broad scope, and wide readership a perfect fit for your research every time. Louisiana. The CDC's report is the latestin a growing body of evidence establishing mask mandates as an effective strategy in curbing the virus. For all 50 states and D.C., data on mask wearing and physical distance policies, mask adherence, COVID-19 cases, and demographics were abstracted from publicly available sources. I think timing really matters for the decisions.. Our analyses took into consideration the delayed effect of mask wearing and policies on COVID-19 health outcomes. | Some reopened quickly and saw cases rise. Here's what it could mean for all of us. Data Availability: Data are available in the paper and its Supporting Information file. While it controlled for other policies that have been used to try to mitigate new infections from the coronavirus including bar closures, stay-at-home orders and bans on gatherings of 10 or more people it did not account for some others, such as physical distancing recommendations and other types of business closures. For mask policy and adherence in September in relation to high COVID-19 rates in October, collinearity caused the odds ratio to flip. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. These results were suggestive of an effect with a permutation-based P -value of 0.094. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. But as Flam notes, "the benefits of universal masking have been difficult to quantify" in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly. In the summer of 2020, Politico praised Rhode Islands wear-your-damn mask policy in an article headlined, How the Smallest State Engineered a Covid Comeback. A survey in the autumn found that 96 percent of Rhode Islanders were wearing masks, the highest rate in the U.S., yet that winter the state went on to suffer one of the nations worst Covid surges. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. 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. Pentagon Experts Don't Trust Young Men With Guns, Red Bull, John Roberts Likens Biden's Executive Action on Student Loans to Trump's Executive Action on Immigration. Discover a faster, simpler path to publishing in a high-quality journal. Boston University School of Public Health, Boston, MA, United States of America, Roles | | Funding: The authors received no specific funding for this work. When the initial spring wave in 2020 subsided, public officials and journalists claimed that the mandates had worked, and they kept up the pretense even when Covid surged again later that year despite the continuing mandates. 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. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. If you've seen pictures of those kids, you know they are not necessarily using masks as intended. Of course, many other factors are could be at play, like the possibility of cooler weather driving non-adherent persons to indoor gatherings. The question is and Im sure thats the conversation now happening in the halls of power what do we do next? 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. Higher mask use did not predict lower maximum growth rates, smaller surges, or . | The index comes from Oxfords Blavatnik School of Government, where researchers track the policies or lack thereof governments use to contain the virus and protect residents, such as contact tracing, mask mandates and restrictions on businesses and gatherings. 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. Mandating masks gave the illusion of doing something against the virus. Doug Burgum reopened the state nearly fully in May. Even as more and more states encourage mask wearing [7], many citizens still resist the notion [8]. For more information about PLOS Subject Areas, click Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Conceptualization, 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. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. 3.1.2023 9:15 AM, Joe Lancaster Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. Methodology, Researchers found that out of 15 states that did not require people to wear masks in public, 14 had high COVID-19 rates. Although Hawaiis governor did not issue a mask wearing policy until after October 2020, we considered that state to have a policy because mayors of the four populous counties had mandated mask wearing earlier in the pandemic. In the first 20 days after implementingmask mandates, new cases slowed by 0.5 percentage points. "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%]. 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. 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. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. 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. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. "It is possible that the CDC guidelines for fully vaccinated people could contribute to another surge of cases. Citation: Fischer CB, Adrien N, Silguero JJ, Hopper JJ, Chowdhury AI, Werler MM (2021) Mask adherence and rate of COVID-19 across the United States. Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. Our study accounted for temporality by staggering COVID-19 outcome data after adherence measures. 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. Contributed equally to this work with: States with the lowest levels of mask adherence were most likely to have high COVID-19 rates in the subsequent month, independent of mask policy or demographic factors. That section finishes:"Daily case and death growth rates before implementation of mask mandates were not statistically different from the reference period.". No, Is the Subject Area "Public and occupational health" applicable to this article? Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. Writing original draft. New Zealands prime minister, Jacinda Ardern, called it a validation of the countrys go hard, go early strategy, in which the country reacts rapidly to signs of community spread. Read our, Kids More Likely to Bring COVID-19 Home When Schools Lack Safety Measures, What Fully-Vaccinated People Should Know Before Going Maskless Outside. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. Massachusetts. 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. Traveling This Summer? 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. 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. When cases first peaked in the United States in the spring, there was no clear correlation between containment strategies and case counts, because most states enacted similar lockdown policies at the same time. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. More could be on the way. Data curation, If youve been vaccinated and still feel mortally threatened by the virus, please read this. No, Is the Subject Area "Public policy" applicable to this article? Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. Several other states have implemented or tightened. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. Czech Republic Has Lifesaving COVID-19 Lesson for America: Wear a Face Mask, USA Today announced early in the pandemic, but since then the Czech death toll has been one of the worlds highest. 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. Though many have taken fresh steps to contain the virus since then, the Times analysis compares cases and hospitalizations for a given date to a states index score from two weeks before, since researchers say it is reasonable to expect a lag between a policy's implementation and its outcome. 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. ", 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." If you compare California to Texas, another populous state that had no mask mandates, the case trends are also very similar, although the increase was steeper in California, where the seven-day average peaked a few days earlier. Even if masking works, that does not necessarily mean mandates do. Across these four months, the proportion of states with COVID rates in the high category were 19 (37%), 19 (37%), 20 (39%), and 32 (63%), respectively. "We feel the time is right to make this . Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. Individuals mask wearing behaviors are not only influenced by recommendations and mandates issued by state leaders, but also by print, televised, and social media [9]. 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. John Tierney is a contributing editor of City Journal and coauthor of The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. 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. But there are still settings where wearing your mask is crucial. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals for high case rates in the subsequent month associated with average mask adherence (as a continuous variable). One of the biggest problems in the United States so far has been the lack of a coherent, cohesive national response, said Wafaa El-Sadr, an epidemiologist at Columbia University. Once you start thinking about acting, it probably is the time to act.. Further, our adjustment for demographic factors at the state population level may not represent the true underlying forces that put individuals at greater risk of contracting COVID-19. While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. If this hasnt persuaded you to take off your mask, you can find lots more reasons in a book by Ian Miller, the data analyst who created the graph for City Journal. 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. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. 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. Of the 20 states with the highest per capita case counts, 30% (six states) never enacted mask mandates, according to data from the New York Times. Because high COVID rates were reported by only eight states in May and four states in June, we did not examine mask adherence or policy in the preceding April or May. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. 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. 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.. Many states in the Upper Midwest and Mountain West resisted more stringent control measures, like limits on gatherings and mask mandates. The same basic pattern was seen in nearly every state. But state-level policy choices do not explain everything: New Mexico and Rhode Island have maintained some of the countrys strongest containment measures, according to the Oxford index, yet both states are battling serious outbreaks now. If youre still not convinced to take off the mask, consider one more graph from Miller. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. Instead of carefully analyzing the effects of masks, the CDC repeatedly tried to justify them by misrepresenting short-term trends and hyping badly flawed research, like studies in Arizona and Kansas purporting to show that infections had been dramatically reduced by the mask mandates imposed in some counties. When Can I Go Out in Public Again After Being Fully Vaccinated? 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. 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. The current study . https://doi.org/10.1371/journal.pone.0249891.s001. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. Start the day smarter Notable deaths in 2023 The world's largest war . When Can I Go to the Movie Theater Again After Being Fully Vaccinated? For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". 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. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. 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. Former Arizona AG Found No Evidence of 2020 Election Fraud. 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. Germanys stringent policies have made it a consistent media darling. Yes Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. Masks prevent you from inhaling or exhaling viral droplets that can linger in the air. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. https://doi.org/10.1371/journal.pone.0249891.t003. It compares Germany with Sweden, the medias Covid villain for refusing to lock down or mandate masks. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. In addition, Hawaii and Oregon, which have both implemented school mask. Subscribe to Reason Roundup, a wrap up of the last 24 hours of news, delivered fresh each morning. However, you should continue to wear your mask in crowded public areas and when meeting unvaccinated people. When Can I Travel Again After Being Fully Vaccinated? A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. He adds that the two states "had nearly identical infection rates.". No, Is the Subject Area "Health care policy" applicable to this article? I just dont know based on reading the OAN summary how they came to the same conclusions because the CDC conclusions were favorable.. In contrast, allowing on . Our fact check work is supported in part by a grant from Facebook. Gavin Newsom ordered the nation's first statewide shutdown because of the coronavirus, masks remain mandated, indoor dining and other activities are significantly limited, and Disneyland remains closed. May 16, 2021 / 7:07 AM / CBS News. Theyre suffering from mask dependency, as this psychological affliction is termed in Japan, where a long tradition of mask-wearing during flu season has left some individuals afraid at any time to expose their faces in public. Yes 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. Privacy Policy | Thank you for supporting our journalism. Weak recent containment measures and many cases. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. Methodology, Both mask policy and mask adherence for states and D.C. were cross-tabulated with high case rates in the subsequent month. If Florida's case numbers understate the true number of infections more than California's do, that could partially explain the difference in COVID-19 deaths per capita. In fact, it doesn't study mask efficacy at all. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. Mast mandates may be back on the table for states where the number of COVID cases are once again causing serious alarm for health officials. 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 requirement is expected to be lifted on March 1. The findings were published in the journal PLOS One in April. Nevertheless, adherence is essential for policy effectiveness. After the pandemic, a survey of gains and losses. [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. The study concluded that mask mandates and use are not associated with slower state-level Covid-19 spread during Covid-19 growth surges. The medias narrative about masks extended throughout the world. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. By Jocelyn Solis-Moreira Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. Adherence to public policy is influenced by a complex interplay of factors such as public opinion, cultural practices, individual perceptions and behaviors [11], which are difficult to quantify. States That Imposed Few Restrictions Now Have the Worst Outbreaks. + Caption. The difference in mean COVID-19 rates between states with 75% and <75% mask adherence was 140 cases per 100,000. 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. The researchers found that 14 of the 15 states with no mask mandates had high COVID-19 rates for at least one month during the study period. Vaccinated persons can carry and spread the virus.". "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. 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. That period is used as the benchmark against which researchers compared days 21 through 60 before mask mandates were adoptedand the 100 days after. 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. Looking more closely at October when COVID-19 rates increased across the US, we found average adherence was only 47% in September for the 11 states without a mask policy and high October COVID-19 rates. 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. What theyre looking at here is efficacy of mask mandates. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. | Sources: Oxford Covid-19 Government Response Tracker, closing bars, restaurants, gyms, theaters and schools, one in 10 North Dakotans have tested positive. Copyright The estimated absolute change in cumulative case rate associated with lifting the mask mandate, remains 28.1 (30.6%) 21 days after lifting the mask mandate. 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. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. | 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. Note: Cases and hospitalizations are data from Nov. 16. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. But the researchers found no clear relationship between mask mandates and mask use. 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. 3.1.2023 11:20 AM, Elizabeth Nolan Brown Latest news. 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. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. Indeed, issuing such a policy is not the same as successfully implementing it. | As of Aug. 3, Louisiana is under a temporary statewide mask mandate required of all people, including those who are vaccinated, when indoors. Jacob Sullum is a senior editor at Reason. States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. The list of states with high COVID-19 rates by month shows the initial wave in northeastern states in May, followed by a wave in southern states, and then spreading across the U.S. over the next four months (Table 2).