| Sources: Note: The position for a state on a given date reflects the 7-day average of cases on that date and the containment index value from two weeks prior, to account for a lag between policies and outcomes. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. [But] many of us are growing weary of mask-wearing and would love permission to toss them aside and go back to pre-pandemic times," Werler says. We examined the impact of state-based mask wearing policy and adherence on COVID-19 case rates during the summer and early fall of 2020 in order to quantify this effect. This association between high mask adherence and reduced COVID-19 rates should influence policy makers and public health officials to focus on ways to improve mask adherence across the population in order to mitigate the spread of COVID-19. But the "reference period" is defined by the report as the 20 days before mask mandates started. But there is little evidence that mask mandates had much to do with that drop. Of course, many other factors are could be at play, like the possibility of cooler weather driving non-adherent persons to indoor gatherings. He Kept Quiet. Since the spring, Maine mandated masks and had strict travel restrictions for out-of-state visitors; South Dakota, meanwhile, has never had a mask mandate and welcomed nearly half a million people to the Sturgis motorcycle rally, as well as its state fair, which attracted more than 100,000 visitors. But despite an official infection rate that was virtually the same as California's, he adds, "Florida had 33% more deaths per capita than California" during the omicron surge. Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. Charlie B. Fischer, For every 1% increase in average adherence in June, the fully adjusted odds ratios for high COVID-19 in July was 0.95, indicating a protective effect against high COVID-19 rates. "Its that simple.. The proportions of states with high COVID-19 rates are shown for those in the low and high quartiles of mask adherence in the preceding month (Fig 1). The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. PLOS ONE promises fair, rigorous peer review, Our research examines mask wearing policy and adherence in association with COVID-19 case rates. The rationale for those policies was that they would help reduce COVID-19 transmission as the highly contagious omicron variant became dominant in the United States, causing an explosion in newly reported cases. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. Ashish Jha, dean of Brown University's School of Public Health, notes that the graph for California, which required masks in indoor public settings beginning on December 15, is "strikingly similar" to the graph for Florida, which had no mask mandates. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. Gov. Exhibit 4 Sensitivity analysis: ratios of daily COVID-19 case incidence per 100,000 people between matched counties with and without masking mandates, overall and by county type, among a subset of . Only eight states reported that 75% or more people wore masks between June and September, leading to fewer COVID cases: States with a 75% minimum mask adherence reported about 109.26 COVID-19 cases per 100,000 residents compared to the average of 249.99 per 100,000 residents in states with low mask adherence. We thank Drs. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." Their cumulative rates of Covid mortality were virtually identical, too (in fact, there were slightly more deaths per capita in the states with mask mandates). While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. The study also found a statistically significant increase in the rate of COVID-19 infections and deaths starting 40 days after indoor or outdoor dining at restaurants was allowed. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. No, Is the Subject Area "Hispanic people" applicable to this article? The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. Investigation, One America News Network on March 7 published an article under the headline CDC: Face masks dont prevent COVID-19, study finds masks have negligible impact on coronavirus numbers. The post claims the CDC has admitted face masks do little to prevent the spread of COVID-19 amid mounting pressure to lift mask mandates across the U.S., Butthe CDCs study doesnt say that. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. Our analyses took into consideration the delayed effect of mask wearing and policies on COVID-19 health outcomes. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. Sources: Restrictions tightened as cases were rising. Thailand, Japan, Taiwan, Hong Kong, the Philippines, Uruguay, Chile, Poland, and Hungary were all hailed as models of scientific enlightenment for their low infection rates and strict mask policiesuntil, as usual, the masks suddenly lost their magical power. Little attention was paid to more rigorous research, like a review of the literature that found little or no benefit from masks, or a study that compared infection rates with mask policies and with rates of mask use in all 50 states over the first year of the pandemic. "Nearly a year after California Gov. We did estimate odds ratios for mask adherence within subgroups of states with and without mask policy. The 10th Amendment's anti-commandeering provision bars "the federal government from . Coronavirus cases are rising in almost every U.S. state. