Prior to adopting mask mandates, those municipalities that eventually adopted mandates had higher transmission rates than the rest of the state, with the mean case rate difference per 100,000 people increasing by 0.32 cases per day (slope of difference = 0.32; 95% CI 0.13 to 0.51). The current study . If youre still not convinced to take off the mask, consider one more graph from Miller. Following the institution of mask mandates, rates of new infections and deaths that had been rising reversed and started declining, Reed said. But there are still settings where wearing your mask is crucial. Policy data on physical distancing were dichotomized as any versus no stay-at-home order during the April 1 to October 31, 2020 interval. Now, Midwestern states have among the worst outbreaks. In Maryland , Gov. Writing review & editing, Roles But there is little evidence that mask mandates had much to do with that drop. Weak recent containment measures and many cases. "Our results suggest that mask-wearing is strongly affected by factors other than mandates. It is worth noting that no states achieved this level of mask adherence in September, which might account in part for the spike in COVID-19 rates in October. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Should You Wear a Mask at Outdoor Events? On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. 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 . We abstracted daily percentages of the population who say they always wear a mask in public. 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. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. The information in this article is current as of the date listed, which means newer information may be available when you read this. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. Centers for Disease Control and Prevention. Thank you for supporting our journalism. Its been largely delegated to a subnational level, to the states, for example, and municipalities to figure it out themselves.. J.B. Pritzker. More detailed message would go here to provide context for the user and how to proceed. "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%]. We recommend renewed efforts be employed to improve adherence to mask wearing. Because stay-at-home order, mask wearing policy, mask adherence, and COVID-19 rates can vary from month to month, we listed those states with consistent classifications across the period April through September (or May through October for COVID-19 rates). We divided the monthly number by 2.2 to obtain the number in a two-week period (43,088). Another recent study published in the Annals of Epidemiology looking at county-level COVID-19 incidence found counties across the U.S. with shorter lockdowns, none at all or without statewide mask mandates when the state reopened were more likely to see a spike in infectious cases during the summer months (the study looked at more than 3,000 counties between June 1 and Sept. 30). 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. 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. Eleven states never mandated masks, while the other 39 states enforced mandates. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. In fact, it doesn't study mask efficacy at all. 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). He adds that the two states "had nearly identical infection rates.". Writing original draft, By the time the mandates were introduced in New York and other states in the spring of 2020 (at the left side of the graph), infections had already been declining in those states, and the mandates didnt prevent a surge later that year, when cases rose and fell in nearly identical trajectories regardless of states mask policies. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. Experts interviewed by USA TODAY said the One America News Network had "misinterpreted" or "mischaracterized" the findings of the CDC study. According to Werler, Arizona's data was unexpected. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. 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. That second observation requires a caveat, since testing rates affect the number of cases that are recorded. Wearing masks is a CDC-recommended* approach to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by reducing the spread of respiratory droplets into the air when a person coughs, sneezes, or talks and by reducing the inhalation of these droplets by the wearer. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. Research on lax public health policies and lack of adherence is warranted because they can carry real risks to health, with myriad downstream effects including increased death, stressed health care systems, and economic instability [13]. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. Coronavirus: How R-0 can be used to fight COVID-19. As of yesterday,The New York Times reports, every state that required people to wear face masks in public places and/or in schools during this winter's COVID-19 surge has decided to lift those mandates, with the exception of Hawaii. 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Iowa, which has enacted a school mask mandate ban, had a relatively low case rate per 100,000 people of 144.7. Here's what it could mean for all of us. States with stronger policy responses over the long run are seeing comparatively smaller outbreaks. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. Even as more and more states encourage or even mandate mask wearing, many citizens sti Is the Subject Area "COVID 19" applicable to this article? When Can I Go to the Movie Theater Again After Being Fully Vaccinated? Maskaholics in the press are calling for permanent masking on trains, planes, and buses. 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. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. 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. But the researchers found no clear relationship between mask mandates and mask use. 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. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. 