Lancet retracts letter on plight of nurses treating COVID-19 patients

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The Lancet Global Health retracts a letter about the plight of nurses treating COVID-19 patients in Wuhan published on February 26. Can editors of peer-reviewed journals take a moral high-ground and make disparaging comments about preprints?

On February 26, The Lancet Global Health retracted a letter by two nurses from Guangzhou province just two days after it was published in the journal. In the letter, the two nurses describe their plight treating COVID-19 patients in Wuhan.

In the letter entitled, “Chinese medical staff request international medical assistance in fighting against COVID-19”, the two nurses claim that “the conditions and environment here in Wuhan are more difficult and extreme than we could ever have imagined. There is a severe shortage of protective equipment…”.

The nurses claim in the letter that they belong to the “first batch of medical aid workers from Guangdong Province” who came to Wuhan to provide support to local nurses in their fight against the disease.

They then add: “In addition to the physical exhaustion, we are also suffering psychologically. While we are professional nurses, we are also human. Like everyone else, we feel helplessness, anxiety, and fear. Experienced nurses occasionally find the time to comfort colleagues and try to relieve our anxiety. But even experienced nurses may also cry, possibly because we do not know how long we need to stay here and we are the highest-risk group for COVID-19 infection.”

Retraction note

The retraction note says: “On Feb 26, 2020, we were informed by the authors of this Correspondence that the account described therein was not a first-hand account, as the authors had claimed, and that they wished to withdraw the piece.”

About the retraction, a spokesperson for The Lancet told Retraction Watch: “Questions regarding the validity of this correspondence were brought to our attention by a number of readers. In addition, we received a direct communication from the authors of this correspondence on 26 February, 2020, stating that the account they described was not first-hand, as they had originally claimed in the correspondence, and that they wished to withdraw the piece. Following due process according to the COPE retraction guidelines, we determined that it was our duty to retract this correspondence.”

Flood of manuscripts after COVID-19 outbreak

Since the outbreak of COVID-19, researchers from across the world, particularly the Chinese researchers, have published numerous papers. These have been published both in peer-reviewed journals as well as preprint servers such bioRxiv and medRxiv.

As the name denotes, preprints are not peer-reviewed and are typically posted by authors to quickly communicate the findings to the research and medical community. The quick dissemination of information has particularly been helpful during the current outbreak, which has been declared a “Public health emergency of international concern” by the WHO on January 30.

As a February 19 report by Reuters points out, 153 articles have been published on COVID-19 and the novel coronavirus (SARS-CoV-2). Of them, 93 have been published in preprint repositories.

Richard Horton’s comment on preprints

While retractions are quite normal in scientific publishing and is in fact a welcome measure to clean the literature of wrong or misleading information, what stands out is the stand taken by Richard Horton, editor-in-Chief of The Lancet group in an article in the Reuters report.

He had in a disparaging tone said that “some of the material that’s been put out — on pre-print servers for example — clearly has been… unhelpful”. He then added: “Whether it’s fake news or misinformation or rumour-mongering, it’s certainly contributed to fear and panic.”

He was referring to a preprint posted in bioRxiv on January 27 by researchers from IIT Delhi and Acharya Narendra Dev College, University of Delhi who claimed “uncanny” similarities between the new coronavirus and HIV, the virus that causes AIDS.

Scientists were quick to point out the glaring mistakes in the preprint and the authors withdrew the manuscript.

Soon thereafter, bioRxiv added a banner on top of all coronavirus preprints clearly stating that they are “preliminary reports that have not been peer-reviewed. They should not be regarded as conclusive, guide clinical practice/health-related behaviour, or be reported in news media as established information”.

Are peer-reviewed journals squeaky clean?

But journals behind paywall can hardly claim the moral high-ground as hundreds of papers published after peer-reviewing are retracted each year.

Of course, letters published in journals are not peer-reviewed. But not everyone outside the scientific community, particularly journalists, is aware of this home truth. So the question before editors of peer-reviewed journals is, like bioRxiv, should they also not alert readers that letters published in their journals are not peer-reviewed?

This is not the first time that letters about COVID-19 or SARS-CoV-2 virus published in peer-reviewed journals have had a problem. A letter published on January 30 in The New England Journal of Medicine about a Chinese woman transmitting the virus to a German colleague during the incubation period (and therefore before symptoms could show up) was found to be wrong. The researchers who wrote the letter had simply failed to confirm with the Chinese woman her true health status before sending in their letter to the journal. One of the authors told Science the reason they went wrong with facts was because “the woman could not be reached at first and people felt this had to be communicated quickly.”

The journal has corrected it by adding supplementary information detailing her health condition even during her stay in Germany and on the days she interacted with her German colleagues.

That is not all. A research paper published on January 22 in the Journal of Medical Virology claimed that snakes had acted as intermediary hosts that spread the novel coronavirus to humans. Unlike letters, this research published post peer-reviewing was heavily criticised and debunked by other researchers.

Published in The Hindu on February 28, 2020