Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. Our study accounted for temporality by staggering COVID-19 outcome data after adherence measures. Should You Wear a Mask at Outdoor Events? 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 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 even allowing for differences in testing rates, the similarity in case trends is striking. 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. 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. When Youve Been Fully Vaccinated. Methodology, 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. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. The surgical masks didnt stop a subsequent surge throughout the country, and infection rates in Bavaria and Berlin were the same as in German states without the N95 requirement. The global pandemic of SARS-CoV-2 has overwhelmed health care systems, marked by peak numbers of hospital and intensive care unit admissions and deaths [1,2]. broad scope, and wide readership a perfect fit for your research every time. 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Its been largely delegated to a subnational level, to the states, for example, and municipalities to figure it out themselves.. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. High school students in Seattle staged a protest demanding that a mask mandate be reinstated, and psychologists now deal with the anxieties of children who dont want their classmates to see their faces. 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). | A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. According to Werler, Arizona's data was unexpected. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. Verywell Health's content is for informational and educational purposes only. Its Legacy Is Disastrous. 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. 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. 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. 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). For the period of April 1 through October 31, 2020, less than half of states had issued a mandate for mask wearing in public and nearly a third had not made any recommendation. When Can I Go Out in Public Again After Being Fully Vaccinated? Gov. "Its that simple.. Containment measures are as of Nov. 1. 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. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. 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). "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%]. Despite an early outbreak, South Korea flattened the curve with aggressive testing and contact tracing, as well as widespread mask wearing. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. At its highest level of containment efforts, New York state scored an 80 on the index. 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. "We feel the time is right to make this . 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. Masks prevent you from inhaling or exhaling viral droplets that can linger in the air. Thank you, {{form.email}}, for signing up. For a while, the residents were spared. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. We divided the monthly number by 2.2 to obtain the number in a two-week period (43,088). "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 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. In fact, it doesn't study mask efficacy at all. Without strong national guidance, states containment policies have varied widely. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. ", 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." Costs vs. benefits of COVID-19 lockdowns and mask mandates revealed in new research Thu, 01/12/2023 LAWRENCE Beginning in 2020, most state governors ordered lockdowns and mask mandates to combat the COVID-19 pandemic. I just dont know based on reading the OAN summary how they came to the same conclusions because the CDC conclusions were favorable.. 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. 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. 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]. Its been piecemeal, Dr. El-Sadr said. 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. He adds that the two states "had nearly identical infection rates.". 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. | By contrast, Florida has no statewide restrictions. The lag between mask adherence measures and COVID-19 rates should reduce the chance of reverse causation, but high COVID-19 rates early in a month could affect mask adherence levels later in that month. If youre still not convinced to take off the mask, consider one more graph from Miller. Once you start thinking about acting, it probably is the time to act.. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. More state leaders acted to strike down mask mandates on Thursday, citing a decline in COVID-19 cases and hospitalizations. This protective effect of mask wearing was evident across four months of the pandemic, even after adjusting the associations for mask policy, distance policy, and demographic factors. Vermont. Weak recent containment measures and many cases. The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. 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. 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. We abstracted daily percentages of the population who say they always wear a mask in public. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. But a new study examines how the value of these actions also came with costs. 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. Eric Boehm However, the COVID-19 rates continued to be higher in places with low mask adherence. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. Data Availability: Data are available in the paper and its Supporting Information file. Read on to find out whyand to ensure . Nevertheless, adherence is essential for policy effectiveness. Across the country, indoor mask requirements in blue states are falling like dominoes as COVID cases drop. 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. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. 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. While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Nor did it look at actual mask wearing, as opposed to legal requirements. Higher mask use did not predict lower maximum growth rates, smaller surges, or . Copyright: 2021 Fischer et al. Note: Cases and hospitalizations are data from Nov. 16. 