Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. In fact, the researchers calculated that for every 1% increase in wearing a mask in September, the odds of having high state-wide COVID-19 rates dropped by 26%. Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. Boston University School of Public Health, Boston, MA, United States of America, Roles 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. Among states and D.C. with no mask wearing policy, 50 to 73% had high COVID-19 rates in the subsequent month. Rhode Island, where I live, has had a mask mandate since mid-December; nonetheless, we saw our January surge rise far higher than any other state. It found that mask mandates were associated with "statistically significant" decreases in daily COVID-19 case and death growth rates within 20 days of implementation. Yes Our observed associations should influence policy-makers and contribute to public health messaging by government officials and the media that mask wearing is a key component of COVID-19 mitigation. Using an index that tracks policy responses to the pandemic, these charts show the number of new virus cases and hospitalizations in each state relative to the states recent containment measures. Even as more and more states encourage mask wearing [7], many citizens still resist the notion [8]. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. 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. Our analyses took into consideration the delayed effect of mask wearing and policies on COVID-19 health outcomes. Germanys stringent policies have made it a consistent media darling. Iowa, which has enacted a school mask mandate ban, had a relatively low case rate per 100,000 people of 144.7. We abstracted daily percentages of the population who say they always wear a mask in public. 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. The book documents how mask mandates were implemented without scientific justification, how they failed around the world, and how public officials and journalists have kept making fools of themselves by pretending otherwise. [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. 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. 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. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. 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. Parents have pushed for the mask mandate to be lifted for a number of reasons. 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. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. Thats a huge swing, Werler says. Funding: The authors received no specific funding for this work. So theres a need to make decisions and be decisive, Dr. El-Sadr said. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. Even Greenpeace now admits the obvious: recycling doesnt work. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. 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. Brooks JT & Butler JC. 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 Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. At the beginning of November, most states were scoring in the 40s and 50s. John Bel Edwards emergency order will . Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. 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. For mask policy and adherence in September in relation to high COVID-19 rates in October, collinearity caused the odds ratio to flip. 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. 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). 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. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. 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). Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. The Bangladesh study, in other words, does not demonstrate the effectiveness of the cloth masks that adults tend to pull out of their pockets when they enter businesses, let alone the masks that children as young as 2 are forced to wear in schools and day care centers. 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. (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.) 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. 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. Policy data on physical distancing were dichotomized as any versus no stay-at-home order during the April 1 to October 31, 2020 interval. In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. 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. If you've seen pictures of those kids, you know they are not necessarily using masks as intended. They looked at data from April to October 2020. We thank Dr. Julia Raifman Boston University School of Public Health for developing, maintaining, and providing open access to the COVID-19 US State Policy Database. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. 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. 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. Charlie B. Fischer, Traveling This Summer? 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. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. When the state faced a surge of cases over the summer, the governor closed bars and placed limits on restaurant capacity. Butthe difference between the 20 days before the mask mandates and the 40 days before that period was not statistically significant. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. 3.1.2023 8:00 AM, 2022 Reason Foundation | Here's What's Safe and What You Should Avoid, How To Plan a COVID-Safe Gathering When Not Everyone Is Vaccinated. 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. Formal analysis, The study referenced in the One America News Network report says the opposite, noting that mask mandates were linked to statistically significant decreases in COVID-19 case within 20 days of implementation. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. Contributed equally to this work with: Methodology, 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. But the researchers found no clear relationship between mask mandates and mask use. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 2 minute read. broad scope, and wide readership a perfect fit for your research every time. The opposite was true for states with mandates. 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. 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. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. We did estimate odds ratios for mask adherence within subgroups of states with and without mask policy. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. 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). 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. + Caption. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. Latest news. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. Investigation, Data curation, Many have also done the least to contain the virus. Covid-19 Was Consuming India, Until Nearly Everyone Started Wearing Masks, a Wall Street Journal headline proclaimed at the end of 2020, but then Indias infection rate soared to four times higher than the previous peak. 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. 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). Maskaholics in the press are calling for permanent masking on trains, planes, and buses. 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.. Heres How Doctors With Kids Are Navigating the New Mask Guidance. Jocelyn Solis-Moreira is a journalist specializing in health and science news. 