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. "We do not find evidence that mandating mask-wearing reduces transmission," the authors reported. https://doi.org/10.1371/journal.pone.0249891.t002. But the "reference period" is defined by the report as the 20 days before mask mandates started. But despite an official infection rate that was virtually the same as California's, he adds, "Florida had 33% more deaths per capita than California" during the omicron surge. Cases were higher in the non-mandate states last summer, when the seasonal surge in the South disproportionately hit Republican states without mandates, but those states went on to have fewer cases during the winter, when the seasonal surge in the North hit more Democratic states with mandates. Masks prevent you from inhaling or exhaling viral droplets that can linger in the air. Public health policy-making requires navigating the balance of public good and individual rights [10]. 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. Traveling This Summer? Methodology, If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. Doug Burgum reopened the state nearly fully in May. Like the debate about lockdowns, the debate about mask mandates will continue. Our analyses took into consideration the delayed effect of mask wearing and policies on COVID-19 health outcomes. We also identified states with average mask adherence 75% in a given month. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. Rhode Island. No, Is the Subject Area "United States" applicable to this article? Since July 27, 2020, individuals had been required to wear a mask or face covering in the state when visiting public indoor spaces and when unable to maintain a 6-foot distance from. Latest news. 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. More detailed message would go here to provide context for the user and how to proceed. And in New York and some other states, those lockdowns came too late to prevent a big outbreak, because thats where the virus hit first, said Thomas Hale, associate professor of global public policy at the Blavatnik School of Government, who leads the Oxford tracking effort. Discover a faster, simpler path to publishing in a high-quality journal. The CDC's report is the latestin a growing body of evidence establishing mask mandates as an effective strategy in curbing the virus. Verywell Health's content is for informational and educational purposes only. Its been piecemeal, Dr. El-Sadr said. Centers for Disease Control and Prevention. Instead, it analyzed the connection between mask mandate policies and the rate of new county-level coronavirus cases and deaths. We recommend renewed efforts be employed to improve adherence to mask wearing. 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. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. Both mask policy and mask adherence for states and D.C. were cross-tabulated with high case rates in the subsequent month. 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. For a while, the residents were spared. Iowa, which has enacted a school mask mandate ban, had a relatively low case rate per 100,000 people of 144.7. Our study accounted for temporality by staggering COVID-19 outcome data after adherence measures. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. You cansubscribe to our print edition, ad-free app or electronic newspaper replica here. 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. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." 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. 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. 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. No, Is the Subject Area "Public policy" applicable to this article? CNBC called the nations early Covid response a master class in science communication, and last fall it was praised for tightening its mask mandate in an Atlantic article, Four Measures That Are Helping Germany Beat Covid. Its stricter mandate early last year banished cloth masks, requiring surgical masks instead, and the states of Berlin and Bavaria went still further, requiring masks of N95 quality. "They dont know how well people complied with these mandates or what proportion of the populationwas actually wearing masks.. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. It compares Germany with Sweden, the medias Covid villain for refusing to lock down or mandate masks. How Are States Responding to CDC Mask Guidelines? By contrast, Florida has no statewide restrictions. Its Legacy Is Disastrous. If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. 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. 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. Several other states have implemented or tightened. 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 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. 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. 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. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. PLoS ONE 16(4): When the state faced a surge of cases over the summer, the governor closed bars and placed limits on restaurant capacity. We combined the Recommended and Strict groups into Any policy. They looked at data from April to October 2020. After the pandemic, a survey of gains and losses. 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. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. "Our results suggest that mask-wearing is strongly affected by factors other than mandates. We thank Dr. Julia Raifman Boston University School of Public Health for developing, maintaining, and providing open access to the COVID-19 US State Policy Database. 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. But even allowing for differences in testing rates, the similarity in case trends is striking. 2 minute read. Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. Virginia. | States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. 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. States in COVID-19 high-risk categories are listed in Table 1. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. 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. Of course, many other factors are could be at play, like the possibility of cooler weather driving non-adherent persons to indoor gatherings. In contrast, allowing on . Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. https://doi.org/10.1371/journal.pone.0249891.t001. 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. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. States That Imposed Few Restrictions Now Have the Worst Outbreaks. Investigation, Yes 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. Yes "Arizona surprised me because they went from having the second-lowest mask adherence in May and June [less than 22%] to the highest level in July and August [greater than 80%]. He Kept Quiet. 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. Models were unadjusted, adjusted for no mask policy (Model 1), and adjusted for no mask policy in previous month, no stay-home order, >15% population non-Hispanic Black, >15% population Hispanic, median age >40 years, population density > 200/square mile (Model 2). 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. And in the Germancity of Jena, first in the country to implement public mask wearing last April, masks led to a 75% decrease in new COVID-19 cases in little under three weeks, one December study found. They continued to fall over the 100 days analyzed in the study. Yes When Can I Go to the Movie Theater Again After Being Fully Vaccinated? The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Note: Measurements of government response come from the Oxford Covid-19 Government Response Trackers Containment and Health Index, which is the organizations index focused on virus containment and protecting citizen health. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. 18, 2020. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. 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. A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. No, Is the Subject Area "Public and occupational health" applicable to this article? The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. "Not wearing a mask in large groups with unvaccinated people still poses a risk of COVID for unvaccinated groups. 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). 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. Its a graph that should be required viewing for everyone still wearing a mask and every public official or journalist who still insists that mask mandates control the spread.. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Copyright 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. North Dakota, for example, made few efforts to contain the virus. Many local leaders went further. PLOS ONE promises fair, rigorous peer review, Charlie B. Fischer, Instead of carefully analyzing the effects of masks, the CDC repeatedly tried to justify them by misrepresenting short-term trends and hyping badly flawed research, like studies in Arizona and Kansas purporting to show that infections had been dramatically reduced by the mask mandates imposed in some counties. Heres How Doctors With Kids Are Navigating the New Mask Guidance. ", 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." Writing original draft. Odds ratios indicating protection against high COVID-19 rates remained for all months and policy subgroups, ranging from 0.82 to 0.93 for states with any policy and from 0.60 to 0.95 for states with no policy. The masks in Germany obviously didnt beat Covid. From the start of the pandemic through this spring, the cumulative rate of Covid mortality has been slightly higher in Sweden than in Germany (by about 15 percent), but the rate of overall excess mortality has been slightly higher in Germany (by about 8 percent). If you've seen pictures of those kids, you know they are not necessarily using masks as intended. While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson. Even Greenpeace now admits the obvious: recycling doesnt work. 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