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. The CDC received some criticism for its junk science on masks, particularly for its false claims about the benefits of masking schoolchildren, but the press mostly promoted the agencys narrative. Latest news. We utilized the COVID-19 US State Policy Database, created by Dr. Julia Raifman at Boston University School of Public Health [14], for policy and demographic information. On the other hand, Hawaii and Connecticut had two of the longest mask mandates and also some of the lowest per capita case counts of all the states. February 28, 2023. Indeed, issuing such a policy is not the same as successfully implementing it. The findings were published in the journal PLOS One in April. States and cities are reinstating restrictions and implementing new ones: In recent days, the governors of Iowa, North Dakota and Utah imposed mask mandates for the first time since the outbreak began. But "few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing.". Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. Mask mandates are associated with reductions in COVID-19 case and hospitalization growth rates (6,7), whereas reopening on-premises dining at restaurants, a known risk factor associated with SARS-CoV-2 infection (2), is associated with increased COVID-19 cases and deaths, particularly in the absence of mask mandates (8). Eleanor J. Murray and Jennifer Weuve and the Boston University School of Public Health Epidemiology COVID-19 Response Corps for bringing together students and faculty for this project. The opposite was true for states with mandates. The pandemics second year saw slight deviations in both directions, but those reflected the seasonality of the virus and the geography of mask mandates, which remained more common in northern states. All the state does is encourage Alaskans to do their part to limit the spread of Covid-19, recommending that residents practice social distancing and wear a mask, without any mandate. By Lauren Leatherby and Rich HarrisNov. A couple weeks into those lockdowns, countries with new restrictions may be seeing results: The rate of new daily cases has begun to level off or drop in France, Spain, Germany and Italy, though it continues to rise in the United Kingdom. New York. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. But then Fauci, like the CDC and the WHO, bowed to political expediency and media hysteria. Conceptualization, One state is the lone holdout. Visualization, Massachusetts. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. Nevertheless, it is possible that average mask adherence in a given month does not capture the most effective time period that influences COVID-19 rates. States are issuing a new wave of mask mandates and social restrictions as record numbers of Covid-19 hospitalizations and soaring daily cases strain US medical systems. Weak recent containment measures and many cases. Its Legacy Is Disastrous. Traveling This Summer? "Masks have been the most visible part of America's pandemic response, but one of the least consequential," science journalist Faye Flam writes in a Bloomberg Opinion essay. Some states now have ended their statewide masks mandates, but the president, and others, have urged them to reinstate masks mandates because of the recent upsurge that our nation has seen in COVID-19 cases. Across the country, indoor mask requirements in blue states are falling like dominoes as COVID cases drop. And in New York and some other states, those lockdowns came too late to prevent a big outbreak, because thats where the virus hit first, said Thomas Hale, associate professor of global public policy at the Blavatnik School of Government, who leads the Oxford tracking effort. The same study found that cloth masks did not have a statistically significant effect. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. | A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. Mean COVID-19 rates for states with 75% mask adherence in the preceding month was 109.26 per 100,000 compared to 249.99 per 100,000 for those with less adherence. But it seems clear that anyone who takes it for granted that mask mandates have played a crucial role in controlling the spread of COVID-19 is making a series of assumptions that are not justified by the evidence. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. Investigation, Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Louisiana. The worst outbreaks in the country now are in places where policymakers did the least to prevent transmission, according to the Oxford index. | Sources: Oxford Covid-19 Government Response Tracker, closing bars, restaurants, gyms, theaters and schools, one in 10 North Dakotans have tested positive. Given the situation during the omicron surge, there are additional reasons to doubt that mask mandates, even with perfect compliance, had much of an impact. The masks in Germany obviously didnt beat Covid. From the start of the pandemic through this spring, the cumulative rate of Covid mortality has been slightly higher in Sweden than in Germany (by about 15 percent), but the rate of overall excess mortality has been slightly higher in Germany (by about 8 percent). They looked at data from April to October 2020. (Though todays ruling by U.S. District Judge Kathryn Kimball Mizelle in Tampa, declaring the Biden administrations mask mandate for public transportation unlawful, comes as welcome news.) Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. Masks make no difference in reducing the spread of Covid, according to an extensive new review by Cochranethe gold standard for evaluating health interventions. But since people were allowed to remove their masks while eating and drinking, requiring them to cover their faces upon entry was more a symbolic gesture than a serious safeguard. Public health policy-making requires navigating the balance of public good and individual rights [10]. https://doi.org/10.1371/journal.pone.0249891.t001. Once you start thinking about acting, it probably is the time to act.. The study used county-level data from March 1 through Dec. 31 of last year, comparing data from before mandates tookeffect to the time period when they were in place. After the pandemic, a survey of gains and losses. The requirement is expected to be lifted on March 1. The proportions of states and D.C. with high COVID-19 rates were greatest for those with no mask wearing policy for the general public in the preceding month (Fig 2). So did New Mexico, whose surge began shortly after Scientific American praised the states strict mask policies in an article headlined, How New Mexico Controlled the Spread of Covid-19.. Many have also done the least to contain the virus. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. Its been largely delegated to a subnational level, to the states, for example, and municipalities to figure it out themselves.. Most states in the low quartile had high COVID-19 rates in the subsequent month. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. At Humble ISD, 4.59 percent have tested positive for COVID. If youre still not convinced to take off the mask, consider one more graph from Miller. When Can I Go Out in Public Again After Being Fully Vaccinated? JAMA. States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. For mask adherence, the cut-off values for the low and high quartiles were 31% and 46% in June, 53% and 72% in July, 55% and 71% in August, and 55% and 68% in September. "Arizona surprised me because they went from having the second-lowest mask adherence in May and June [less than 22%] to the highest level in July and August [greater than 80%]. Explaining the justification for lifting mask requirements, governors and public health agencies generally have cited the precipitous decline in daily new cases since mid-January. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. Over the course of the pandemic, the scientific evidence and our understanding of masks have grown. It compares Germany with Sweden, the medias Covid villain for refusing to lock down or mandate masks. For more information about PLOS Subject Areas, click We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. No, Is the Subject Area "Pandemics" applicable to this article? Vermont. The United States, as of Friday, posted a seven-day moving average of 62,555 new COVID-19 cases reported daily, according to data from the Centers for Disease Control and Prevention.The last time . In contrast, just one state in July, August, and September and three in October in the high quartile had high COVID-19 rates in the subsequent month. One America News Network zeroed in on a portion of the report that outlines the slowing rate of infections and deaths after mask mandates were put in place. Yes Fully vaccinated adults are still wearing masks on their solitary walks outdoors, and officials have beenenforcing mask mandates on airline passengers and on some city-dwellers and students. John Bel Edwards emergency order will . In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. The current surge is worst in places with few containment measures. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. No, Is the Subject Area "United States" applicable to this article? No, Is the Subject Area "Public and occupational health" applicable to this article? This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. "Unfortunately, the virus hasnt gone away and is still easily transmissible. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. https://doi.org/10.1371/journal.pone.0249891.s001. Like the debate about lockdowns, the debate about mask mandates will continue. Doug Burgum reopened the state nearly fully in May. Maskaholics in the press are calling for permanent masking on trains, planes, and buses. For each month, the distributions of mask adherence across all 50 states and D.C. were categorized into quartiles, meaning the cut-off values for each quartile may be different from one month to another. "Our results suggest that mask-wearing is strongly affected by factors other than mandates. https://doi.org/10.1371/journal.pone.0249891.g001. Yes Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. Nor did it look at actual mask wearing, as opposed to legal requirements. Further analyses of more granular geographic regions would be a logical next step. Mask adherence was associated with lower odds of high COVID-19 rates, even after adjustment for mask policy