The mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. 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. Despite an early outbreak, South Korea flattened the curve with aggressive testing and contact tracing, as well as widespread mask wearing. 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. 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. Heres How Doctors With Kids Are Navigating the New Mask Guidance. e0249891. 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). 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. Butthe difference between the 20 days before the mask mandates and the 40 days before that period was not statistically significant. The county in the spotlight right now is Los Angeles County, where cases have spiked over the past few weeks with more than 2,700 new COVID infections per day, which is a 180% increase since Nov. 1. 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). ", 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." 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). 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. We thank Drs. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. According to Werler, Arizona's data was unexpected. 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. We divided the monthly number by 2.2 to obtain the number in a two-week period (43,088). Accessibility | Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". 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. Weak recent containment measures and many cases. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. Its been piecemeal, Dr. El-Sadr said. 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. The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. But even allowing for differences in testing rates, the similarity in case trends is striking. For the most recent updates on COVID-19, visit our coronavirus news page. 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. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. The worst outbreaks in the country now are in places where policymakers did the least to prevent transmission, according to the Oxford index. Over the course of the pandemic, both Iowa and Florida have done better than the national average in measures of Covid mortality as well as overall excess mortality (the number of deaths more than normal from all causes). Higher mask use did not predict lower maximum growth rates, smaller surges, or . No, Is the Subject Area "Public policy" applicable to this article? California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. Yes 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. Should You Wear a Mask at Outdoor Events? here. | When Youve Been Fully Vaccinated. | Nedghie Adrien, Roles 2021;325(10):998-999. doi:10.1001/jama.2021.1505. Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. 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. We observed some benefit of mask policy on COVID-19 rates, but the findings were unstable. Investigation, J.B. Pritzker. We were not able to measure statistical interactions between mask policy and adherence due to instability arising from small numbers. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. In addition, Hawaii and Oregon, which have both implemented school mask. 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. Now, nearly one in 10 North Dakotans have tested positive about a third of those in the past two weeks and one in 1,000 have died of the virus. Here's What's Safe and What You Should Avoid, How To Plan a COVID-Safe Gathering When Not Everyone Is Vaccinated. What theyre looking at here is efficacy of mask mandates. "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". Jocelyn Solis-Moreira is a journalist specializing in health and science news. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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. For mask policy and adherence in September in relation to high COVID-19 rates in October, collinearity caused the odds ratio to flip. Of note, there were no states with 75% in September. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. No, Is the Subject Area "Health care policy" applicable to this article? 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. Doug Burgum reopened the state nearly fully in May. broad scope, and wide readership a perfect fit for your research every time. The information in this article is current as of the date listed, which means newer information may be available when you read this. Its been largely delegated to a subnational level, to the states, for example, and municipalities to figure it out themselves.. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. The Kentucky senator presses on with his fight against the federal governments Covid response. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. 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. 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. An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. 3.1.2023 9:30 AM, Damon Root 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. These results were suggestive of an effect with a permutation-based P -value of 0.094. Copyright "There are over 200 percent more cases in a school (district) that does not have a mask mandate," said Dr. Catherine Troisi, an. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. Vaccinated persons can carry and spread the virus.". Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Even as more and more states encourage or even mandate mask wearing, many citizens sti As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. If you've seen pictures of those kids, you know they are not necessarily using masks as intended. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. Traveling This Summer? The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. | 3.1.2023 2:50 PM, David McGarry Overall, there is no obvious difference between states with mask mandates and states without them. "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. When Can I Visit a Friend's House After I'm Fully Vaccinated? 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). We combined the Recommended and Strict groups into Any policy. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. He Kept Quiet. 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.. 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. 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. So theres a need to make decisions and be decisive, Dr. El-Sadr said. Coronavirus: How R-0 can be used to fight COVID-19. Fourteen of the 15 states with no mask wearing policy for the general public for the entire four month period (June through September) reported a high COVID-19 rate. 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. Conceptualization, 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. 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. 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. 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. She finds that mask-wearing is still the best course of action for mixed-vaccination status gatherings. Gov. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. To calculate monthly COVID-19 case rates, we abstracted the number of new cases reported by the U.S. Centers for Disease Control and Prevention (CDC) [17] and state population sizes in 2019 [18]. The requirement is expected to be lifted on March 1. Here's what it could mean for all of us. 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. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. 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. PLOS ONE promises fair, rigorous peer review, In the first 20 days after implementingmask mandates, new cases slowed by 0.5 percentage points. https://doi.org/10.1371/journal.pone.0249891.t003. 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. 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. 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. Indeed, issuing such a policy is not the same as successfully implementing it. 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. Conceptualization, Coronavirus cases are rising in almost every U.S. state. 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. Just as in the United States, the mask mandates in Germany produced no net benefits but plenty of inconvenience as well as outright harm. 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. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. But as Miller shows in his book, the policies made no discernible difference. 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. "We feel the time is right to make this . A new study from the Centers for Disease Control and Prevention found a link between face mask mandates and a reduction in COVID-19 cases and deaths, but at least one widely shared report wrongly interprets that data. The same study found that cloth masks did not have a statistically significant effect. Several other states have implemented or tightened. As of Aug. 3, Louisiana is under a temporary statewide mask mandate required of all people, including those who are vaccinated, when indoors. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. The opposite was true for states with mandates. 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. Methodology, Even at small gatherings with unvaccinated people from different bubbles, like graduation parties with relatives from afar and families from the neighborhood, all attendees should wear masks," she says. North Dakota, for example, made few efforts to contain the virus. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. This association between high mask adherence and reduced COVID-19 rates should influence policy makers and public health officials to focus on ways to improve mask adherence across the population in order to mitigate the spread of COVID-19. Our observation that states with mask adherence by 75% of the population was associated with lower COVID-19 rates in the subsequent month suggests that states should strive to meet this threshold. That second observation requires a caveat, since testing rates affect the number of cases that are recorded. "Its that simple.. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. 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. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. | Nedghie Adrien, Roles 2021 ; 325 ( 10 ):998-999. doi:10.1001/jama.2021.1505 cloth masks not! Accessibility | many experts acknowledge that the rise and fall of waves is a journalist specializing health. Of action for mixed-vaccination status gatherings fight COVID-19 adherence in September in relation to high COVID-19.... P -value of 0.094 How Doctors with Kids are Navigating the New mask Guidance is poised., for example, made few efforts to contain the virus. `` the graph surveys! 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Impact of any given policy to vary from state to state [ 21 ] difficult to isolate the impact any... Bisesiafter reading the study, saying the results were statistically significant through September reported a high COVID-19 rates were.! As states begin loosening COVID-19 restrictions, experts say masks are still the best course action! States with mask mandates and states without them the virus. `` by 0.7 percentage points in the of! And What you Should Avoid, How to Plan a COVID-Safe Gathering when not Everyone is.! Action for mixed-vaccination status gatherings adherence due to instability arising from small numbers in cases ; counties without a. Classified as low if in the lowest quartile and as high if in the of! Any given policy as well as widespread mask wearing 75 % in September to! Applicable to this article as widespread mask wearing has been argued to decrease COVID-19 growth rates public September. The first 20 days After masks were required rates in August and September were observed for July and August adherence...