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]. | 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. Latest news. https://doi.org/10.1371/journal.pone.0249891.t002. States in COVID-19 high-risk categories are listed in Table 1. 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. The 10th Amendment's anti-commandeering provision bars "the federal government from . Methodology, 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19 [35]. By Lauren Leatherby and Rich HarrisNov. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. 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. 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. 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). 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). 3.1.2023 8:00 AM, 2022 Reason Foundation | 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. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 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. 2 minute read. Vaccinated persons can carry and spread the virus.". But with variants of concern circulating around the world, masking remains importanteven as the public battles mask fatigue. Conceptualization, Formal analysis, 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. But there are still settings where wearing your mask is crucial. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. When Can I Dine Indoors Again After Being Fully Vaccinated? 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. February 28, 2023. "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". The information in this article is current as of the date listed, which means newer information may be available when you read this. 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. 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. 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 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. More could be on the way. 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. If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. 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. here. 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. 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. 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. 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. 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]. Thats a huge swing, Werler says. Immediately after these mandates were instituted, these declines were statistically significant.. | Sources: Note: State containment measures are shown from two weeks prior, to account for a lag between policies and outcomes. https://doi.org/10.1371/journal.pone.0249891.g001. 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. The study referenced in the One America News Network report says the opposite, noting. The list of states with high COVID-19 rates by month shows the initial wave in northeastern states in May, followed by a wave in southern states, and then spreading across the U.S. over the next four months (Table 2). We abstracted data on whether the state issued a mandate of mask use by all individuals in public spaces, and if so, the dates of implementation and whether the mandate was enforced by fines or criminal charge/citation(s). 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. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 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. 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. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. 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. One America News Network zeroed in on a portion of the report that outlines the slowing rate of infections and deaths after mask mandates were put in place. 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. Eric Boehm Higher mask use did not predict lower maximum growth rates, smaller surges, or . https://doi.org/10.1371/journal.pone.0249891.g002. Individuals mask wearing behaviors are not only influenced by recommendations and mandates issued by state leaders, but also by print, televised, and social media [9]. Yes More state leaders acted to strike down mask mandates on Thursday, citing a decline in COVID-19 cases and hospitalizations. When cases first peaked in the United States in the spring, there was no clear correlation between containment strategies and case counts, because most states enacted similar lockdown policies at the same time. | Parents have pushed for the mask mandate to be lifted for a number of reasons. 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. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. 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. Yes Larry Hogan called on the State Board of Education to . Louisiana. When Can I Go Out in Public Again After Being Fully Vaccinated? 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. Over the course of the pandemic, the scientific evidence and our understanding of masks have grown. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. If Florida's case numbers understate the true number of infections more than California's do, that could partially explain the difference in COVID-19 deaths per capita. here. 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). 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]. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. 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. When Youve Been Fully Vaccinated. Like the debate about lockdowns, the debate about mask mandates will continue. A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 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. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. 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,. One state is the lone holdout. 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. Our study was also limited by the lack of information on accessibility of COVID-19 testing; if less accessible testing is associated with less mask adherence, the associations we report here may be under-estimates. The proportions of states and D.C. with high COVID-19 rates were greatest for those with no mask wearing policy for the general public in the preceding month (Fig 2). Of the 15 states with no mask policy from April through September, 14 reported high COVID-19 rates in at least one month from May to October. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. But state-level policy choices do not explain everything: New Mexico and Rhode Island have maintained some of the countrys strongest containment measures, according to the Oxford index, yet both states are battling serious outbreaks now. Five states are rolling back mask mandates. 18, 2020. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. 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. Investigation, 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. Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. States with mask mandates saw higher mask adherence. He adds that the two states "had nearly identical infection rates.". Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. 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 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. Yes But as Miller shows in his book, the policies made no discernible difference. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Data released by the agency in November looking at COVID-19 incidence in Kansas after a statewide mask mandate also found the measure resulted in a drop in infectious cases. When the outbreak slammed the New York City area in March and April, leaders locked down. If youre still not convinced to take off the mask, consider one more graph from Miller. Investigation, All reviews and studies included in this document report on data collected in a time period prior For the most recent updates on COVID-19, visit our coronavirus news page. I think timing really matters for the decisions.. Writing review & editing, Affiliation Even if masking works, that does not necessarily mean mandates do. Over a third of states are ending COVID-19 mask mandates. 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.. States That Imposed Few Restrictions Now Have the Worst Outbreaks. Virginia. No, Is the Subject Area "United States" applicable to this article? It compares Germany with Sweden, the medias Covid villain for refusing to lock down or mandate masks. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. 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. For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. PLoS ONE 16(4): 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 mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. Covering up may give the maskaholics a false sense of securitybut they could breathe more easily if theyd just face the facts. Mask adherence was associated with lower odds of high COVID-19 rates, even after adjustment for mask policy and for demographic factors. In contrast, 25% or fewer states with a mask wearing policy had high COVID-19 rates, except in September when over half experienced high rates. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. Read on to find out whyand to ensure . Rhode Island, where I live, has had a mask mandate since mid-December; nonetheless, we saw our January surge rise far higher than any other state. New Zealand recently lifted all restrictions following 10 days with no new cases. 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.. Variants of COVID-19 Are Spreading Across the U.S. How to Plan a COVID-Safe Summer Vacation in 2022. 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). When the state faced a surge of cases over the summer, the governor closed bars and placed limits on restaurant capacity. The claim: CDC study found that face masks have a negligible effect on the spread of COVID-19. 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. 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. [But] many of us are growing weary of mask-wearing and would love permission to toss them aside and go back to pre-pandemic times," Werler says. We recommend renewed efforts be employed to improve adherence to mask wearing. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. 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. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. 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. Visualization, May 16, 2021 / 7:07 AM / CBS News. States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. In August 2020, the Congressional Research Service also wrote that federal constitutional precedents made it unlikely that the federal government could issue a national mask wearing mandate that applies to the states. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. Discover a faster, simpler path to publishing in a high-quality journal. Even Greenpeace now admits the obvious: recycling doesnt work. Of note, there were no states with 75% in September. Contributed equally to this work with: Sources: Restrictions tightened as cases were rising. Several other states have implemented or tightened. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. When Can I Visit a Friend's House After I'm Fully Vaccinated? It is worth noting that no states achieved this level of mask adherence in September, which might account in part for the spike in COVID-19 rates in October. More detailed message would go here to provide context for the user and how to proceed. No, Is the Subject Area "Health care policy" applicable to this article? 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. 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. Many states in the Upper Midwest and Mountain West resisted more stringent control measures, like limits on gatherings and mask mandates. 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). 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. 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]. Instead, it analyzed the connection between mask mandate policies and the rate of new county-level coronavirus cases and deaths. | Sources: Oxford Covid-19 Government Response Tracker, closing bars, restaurants, gyms, theaters and schools, one in 10 North Dakotans have tested positive. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. 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. Germanys stringent policies have made it a consistent media darling. Methodology, Gov. In contrast, allowing on . The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. One America News Network on March 7 published an article under the headline CDC: Face masks dont prevent COVID-19, study finds masks have negligible impact on coronavirus numbers. The post claims the CDC has admitted face masks do little to prevent the spread of COVID-19 amid mounting pressure to lift mask mandates across the U.S., Butthe CDCs study doesnt say that. 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