and for demographic factors. We categorized the existence of a mask policy as None if there was no requirement for face coverings in public spaces, Recommended if required in all public spaces without consequences, and Strict if required in all public spaces with consequences in the form of fine(s) or citation(s). The Department of Homeland Security Turns 20. We divided the monthly number by 2.2 to obtain the number in a two-week period (43,088). Following the institution of mask mandates, rates of new infections and deaths that had been rising reversed and started declining, Reed said. We infer that mandates likely did not affect COVID-19 case growth, as growth rates were similar on all days between actual or modeled issuance dates and 6 March 2021. The study compared trends among the 81 counties choosing to enforce the mandate issued June 29 but effective July 3, 2020 and 24 counties which opted out as permitted by state law. For all 50 states and the District of Columbia (DC), these data were abstracted by month for April September 2020 to measure their impact on COVID-19 rates in the subsequent month (May October 2020). Immediately after these mandates were instituted, these declines were statistically significant.. By contrast, Florida has no statewide restrictions. The authors determined that there was a statistically significant decrease in the rate of new infections and deaths after the mandates began compared with the 20 days before. Now, Midwestern states have among the worst outbreaks. Fact check: Masks and vaccines are effective at combating COVID-19 spread. CNBC called the nations early Covid response a master class in science communication, and last fall it was praised for tightening its mask mandate in an Atlantic article, Four Measures That Are Helping Germany Beat Covid. Its stricter mandate early last year banished cloth masks, requiring surgical masks instead, and the states of Berlin and Bavaria went still further, requiring masks of N95 quality. Over a third of states are ending COVID-19 mask mandates. No, Is the Subject Area "Health care policy" applicable to this article? Start the day smarter Notable deaths in 2023 The world's largest war . No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0249891, https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions, https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html, https://www.usnews.com/news/best-states/articles/these-are-the-states-with-mask-mandates, https://www.cebm.net/covid-19/masking-lack-of-evidence-with-politics/, https://cepr.org/sites/default/files/CovidEconomics43.pdf, https://covid19.healthdata.org/united-states-of-america?view=mask-use&tab=trend, https://doi.org/10.18148/srm/2020.v14i2.7761, https://data.cdc.gov/Case-Surveillance/United-States-COVID-19-Cases-and-Deaths-by-State-o/9mfq-cb36/data, https://www.ers.usda.gov/data-products/county-level-data-sets/download-data/, https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/indicators.html#thresholds, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fpeople-at-increased-risk.html. States that have kept more control policies in a more consistent way New England states, for example have avoided a summer surge and are now having a smaller fall surge, as opposed to states that rolled them back very quickly like Florida or Texas, Mr. Hale said. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. But the researchers found no clear relationship between mask mandates and mask use. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Coronavirus: How R-0 can be used to fight COVID-19. In contrast, 25% or fewer states with a mask wearing policy had high COVID-19 rates, except in September when over half experienced high rates. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. ", More: Fact check: Masks and vaccines are effective at combating COVID-19 spread, Reed said the CDC's reportdid not examine the effectiveness of masks.. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. Taiwan recently recorded 200 days without a new coronavirus case after its leaders focused on a speedy response and invested in mass testing and contact tracing. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. Virginia. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. The black line on the graph shows the weekly rate of Covid cases in all the states with mask mandates that week, while the orange line shows the rate in all the states without mandates. Our analysis of state and D.C.-level data does not account for variations in policy, adherence, and demographic factors at smaller geographic levels, such as county-levels. Centers for Disease Control and Prevention. In addition, Hawaii and Oregon, which have both implemented school mask. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. This protective effect of mask wearing was evident across four months of the pandemic, even after adjusting the associations for mask policy, distance policy, and demographic factors. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. When Can I Dine Indoors Again After Being Fully Vaccinated? Instead, it links mask mandates to statistically significant decreases in county-level daily COVID-19 case and death growth rates within 20 days of implementation..
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