SCIENCE science.org 3 DECEMBER 2021 • VOL 374 ISSUE 6572 1181can probably agree that they seem to work.”
Small studies can also play a crucial role
in preventing waste, adds Manoj Lalu, an
evidence quality researcher at the Ottawa
Hospital Research Institute. They allow re-
searchers to road-test crucial questions such
as how to recruit participants or keep consis-
tency across study sites before embarking on
a study involving thousands of people.
But hoping that someone will pick up the
baton after a small trial is not a strong jus-
tification, says McGill University bioethicist
Jonathan Kimmelman. Testing involving hu-
mans is only ethical when it can inform an
important decision—like whether to launch a
large trial following a pilot study, or whether
to roll out vaccination after a large trial. Run-
ning a small study without the intent to take
it further comes with a range of harms, he
says: “You’re wasting volunteers’ time, there’s
an opportunity cost, you’re putting out shit
information that can only be misinterpreted
by people who don’t know how to interpret
it, and it’s only going to take time away from
the people who do know how to interpret it.”
Misinformation is a critical problem, Haber
and his co-authors say. Any small, inconclu-
sive study opens the door to misinterpreta-
tion, says Emily Smith, a George Washington
University epidemiologist and a co-author of
Haber’s. “We live in the real world.”
There’s also the danger that policymakers
will base decisions on single flawed studies,
says Kelly Cobey, a metascientist at the Uni-
versity of Ottawa Heart Institute. Syntheses
that pull together large bodies of evidence,
like meta-analyses, aren’t the answer either:
“If the quality of the individual studies is
poor, the quality of the synthesis is poor.”
Haber and his co-authors agree that
health measures such as wearing masks or
school closures are difficult to study. That’s
because of the complexities of studying
human behavior—such as whether people
wear masks routinely and correctly—and
because small effects require huge popula-
tions, Haber says. A high-quality trial on
mask wearing is possible, he says, noting
a massive trial in Bangladesh, released as
a preprint in May and published in Science
today. The trial, which had a large sample
and careful design, reported small benefits.
But it, too, has been criticized for its analy-
sis methods and for overstating its findings.
The pandemic has shown both “the best
and the worst” of science, Kimmelman says.
Vaccine trials and the large-scale Recovery
trial of treatments have been “unbelievable,”
he says. But questions about mask wearing
or the ideal timing of booster shots haven’t
had the same resources or attention: “We’ve
discovered how piss-poor we are at answer-
ing certain kinds of questions that are of
paramount importance for public health.” j
W
hen prodemocracy demonstra-
tions erupted in Hong Kong in
2019, its publicly funded uni-
versities were hotbeds of un-
rest. A year later, five university
presidents signed a statement
supporting a law that would make such
protests difficult if not impossible. Two
did not sign the document, which endorsed
the new National Security Law Beijing
was about to pass: Wei Shyy of the Hong
Kong University of Science and Technology
(HKUST) and Kuo Way of the City University
of Hong Kong. Both universities have now
announced their presidents will step down.
Kuo’s departure is timed to the end of
his third 5-year contract in 2023, by which
time he’ll be 72, dampening
speculations about political
pressure. But Shyy, 66, will
resign in October 2022, a
year before his contract
ends. “Everybody is wonder-
ing what’s his rationale for
stepping down a year early,”
says Carsten Holz, a develop-
ment economist at HKUST.
Many other Hong Kong
academics are leaving, too.
The city’s universities, among the best in
Asia and long known for their academic
freedom, are seeing a wave of resignations
and departures as China tightens its grip
in what one academic calls the “mainland-
izing” of the universities. Three deans at the
University of Hong Kong (HKU), including
Gabriel Leung, who played an important
role in Hong Kong’s successful fight against
COVID-19, recently announced they are
leaving early or not renewing contracts.
Although numbers are hard to come by,
sources within the city’s universities—few
of whom want to be named—say significant
numbers of native Hong Kong scholars and
Westerners at lower levels are leaving as
well, troubled by declining academic free-
dom, attacks on those considered disloyal
by pro-Beijing local media, “patriotic edu-
cation” being imposed on their school-age
children, and investigations under the Na-tional Security Law, which passed in June- Whereas Hong Kong’s Basic Law, in
effect since the territory passed from the
United Kingdom to China in 1997, guaran-
tees its universities autonomy and academic
freedom, the new law called on the govern-
ment to strengthen its guidance and super-
vision of the universities. It gave authorities
new powers to punish vaguely defined of-
fenses such as “secession” and “subversion.”
Some caution against reading too much
into the upheaval. “There will be adjust-
ments among Hong Kong universities,”
given the changing political climate, says
astronomer Sun Kwok, a former dean of sci-
ence at HKU. But he believes China will rec-
ognize that HKU’s “diverse, multicultural
academic staff ” is a strength that will help
advance the overall level of scholarship in
China and the region.
Others are gloomy. “It’s
sad for the universities and
sad for the city,” says one
tenured Western academic.
“Three years ago I thought I
would be here until I retire,”
he says, but now he is keep-
ing an eye out for oppor-
tunities to move. Another
Western scholar predicts
the trend will turn the city’s
universities into “ciphers of the mainland
China institutions.”
Critics say the shake-up at HKU, the ter-
ritory’s oldest and most prestigious uni-
versity, has been driven by Xiang Zhang,
a physicist who became president in July - Zhang is the first HKU head to have
b e e n b o r n a n d e d u c a t e d t h r o u g h t h e u n d e r -
graduate level in China. He later worked at
the mechanical engineering department at
the University of California, Berkeley, and
is a naturalized U.S. citizen. HKU recently
announced that his 5-year contract will be
renewed in 2023.
Among top-level researchers parting
ways with HKU are the former dean of sci-
ence, U.K. ecologist Matthew Evans, who
stepped down in October to take a posi-
tion at United Arab Emirates University.
He declined to comment for this article. The
dean of social sciences, psychologist William
China tightens its grip on
Hong Kong universities
As dissent is stifled, a wave of departures at all levels
is “mainlandizing” the higher education system
ACADEMIC FREEDOMBy Dennis Normile“Everybody is
wondering what the
future holds
for the city and the
universities.”
A Hong Kong academic