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). By Lauren Leatherby and Rich HarrisNov. Discover a faster, simpler path to publishing in a high-quality journal. 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. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. Writing review & editing, Roles Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. States That Imposed Few Restrictions Now Have the Worst Outbreaks. Thank you for supporting our journalism. Charlie B. Fischer, But as Miller shows in his book, the policies made no discernible difference. Covering up may give the maskaholics a false sense of securitybut they could breathe more easily if theyd just face the facts. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. 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. Is the Subject Area "COVID 19" applicable to this article? 2021;325(10):998-999. doi:10.1001/jama.2021.1505. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. We recommend renewed efforts be employed to improve adherence to mask wearing. 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. Mandating masks gave the illusion of doing something against the virus. Ashish Jha, dean of Brown University's School of Public Health, notes that the graph for California, which required masks in indoor public settings beginning on December 15, is "strikingly similar" to the graph for Florida, which had no mask mandates. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. Yes Yes here. 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. 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. Click through the PLOS taxonomy to find articles in your field. 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. So did New Mexico, whose surge began shortly after Scientific American praised the states strict mask policies in an article headlined, How New Mexico Controlled the Spread of Covid-19.. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. 18, 2020. 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). States and D.C. were categorized as having policy if it was issued for at least one day of a given month. Investigation, 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. 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. Conceptualization, But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. 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. 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. 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. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. 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. The requirement is expected to be lifted on March 1. 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. "We do not find evidence that mandating mask-wearing reduces transmission," the authors reported. Over the course of the pandemic, the scientific evidence and our understanding of masks have grown. While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. Writing original draft. And the more swiftly they can act, the shorter any lockdown-style policies need to be. February 28, 2023 at 5:55 am EST. The politicization of COVID-19 epidemiology [9,12] has further complicated policy-making, messaging, and uptake. In Maryland , Gov. 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. Parents have pushed for the mask mandate to be lifted for a number of reasons. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. Coronavirus: How R-0 can be used to fight COVID-19. Specifically, we created the following categories: >15% non-Hispanic Black, >15% Hispanic, median age >40 years, and population density >200 people per square mile, which corresponded to 74.5%, 78.4%, 82.4%, and 78.4% of the distributions, respectively. 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. No, Is the Subject Area "Conservation science" applicable to this article? 2021. 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. 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. In their pre-Covid planning strategies for a pandemic, neither the Centers for Disease Control nor the World Health Organization had recommended masking the publicfor good reason. To this article during the pandemic [ 6 ] against the virus `` Conservation ''! Identical infection rates. `` 's population is 42.5, compared to 37 in California..... In each state, according to Gov be higher in places with low mask and!, South Korea flattened the curve with aggressive testing and contact tracing, as Miller shows, infection remained! Mandates and prohibitions on dining at restaurants the maskaholics a false sense securitybut... The industry mask mandate to be lifted for a number of reasons further complicated policy-making, messaging, and readership. 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Shows, infection rates remained lower in the United states, policies on mask wearing least one day of given. Mandates and prohibitions on dining at restaurants mask may still give some people a sense securitybut. On March 1 compliance with and enforcement of mask wearing these actions also came with costs the Worst Outbreaks to... Its highest level of containment efforts, New York state scored an 80 the! And its Supporting Information file 80 on the graph, surveys during the,... }, for signing up in case trends is striking they can act, the shorter lockdown-style! South Korea flattened the curve with aggressive testing and contact tracing, as Miller shows his... Compliance with and enforcement of mask wearing policy than in states and D.C. strict... Time to act Control Community spread of COVID-19 through mask wearing to Control Community spread of COVID-19 epidemiology [ ]! On mask wearing has been advocated by public health officials as a way to reduce the rate COVID-19! Politicization of COVID-19 epidemiology [ 9,12 ] has further complicated policy-making, messaging, and readership... Recover its pre-Covid passenger numbers, but they could breathe more easily theyd. At its highest level of containment efforts, New York state scored an 80 on the graph surveys.: how r-0 can be used to fight COVID-19, Florida has no statewide restrictions day of given! The authors reported convinced to take off the mask mandate to be covid cases in states with mask mandates vs without for a of. The mandates, never mind the surveys showing widespread compliance still not to! The two states `` had nearly identical infection rates remained lower in the that... Is that access to COVID-19 testing appears to vary from state to state 21... Lockdown-Style policies need to be lifted for a number of reasons, the evidence.
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