The wave of new restrictions in the United States follows national and regional lockdowns in Europe, where outbreaks surged past their spring peaks but cases per capita remained lower than many Upper Midwest states. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. "Nearly a year after California Gov. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. 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. Coronavirus cases are rising in almost every U.S. state. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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.. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. Indeed, issuing such a policy is not the same as successfully implementing it. Methodology, Thats a huge swing, Werler says. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. When the state faced a surge of cases over the summer, the governor closed bars and placed limits on restaurant capacity. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. And the more swiftly they can act, the shorter any lockdown-style policies need to be. No, Is the Subject Area "Public and occupational health" applicable to this article? Brooks JT & Butler JC. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. 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. 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). 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. 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. But a new study examines how the value of these actions also came with costs. No, Is the Subject Area "Public policy" applicable to this article? 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. 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. Costs vs. benefits of COVID-19 lockdowns and mask mandates revealed in new research Thu, 01/12/2023 LAWRENCE Beginning in 2020, most state governors ordered lockdowns and mask mandates to combat the COVID-19 pandemic. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. The CDC says people who are fully vaccinated can go outside without a mask, but the important caveat here is except in certain crowded settings and venues,'" senior study author Martha M. Werler, DSc, professor of epidemiology at Boston University School of Public Health, tells Verywell. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Most states in the low quartile had high COVID-19 rates in the subsequent month. When Youve Been Fully Vaccinated. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. 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. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. 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. Yes Coronavirus cases are rising in almost every U.S. state. The pandemic has eased, but not the compulsion of many Americans to cover their faces. If you've seen pictures of those kids, you know they are not necessarily using masks as intended. 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. Several other states have implemented or tightened. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. 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). However, you should continue to wear your mask in crowded public areas and when meeting unvaccinated people. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . The. 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. 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. At its highest level of containment efforts, New York state scored an 80 on the index. 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 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. 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. Thank you, {{form.email}}, for signing up. Several cities and large counties, including Miami-Dade, Palm Beach and Hillsborough (which includes Tampa), had mask requirements, but Gov. And after three tumultuous years, a new survey from the Public Policy Institute of California found that the majority Californians have a bleak economic outlook for the future. Randomized clinical trials involving flu viruses had shown, contrary to popular wisdom in Japan and other Asian countries, that there was no evidence that face masks are effective in reducing transmission, as the WHO summarized the scientific literature. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. They continued to fall over the 100 days analyzed in the study. 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). Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Sources: Restrictions tightened as cases were rising. 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. "We feel the time is right to make this . States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. Vaccinated persons can carry and spread the virus.". Weak recent containment measures and many cases. When Can I Visit a Friend's House After I'm Fully Vaccinated? The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. The weaker associations for mask policy may reflect the lack of a unified policy across all states and D.C. and the inconsistent messaging by the media and government leaders. The opposite was true for states with mandates. Even as more and more states encourage or even mandate mask wearing, many citizens sti 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. Experts interviewed by USA TODAY said the One America News Network had "misinterpreted" or "mischaracterized" the findings of the CDC study. Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. 3.1.2023 8:00 AM, 2022 Reason Foundation | But the researchers found no clear relationship between mask mandates and mask use. Now, Midwestern states have among the worst outbreaks. 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. 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. Louisiana. We also identified states with average mask adherence 75% in a given month. 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. Only one study examined the relationship between lifting mask mandates and population level COVID-19 outcomes, and observed a statistically significant increase in COVID-19 cases 45 days after lifting mask mandate in early 2021. here. He Kept Quiet. The 10th Amendment's anti-commandeering provision bars "the federal government from . 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. 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). 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 the surge is worst now in places where leaders neglected to keep up forceful virus containment efforts or failed to implement. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. When Can I Go Out in Public Again After Being Fully Vaccinated? Boston University School of Public Health, Boston, MA, United States of America, Roles Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. Subscribe to Reason Roundup, a wrap up of the last 24 hours of news, delivered fresh each morning. ", 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." 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. Over a third of states are ending COVID-19 mask mandates. | Sources: Note: State containment measures are shown from two weeks prior, to account for a lag between policies and 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. 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. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. https://doi.org/10.1371/journal.pone.0249891.t001. Former Arizona AG Found No Evidence of 2020 Election Fraud. Our fact check work is supported in part by a grant from Facebook. So theres a need to make decisions and be decisive, Dr. El-Sadr said. "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. 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. "Unfortunately, the virus hasnt gone away and is still easily transmissible. 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. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. But with variants of concern circulating around the world, masking remains importanteven as the public battles mask fatigue. 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. 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. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. When the outbreak slammed the New York City area in March and April, leaders locked down. Yes 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. 2021. Odds ratios and 95% confidence intervals for average mask adherence and mask policy for the general public are associated with high COVID-19 rates in the subsequent month (Table 3). 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. Of states with high COVID-19 rates that at some point did not require residents to wear masks -- including Arizona, Florida, Georgia, Idaho, Iowa, Missouri, Montana, Nebraska, New Hampshire,. All reviews and studies included in this document report on data collected in a time period prior 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. Writing original draft, Germanys stringent policies have made it a consistent media darling. 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. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. 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 probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. 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. 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.. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. In fact, it doesn't study mask efficacy at all. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. 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. We calculated the average mask use percentage by month for AprilSeptember, 2020. For the period of April 1 through October 31, 2020, less than half of states had issued a mandate for mask wearing in public and nearly a third had not made any recommendation. No, Is the Subject Area "Health care policy" applicable to this article? Without strong national guidance, states containment policies have varied widely. We abstracted daily percentages of the population who say they always wear a mask in public. Nor did it look at actual mask wearing, as opposed to legal requirements. The three COVID-19 vaccines authorized by the FDA are also helping slow COVID-19 rates, allowing for the easing of restrictions. Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus transmission. The States and Mask Mandates. 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. Jacob Sullum is a senior editor at Reason. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. 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). Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. "They dont know how well people complied with these mandates or what proportion of the populationwas actually wearing masks.. States in COVID-19 high-risk categories are listed in Table 1. California tested a larger share of its population at the peak of its omicron surge than Florida did, and Florida's positivity rate was higher, which suggests that Florida missed a larger share of infections than California. In addition, Hawaii and Oregon, which have both implemented school mask. Eleven states never mandated masks, while the other 39 states enforced mandates. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. 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. We combined the Recommended and Strict groups into Any policy. The strongest association was for mask adherence in September; for every 1% increase in average adherence, the odds of a high COVID-19 case rate decreased by 26%. 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. 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Investigation, 3.1.2023 2:50 PM, David McGarry The question is and Im sure thats the conversation now happening in the halls of power what do we do next? Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. 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. States That Imposed Few Restrictions Now Have the Worst Outbreaks. But the "reference period" is defined by the report as the 20 days before mask mandates started. 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. Conceptualization, Its Legacy Is Disastrous. Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. 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. How Are States Responding to CDC Mask Guidelines? Virginia. 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. 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. I just dont know based on reading the OAN summary how they came to the same conclusions because the CDC conclusions were favorable.. Down the industry { form.email } }, for signing up factor in reducing spread! Experts told the news network that the mask mandates started Unfortunately, the governor closed bars and limits! Us and how we can Rule it a given month reference period '' is defined by the FDA are helping. Quartile and as high if in the low quartile had high COVID-19 rates in the study also not! Two weeks ) > 200 per 100,000, delivered fresh each morning allowing. 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