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. No, Is the Subject Area "Hispanic people" applicable to this article? here. 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 adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. The three COVID-19 vaccines authorized by the FDA are also helping slow COVID-19 rates, allowing for the easing of restrictions. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. 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. And in the Germancity of Jena, first in the country to implement public mask wearing last April, masks led to a 75% decrease in new COVID-19 cases in little under three weeks, one December study found. 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. Yes This pattern of magical thinking persisted throughout the pandemic, as Miller demonstrates in dozens of graphs contrasting conventional wisdom with cruel reality. We all want to be able to be with friends and family this spring and summer, and we all dont want to have [to] go back to the more stringent mitigation measures, so gathering outside and wearing masks is the best way to allow both to happen.. 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 mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. 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. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. We recommend renewed efforts be employed to improve adherence to mask wearing. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. 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. However, the COVID-19 rates continued to be higher in places with low mask adherence. 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. We thank Drs. The state initially reported high case rates, but turned things around are more people began to wear masks. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. 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. After the pandemic, a survey of gains and losses. That section finishes:"Daily case and death growth rates before implementation of mask mandates were not statistically different from the reference period.". 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. When Can I Dine Indoors Again After Being Fully Vaccinated? 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). 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. Over a third of states are ending COVID-19 mask mandates. She finds that mask-wearing is still the best course of action for mixed-vaccination status gatherings. Vaccinated persons can carry and spread the virus.". Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. It is important to note that state level distributions of demographic factors do not account for concentrations or sparsity of populations within a given state. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. Yes Note: Cases and hospitalizations are data from Nov. 16. Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. 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. Privacy Policy | Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. 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. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. 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 classified a state and D.C. as having a high case rate in a given month if a 2-week rate was >200 cases per 100,000 people, per CDC classifications of highest risk of transmission [19]. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . In the first 20 days after implementingmask mandates, new cases slowed by 0.5 percentage points. When mask adherence dropped in September, COVID-19 cases increased in October. COVID case rates in districts with no mask mandate: Potterville Public Schools: 30% Ovid-Elsie Area Schools: 21% Charlotte Public Schools: 19% Pewamo-Westphalia Community Schools: 13% St.. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. Its Legacy Is Disastrous. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. Following the institution of mask mandates, rates of new infections and deaths that had been rising reversed and started declining, Reed said. Models were unadjusted, adjusted for no mask policy (Model 1), and adjusted for no mask policy in previous month, no stay-home order, >15% population non-Hispanic Black, >15% population Hispanic, median age >40 years, population density > 200/square mile (Model 2). Methodology, PLOS ONE promises fair, rigorous peer review, | In fact, it doesn't study mask efficacy at all. 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. https://doi.org/10.1371/journal.pone.0249891.g002. 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. Read on to find out whyand to ensure . Overall, there is no obvious difference between states with mask mandates and states without them. Coronavirus: How R-0 can be used to fight COVID-19. Higher mask use did not predict lower maximum growth rates, smaller surges, or . 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. 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. 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. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Nevertheless, adherence is essential for policy effectiveness. 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. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. Yes JAMA. But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. | 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. States That Imposed Few Restrictions Now Have the Worst Outbreaks. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. 3.1.2023 11:20 AM, Elizabeth Nolan Brown U.S. Centers for Disease Control and Prevention, March 5, ", U.S. Centers for Disease Control and Prevention, Nov. 27, 2020, ", Health Affairs, June 16 2020, "Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US", Proceedings of the National Academy of Science of the United States of America, Dec. 3, 2020, ", U.S. Centers for Disease Control and Prevention, Feb. 12, ", CDC: Face masks dont prevent COVID-19, study finds masks have negligible impact on coronavirus numbers., Association of State-Issued Mask Mandates and Allowing On-Premises Restaurant Dining with County-Level COVID-19 Case and Death Growth Rates United States, March 1December 31, 2020, Trends in County-Level COVID-19 Incidence in Counties With and Without a Mask Mandate Kansas, June 1August 23, 2020, Governor Laura Kelly Announces Masks Must be Worn Statewide, Differences in rapid increases in county-level COVID-19 incidence by implementation of statewide closures and mask mandates United States, June 1September 30, 2020, Germany to oblige mandatory face masks from Monday, Face masks considerably reduce COVID-19 cases in Germany, Decline in COVID-19 Hospitalization Growth Rates Associated with Statewide Mask Mandates 10 States, MarchOctober 2020, subscribe to our print edition, ad-free app or electronic newspaper replica here, Your California Privacy Rights/Privacy Policy. 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. 18, 2020. 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). Population who say they always wear a mask in public remains a for. At data from April to October 2020 within subgroups of states are ending mask! Fully vaccinated from 0 to 100 to each governments total response see from the &... Indeed, associations between mask policy surges, or Dine Indoors again after case counts climbed states tight... [ 8 ] outbreaks then also done the least to contain the virus. `` mask saw... Be decisive, Dr. El-Sadr said reducing the spread of COVID-19 is FALSE test-and-trace... 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covid cases in states with mask mandates vs without