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). The cumulative rate of infection over the course of the pandemic was about 24 percent in the mandate states as well as in the non-mandate states. We used state-level data on mask wearing policy for the general public and on proportion of residents who stated they always wear masks in public. Indeed, issuing such a policy is not the same as successfully implementing it. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. 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.. Gov. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. No, Is the Subject Area "Health care policy" applicable to this article? 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. When we looked at states with 75% mask adherence (Arizona, Connecticut, Hawaii, Massachusetts, Michigan, New York, Rhode Island, Vermont), we found none had experienced a high COVID-19 rate in the subsequent month. What theyre looking at here is efficacy of mask mandates. Crude and adjusted odds ratios for any mask policy in relation to high COVID-19 rates in the subsequent month were below 1.0; but confidence intervals were wide. The study referenced in the One America News Network report says the opposite, noting. The mandate will still require masks where . Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". 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. Latest news. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. https://doi.org/10.1371/journal.pone.0249891, Editor: Wen-Jun Tu, Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA, Received: January 12, 2021; Accepted: March 26, 2021; Published: April 14, 2021. Overall, there is no obvious difference between states with mask mandates and states without them. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. More could be on the way. We combined the Recommended and Strict groups into Any policy. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. Odds ratios indicating protection against high COVID-19 rates remained for all months and policy subgroups, ranging from 0.82 to 0.93 for states with any policy and from 0.60 to 0.95 for states with no policy. Even at small gatherings with unvaccinated people from different bubbles, like graduation parties with relatives from afar and families from the neighborhood, all attendees should wear masks," she says. 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. | There's little evidence that mask mandates are the primary reason the pandemic waves eventually fallthough much of the outrage over lifting mandates is based on that assumption. Competing interests: The authors have declared that no competing interests exist. A new study from the Centers for Disease Control and Prevention found a link between face mask mandates and a reduction in COVID-19 cases and deaths, but at least one widely shared report wrongly interprets that data. In their pre-Covid planning strategies for a pandemic, neither the Centers for Disease Control nor the World Health Organization had recommended masking the publicfor good reason. But the "reference period" is defined by the report as the 20 days before mask mandates started. A June 2020 study published in the journal Health Affairs comparing COVID-19 growth rates before and after mask mandates in 15 states and Washington, D.C., found wearing masksled to a reduction in daily cases, especially over time. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. 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 . Some reopened quickly and saw cases rise. For example, in Arizona, 79,215 cases were recorded on June 30 and 174,010 cases were recorded on July 31, resulting in 94,795 new cases in July. Doug Burgum reopened the state nearly fully in May. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. Writing review & editing, Affiliation Many Americans went maskless in public on Friday for the first time in months a day after the . Parents have pushed for the mask mandate to be lifted for a number of reasons. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. Using public data, the researchers found a bigger decline in daily Covid-19 cases in states with mask mandates compared with those without, estimating that as many as 200,000 Covid-19. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. Jacob Sullum Even Greenpeace now admits the obvious: recycling doesnt work. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. May 16, 2021 / 7:07 AM / CBS News. Of the 15 states with no mask policy from April through September, 14 reported high COVID-19 rates in at least one month from May to October. "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. here. 2021. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Note: Measurements of government response come from the Oxford Covid-19 Government Response Trackers Containment and Health Index, which is the organizations index focused on virus containment and protecting citizen health. North Dakota, for example, made few efforts to contain the virus. The strongest real-world evidence in favor of general masking comes from a randomized trial in Bangladesh, which found that the use of surgical masks reduced symptomatic infections by 11 percent. Jha thinks vaccination rates areanother important factor: While "only 59% of eligible Florida seniors have gotten boosted," he notes, the rate for California is 70 percent. Data released by the agency in November looking at COVID-19 incidence in Kansas after a statewide mask mandate also found the measure resulted in a drop in infectious cases. Again and again, journalists and public-health officials would single out a state or a nation that had supposedly tamed Covid by forcing citizens to wear masksand then these masks would promptly fail to prevent an unprecedented wave of infections. 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. ", An August 2021 systematic review of 21 observational studies found that all of them "reported SARS-CoV-2 benefits" from mask mandates "in terms of reductions in either the incidence, hospitalization, or mortality, or a combination of these outcomes." Over the course of the pandemic, both Iowa and Florida have done better than the national average in measures of Covid mortality as well as overall excess mortality (the number of deaths more than normal from all causes). 