took the time to read it could identify major flaws and tell it lacked credibility. Among the problems: the initial collated review of 1732 papers were cherrypicked to only 13 with no explanation, and the literature search was confined to the earliest five months of the pandemic in 2020. One study was based on a previous coronavirus infection from 2004, and another was not even about facemasks. This does not include sophomoric errors in the study’s data analysis and statistics. Without drawing any conclusions on the effectiveness of facemasks, it is safe to say the Hofstra study is not worth much.
Now preprints studies disseminated in twitter posts, which have not been peer reviewed by experts, are not your father’s science. Publication in lay news accounts is not the same as publication in scientific journals, which are demonstrating their own credibility problems. Yet speed now trumps accuracy, and this is how much of our scientific information is transmitted today, especially when dealing with contentious scientific issues like facemasks. The lay public may be unaware of these limitations, which makes publishing or conveying what you want to believe such a powerful trap. This is known as confirmation bias.
When scientists and journalists, especially those with a large public following, don’t perform even the most elementary vetting of what purports to be an important scientific review that happens to contain obvious errors, how can they be trusted in other matters they report on? This goes to the heart of the accountability of these professions.
Another recent incident eeek reinforced this message. A well-known French physicist, Étienne Klein, research director at France’s Alternative Energies and Atomic Energy Commission, tweeted a dramatic photo of a red dwarf star more than four light years from the Sun, Proxima Centauri. The photo was taken with the James Webb Space Telescope and was liked and retweeted by thousands across the globe.
A few days later Klein admitted he was trolling. The photo was not Proxima Centauri via the Webb Telescope but a slice of chorizo sausage. Klein said he meant to educate people about fake news online, adding that “I also think that if I hadn’t said it was a James Webb photo, it wouldn’t have been so successful.”
(Personal aside. Many years ago, at an important conference of the country’s leading pathologists, my father was charged with preparing pathology slides for the illustrious experts to identify. As a joke, instead of human tissue, he prepared a slide of a slice of kosher salami, thereby flummoxing the pathologists who studied it intently but had no idea what body part it could be. This was before it was known as trolling.)
There is a lesson here. The next time someone tells you, with unmistakable conviction, that he believes in “the science,” gladly offer to discuss science with him over a sandwich. Give him a choice, chorizo or perhaps kosher salami.
About the author:
Cory Franklin, physician and writer is a frequent contributor to johnkassnews.com.
He was director of medical intensive care at Cook County Hospital in Chicago for more than 25 years. An editorial ng the pathologists who studied it intently but had no idea what body part it could be. This was before it was known as trolling.)
There is a lesson here. The next time someone tells you, with unmistakable conviction, that he believes in “the science,” gladly offer to discuss science with him over a sandwich. Give him a choice, chorizo or perhaps kosher salami. board contributor to the Chicago Tribune op-ed page, he writes freelance medical and non-medical articles. His work has also appeared in the New York Times, Jerusalem Post, Chicago Sun-Times, New York Post, Guardian, Washington Post and has been excerpted in the New York Review of Books. Cory was also Harrison Ford’s technical adviser and one of the role models for the character Ford played in the 1993 movie, “The Fugitive.” His YouTube podcast “Rememberingthepassed” has received 900,000 hits to date. He published “Chicago Flashbulbs” in 2013, “Cook County ICU: 30 Years of Unforgettable Patients and Odd Cases” in 2015, and most recently coauthored, A Guide to Writing College Admission Essays: Practical Advice for Students and Parents in 2021.