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. 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. 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. Coronavirus cases are rising in almost every U.S. 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. You cansubscribe to our print edition, ad-free app or electronic newspaper replica here. Its been piecemeal, Dr. El-Sadr said. But the "reference period" is defined by the report as the 20 days before mask mandates started. But the researchers found no clear relationship between mask mandates and mask use. 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. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 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. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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 current surge is worst in places with few containment measures. And the more swiftly they can act, the shorter any lockdown-style policies need to be. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. 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. We examined the impact of state-based mask wearing policy and adherence on COVID-19 case rates during the summer and early fall of 2020 in order to quantify this effect. 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. 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,. 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. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. The current study . What theyre looking at here is efficacy of mask mandates. 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. No, Is the Subject Area "Conservation science" applicable to this article? 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. 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. | 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. Formal analysis, 3.1.2023 2:50 PM, David McGarry For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Across the country, indoor mask requirements in blue states are falling like dominoes as COVID cases drop. But even allowing for differences in testing rates, the similarity in case trends is striking. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. Yes Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. PLoS ONE 16(4): Visualization, The States and Mask Mandates. 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. 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]. 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. (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.) For more information about PLOS Subject Areas, click But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. Since the spring, Maine mandated masks and had strict travel restrictions for out-of-state visitors; South Dakota, meanwhile, has never had a mask mandate and welcomed nearly half a million people to the Sturgis motorcycle rally, as well as its state fair, which attracted more than 100,000 visitors. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. 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. (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 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. Thats what this study was pursuing to try to answer,"said Michael Bisesi, vice dean and interim chair of environmental health sciences in Ohio State University's College of Public Health. 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. Even as more and more states encourage or even mandate mask wearing, many citizens sti 2 minute read. e0249891. Its Legacy Is Disastrous. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. 3.1.2023 9:30 AM, Damon Root States with stronger policy responses over the long run are seeing comparatively smaller outbreaks. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. 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. This pattern of magical thinking persisted throughout the pandemic, as Miller demonstrates in dozens of graphs contrasting conventional wisdom with cruel reality. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. The index does not evaluate the effectiveness of individual policies. Overall, there is no obvious difference between states with mask mandates and states without them. 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. Conceptualization, Many have also done the least to contain the virus. The claim: CDC study found that face masks have a negligible effect on the spread of COVID-19. Further analyses of more granular geographic regions would be a logical next step. The pandemic has eased, but not the compulsion of many Americans to cover their faces. 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. 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. Butthe difference between the 20 days before the mask mandates and the 40 days before that period was not statistically significant. Weak recent containment measures and many cases. We utilized the COVID-19 US State Policy Database, created by Dr. Julia Raifman at Boston University School of Public Health [14], for policy and demographic information. 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). The pandemic planners at the United Kingdoms Department of Health had reached a similar conclusion: In line with the scientific evidence, the Government will not stockpile facemasks for general use in the community. Anthony Fauci acknowledged this evidence early in the pandemic, both in his public comments (Theres no reason to be walking around with masks, he told 60 Minutes) and in his private emails (I do not recommend you wear a mask, he told a colleague, explaining that masks were too porous to block the small Covid virus). If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. Read on to find out whyand to ensure . Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. The data we now have conclusively show that widespread use of masks is a very effective way to reduce the spread of COVID-19, CDC spokeswoman Jasmine Reed wrote in an email to USA TODAY. The mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. 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). When Can I Travel Again After Being Fully Vaccinated? Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. Doug Burgum reopened the state nearly fully in May. For mask adherence levels, we utilized the Institute of Health Metrics and Evaluation (IHME) COVID-19 Projections online database [15], which holds data collected by Facebook Global in partnership with the University of Maryland Social Data Science Center [16]. Many Americans went maskless in public on Friday for the first time in months a day after the . No, Is the Subject Area "United States" applicable to this article? Jocelyn Solis-Moreira is a journalist specializing in health and science news. 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. 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. 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. Indeed all 13 states in the low mask adherence group in September had high COVID-19 rates in October. Jocelyn Solis-Moreira is a journalist specializing in health and science news. But there are still settings where wearing your mask is crucial. 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. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. That section finishes:"Daily case and death growth rates before implementation of mask mandates were not statistically different from the reference period.". A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. Given the situation during the omicron surge, there are additional reasons to doubt that mask mandates, even with perfect compliance, had much of an impact. Heres How Doctors With Kids Are Navigating the New Mask Guidance. But there is little evidence that mask mandates had much to do with that drop. New Zealand recently lifted all restrictions following 10 days with no new cases. 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. May 16, 2021 / 7:07 AM / CBS News. 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. Once you start thinking about acting, it probably is the time to act.. "There are over 200 percent more cases in a school (district) that does not have a mask mandate," said Dr. Catherine Troisi, an. 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. https://doi.org/10.1371/journal.pone.0249891.g002. Some states now have ended their statewide masks mandates, but the president, and others, have urged them to reinstate masks mandates because of the recent upsurge that our nation has seen in COVID-19 cases. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Gov. 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. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. 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). 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Mask mandates are associated with reductions in COVID-19 case and hospitalization growth rates (6,7), whereas reopening on-premises dining at restaurants, a known risk factor associated with SARS-CoV-2 infection (2), is associated with increased COVID-19 cases and deaths, particularly in the absence of mask mandates (8). Funding: The authors received no specific funding for this work. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Outbreaks are comparatively smaller in states where efforts to contain the virus were stronger over the summer and fall potential good news for leaders taking action now. That second observation requires a caveat, since testing rates affect the number of cases that are recorded. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. Nevertheless, it is possible that average mask adherence in a given month does not capture the most effective time period that influences COVID-19 rates. The information in this article is current as of the date listed, which means newer information may be available when you read this. States That Imposed Few Restrictions Now Have the Worst Outbreaks. A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. When Can I Go to the Movie Theater Again After Being Fully Vaccinated? Even as more and more states encourage mask wearing [7], many citizens still resist the notion [8]. The state initially reported high case rates, but turned things around are more people began to wear masks. 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. But it seems clear that anyone who takes it for granted that mask mandates have played a crucial role in controlling the spread of COVID-19 is making a series of assumptions that are not justified by the evidence. But the surge is worst now in places where leaders neglected to keep up forceful virus containment efforts or failed to implement basic measures like mask mandates in the first place, according to a New York Times analysis of data from the University of Oxford. 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). Several cities and large counties, including Miami-Dade, Palm Beach and Hillsborough (which includes Tampa), had mask requirements, but Gov. 2023 Manhattan Institute for Policy Research, Inc. All rights reserved. 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