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. Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. Coronavirus cases are rising in almost every U.S. state. 3.1.2023 11:20 AM, Elizabeth Nolan Brown Without strong national guidance, states containment policies have varied widely. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Vermont. Yes Many states in the Upper Midwest and Mountain West resisted more stringent control measures, like limits on gatherings and mask mandates. 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. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. Its a graph that should be required viewing for everyone still wearing a mask and every public official or journalist who still insists that mask mandates control the spread.. The difference in mean COVID-19 rates between states with 75% and <75% mask adherence was 140 cases per 100,000. We abstracted data on whether the state issued a mandate of mask use by all individuals in public spaces, and if so, the dates of implementation and whether the mandate was enforced by fines or criminal charge/citation(s). It is also possible that survey respondents misreported their mask wearing adherence; whether they would be more or less likely to over or under-report is open to speculation, but residents in states with mask wearing policy might over-report adherence to appear compliant. 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. We did estimate odds ratios for mask adherence within subgroups of states with and without mask policy. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. According to Werler, Arizonas data was unexpected. Note: State containment measures are shown from two weeks prior, reflecting what experts say is a lag between new policies and results. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. And the more swiftly they can act, the shorter any lockdown-style policies need to be. 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. By contrast, Florida has no statewide restrictions. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. Werler and her team used the COVID-19 U.S. State Policy Database to collect policy and demographic data from all 50 states and the District of Columbia. 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. "Unfortunately, the virus hasnt gone away and is still easily transmissible. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. The graph for New York, which also had a statewide mask mandate, looks very much like the graph for California, but with an earlier peak. Theyre not looking at masks in and of themselves," Josh Petrie, research professor in the University of Michigan's School of Public Health, told USA TODAY. The pandemic has eased, but not the compulsion of many Americans to cover their faces. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. "Lifting of mask mandates across the board without consideration of the caveats does open the opportunity for another wave," Werler says. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. Despite an early outbreak, South Korea flattened the curve with aggressive testing and contact tracing, as well as widespread mask wearing. States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. 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. https://doi.org/10.1371/journal.pone.0249891.g001. Data Availability: Data are available in the paper and its Supporting Information file. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. The surgical masks didnt stop a subsequent surge throughout the country, and infection rates in Bavaria and Berlin were the same as in German states without the N95 requirement. + Caption. The Department of Homeland Security Turns 20. Immediately after these mandates were instituted, these declines were statistically significant.. The index does not evaluate the effectiveness of individual policies. We were not able to measure statistical interactions between mask policy and adherence due to instability arising from small numbers. The politicization of COVID-19 epidemiology [9,12] has further complicated policy-making, messaging, and uptake. No, Is the Subject Area "Public and occupational health" applicable to this article? Many local leaders went further. 3.1.2023 9:15 AM, Joe Lancaster The current surge is worst in places with few containment measures. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. States That Imposed Few Restrictions Now Have the Worst Outbreaks. Formal analysis, Indeed all 13 states in the low mask adherence group in September had high COVID-19 rates in October. [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. 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. Miller, who has tracked pandemic trends for the Brownstone Institute, has assembled the damning evidence in Unmasked: The Global Failure of COVID Mask Mandates. In contrast, allowing on . 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. Traveling This Summer? Copyright Funding: The authors received no specific funding for this work. Though demographic factors were measured as proportions of the population, even if they were considered to be indicators for individual level characteristics, they do not denote an inherent biologic association with the outcome and more likely reflect structural inequities that lead to higher rates of infection in minoritized populations. The States and Mask Mandates. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. 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. In Germany, by contrast, more than 80 percent did so, but look at the similar trajectories of the daily Covid death toll in both countries from the summer of 2020 through March of this year. | Former Arizona AG Found No Evidence of 2020 Election Fraud. Conditions in bars and restaurants are more conducive to virus transmission, since customers spend more time there in closer proximity to each other, often while talking. While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. Mean COVID-19 rates for states with at least 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. 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