A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. 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. Nor did it look at actual mask wearing, as opposed to legal requirements. 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. 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. 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. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. 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. 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. 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. 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. No, Is the Subject Area "Public policy" applicable to this article? 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. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. One state is the lone holdout. 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. 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. Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. 3.1.2023 9:15 AM, Joe Lancaster 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. The study used county-level data from March 1 through Dec. 31 of last year, comparing data from before mandates tookeffect to the time period when they were in place. 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). 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. Both mask policy and mask adherence for states and D.C. were cross-tabulated with high case rates in the subsequent month. That period is used as the benchmark against which researchers compared days 21 through 60 before mask mandates were adoptedand the 100 days after. 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. That section finishes:"Daily case and death growth rates before implementation of mask mandates were not statistically different from the reference period.". Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. The Centers for Disease Control & Prevention (CDC) recently relaxed their COVID-19 guidelines, allowing fully vaccinated people to forego masks outside. Eight states were reported to have at least 75% mask adherence in any month between June and September (AZ, CT, HI, MA, NY, RI, VT, VA); none reported a high COVID-19 rate in the subsequent month. The graph for New York, which also had a statewide mask mandate, looks very much like the graph for California, but with an earlier peak. But a new study examines how the value of these actions also came with costs. PLoS ONE 16(4): Research on lax public health policies and lack of adherence is warranted because they can carry real risks to health, with myriad downstream effects including increased death, stressed health care systems, and economic instability [13]. Accessibility | Investigation, Mast mandates may be back on the table for states where the number of COVID cases are once again causing serious alarm for health officials. 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). Jacob Sullum is a senior editor at Reason. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. In fact, it doesn't study mask efficacy at all. Click through the PLOS taxonomy to find articles in your field. 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. Vaccinated persons can carry and spread the virus.". 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. 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. The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. When Can I Go Out in Public Again After Being Fully Vaccinated? Yes Crude and adjusted odds ratios for any mask policy in relation to high COVID-19 rates in the subsequent month were below 1.0; but confidence intervals were wide. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. 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. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. 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]. The Department of Homeland Security Turns 20. 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. 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. Conceptualization, Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. 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. 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. 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. Just as in the United States, the mask mandates in Germany produced no net benefits but plenty of inconvenience as well as outright harm. Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. 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. 3.1.2023 11:20 AM, Elizabeth Nolan Brown A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. At the beginning of November, most states were scoring in the 40s and 50s. 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. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. We abstracted daily percentages of the population who say they always wear a mask in public. Even Greenpeace now admits the obvious: recycling doesnt work. 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. Despite an early outbreak, South Korea flattened the curve with aggressive testing and contact tracing, as well as widespread mask wearing. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. Coronavirus cases are rising in almost every U.S. state. 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. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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. 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. Mandating masks gave the illusion of doing something against the virus. Many have also done the least to contain the virus. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. 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. ", 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." https://doi.org/10.1371/journal.pone.0249891.t002. 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. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. We did estimate odds ratios for mask adherence within subgroups of states with and without mask policy. 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 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. 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). Its Legacy Is Disastrous. The United States, as of Friday, posted a seven-day moving average of 62,555 new COVID-19 cases reported daily, according to data from the Centers for Disease Control and Prevention.The last time . 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. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. Conceptualization, New infections have stayed among the lowest in the country, adjusted for population though cases now are rising in New York as they are everywhere. | 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. Copyright: 2021 Fischer et al. When Can I Travel Again After Being Fully Vaccinated? 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. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. Writing original draft, Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. 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). 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. The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. Weak recent containment measures and many cases. 3.1.2023 9:30 AM, Damon Root Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. 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. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. 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 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. Immediately after these mandates were instituted, these declines were statistically significant.. Competing interests: The authors have declared that no competing interests exist. Centers for Disease Control and Prevention. Theyre suffering from mask dependency, as this psychological affliction is termed in Japan, where a long tradition of mask-wearing during flu season has left some individuals afraid at any time to expose their faces in public. Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. 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). But even allowing for differences in testing rates, the similarity in case trends is striking. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. 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. Its been piecemeal, Dr. El-Sadr said. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. The study also found a statistically significant increase in the rate of COVID-19 infections and deaths starting 40 days after indoor or outdoor dining at restaurants was allowed. Louisiana. I just dont know based on reading the OAN summary how they came to the same conclusions because the CDC conclusions were favorable.. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. 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. Here's what it could mean for all of us. Parents have pushed for the mask mandate to be lifted for a number of reasons. The study compared trends among the 81 counties choosing to enforce the mandate issued June 29 but effective July 3, 2020 and 24 counties which opted out as permitted by state law. The same study found that cloth masks did not have a statistically significant effect. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. That's not nothing, but it's a pretty modest effect, and it was achieved with surgical masks worn by adults in conditions that encouraged proper and consistent use. No, Is the Subject Area "Health care policy" applicable to this article? OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. Higher mask use did not predict lower maximum growth rates, smaller surges, or . 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). More could be on the way. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. He Kept Quiet. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. Thats a huge swing, Werler says. 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. Many local leaders went further. The current surge is worst in places with few containment measures. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. 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. We used state-level data on mask wearing policy for the general public and on proportion of residents who stated they always wear masks in public. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. We calculated the number of new cases in each month, for each state and D.C. Rates were the number of new cases divided by the population in 2019. I think timing really matters for the decisions.. The worst outbreaks in the country now are in places where policymakers did the least to prevent transmission, according to the Oxford index. 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. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. 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