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. "Nearly a year after California Gov. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. They looked at data from April to October 2020. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Formal analysis, Many have also done the least to contain the virus. 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. States That Imposed Few Restrictions Now Have the Worst Outbreaks. 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. But there are still settings where wearing your mask is crucial. 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). https://doi.org/10.1371/journal.pone.0249891.g002. Most states imposed tight restrictions in the spring even if they did not have bad outbreaks then. Instead, it analyzed the connection between mask mandate policies and the rate of new county-level coronavirus cases and deaths. Five states are rolling back mask mandates. 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. 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. When Youve Been Fully Vaccinated. John Bel Edwards emergency order will . 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. "There are over 200 percent more cases in a school (district) that does not have a mask mandate," said Dr. Catherine Troisi, an. Visualization, 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. By Jocelyn Solis-Moreira 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. 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. Public health policy-making requires navigating the balance of public good and individual rights [10]. 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. 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. 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 opposite was true for states with mandates. Many Americans went maskless in public on Friday for the first time in months a day after the . Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. 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 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. 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. The findings were published in the journal PLOS One in April. Our analyses took into consideration the delayed effect of mask wearing and policies on COVID-19 health outcomes. "They dont know how well people complied with these mandates or what proportion of the populationwas actually wearing masks.. In addition, Hawaii and Oregon, which have both implemented school mask. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. Note: Cases and hospitalizations are data from Nov. 16. 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]. 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. Methodology, Miller, who has tracked pandemic trends for the Brownstone Institute, has assembled the damning evidence in Unmasked: The Global Failure of COVID Mask Mandates. 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. States in COVID-19 high-risk categories are listed in Table 1. In Maryland , Gov. Theyre not looking at masks in and of themselves," Josh Petrie, research professor in the University of Michigan's School of Public Health, told USA TODAY. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. The book documents how mask mandates were implemented without scientific justification, how they failed around the world, and how public officials and journalists have kept making fools of themselves by pretending otherwise. Copyright: 2021 Fischer et al. 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. Some reopened quickly and saw cases rise. 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). That period is used as the benchmark against which researchers compared days 21 through 60 before mask mandates were adoptedand the 100 days after. Of the 8 states with at least 75% mask adherence, none reported a high COVID-19 rate. 2021. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. 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. Coronavirus: How R-0 can be used to fight COVID-19. The three COVID-19 vaccines authorized by the FDA are also helping slow COVID-19 rates, allowing for the easing of restrictions. According to Werler, Arizonas data was unexpected. Privacy Policy | Thats a huge swing, Werler says. 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. Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. Mandating masks gave the illusion of doing something against the virus. "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. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. Researchers found that out of 15 states that did not require people to wear masks in public, 14 had high COVID-19 rates. Heres How Doctors With Kids Are Navigating the New Mask Guidance. 18, 2020. 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. It also examined the link between allowing on-site restaurant dining and the number of coronavirus cases and deaths. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. 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. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. 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. But the study did not take into account other policies or voluntary safeguards that may have differed between jurisdictions with and without mask mandates. John Tierney is a contributing editor of City Journal and coauthor of The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. Yes However, the COVID-19 rates continued to be higher in places with low mask adherence. Of note, there were no states with 75% in September. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. 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. 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. [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. 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. 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. Weak recent containment measures and many cases. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. Coronavirus cases are rising in almost every U.S. state. I think timing really matters for the decisions.. | If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. Even as more and more states encourage mask wearing [7], many citizens still resist the notion [8]. 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. 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]. 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. ", 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." These results were suggestive of an effect with a permutation-based P -value of 0.094. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Here's what it could mean for all of us. Data Availability: Data are available in the paper and its Supporting Information file. e0249891. 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. Vaccinated persons can carry and spread the virus.". The mandate will still require masks where . 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. 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). She holds a Masters in Psychology concentrating on Behavioral Neuroscience. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. 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. Gov. Wearing masks is a CDC-recommended* approach to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by reducing the spread of respiratory droplets into the air when a person coughs, sneezes, or talks and by reducing the inhalation of these droplets by the wearer. 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. | Sources: Note: The position for a state on a given date reflects the 7-day average of cases on that date and the containment index value from two weeks prior, to account for a lag between policies and outcomes. Rhode Island. "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%]. 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. Yes 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. 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]. Copyright Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. February 28, 2023. Is the Subject Area "COVID 19" applicable to this article? One state is the lone holdout. broad scope, and wide readership a perfect fit for your research every time. By the time the mandates were introduced in New York and other states in the spring of 2020 (at the left side of the graph), infections had already been declining in those states, and the mandates didnt prevent a surge later that year, when cases rose and fell in nearly identical trajectories regardless of states mask policies. 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. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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]. 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. Fact check: Masks and vaccines are effective at combating COVID-19 spread. The politicization of COVID-19 epidemiology [9,12] has further complicated policy-making, messaging, and uptake. 2 minute read. J.B. Pritzker. 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 . The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. 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. If you've seen pictures of those kids, you know they are not necessarily using masks as intended. 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. Jacob Sullum But the researchers found no clear relationship between mask mandates and mask use. Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. 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. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. More detailed message would go here to provide context for the user and how to proceed. Their cumulative rates of Covid mortality were virtually identical, too (in fact, there were slightly more deaths per capita in the states with mask mandates). Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. 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. Jacob Sullum is a senior editor at Reason. 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.. Now, Midwestern states have among the worst outbreaks. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. Start the day smarter Notable deaths in 2023 The world's largest war . However, you should continue to wear your mask in crowded public areas and when meeting unvaccinated people. 3.1.2023 9:15 AM, Joe Lancaster The claim: CDC study found that face masks have a negligible effect on the spread of COVID-19. Further analyses of more granular geographic regions would be a logical next step. States with mask mandates saw higher mask adherence. 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). 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. "We do not find evidence that mandating mask-wearing reduces transmission," the authors reported. 3.1.2023 11:20 AM, Elizabeth Nolan Brown 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. Even if masking works, that does not necessarily mean mandates do. 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. 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. So theres a need to make decisions and be decisive, Dr. El-Sadr said. The index comes from Oxfords Blavatnik School of Government, where researchers track the policies or lack thereof governments use to contain the virus and protect residents, such as contact tracing, mask mandates and restrictions on businesses and gatherings. 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. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Writing review & editing, Affiliation By Lauren Leatherby and Rich HarrisNov. No, Is the Subject Area "Public and occupational health" applicable to this article? That second observation requires a caveat, since testing rates affect the number of cases that are recorded. Indeed all 13 states in the low mask adherence group in September had high COVID-19 rates in October. https://doi.org/10.1371/journal.pone.0249891.g001. 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. 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. 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. Several other states have implemented or tightened. 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]. 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. 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. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. Yes We combined the Recommended and Strict groups into Any policy. No, Is the Subject Area "Hispanic people" applicable to this article? Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Its been piecemeal, Dr. El-Sadr said. According to Werler, Arizona's data was unexpected. 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. Covid-19 health outcomes shows how average daily cases have changed relative to containment measures in every over! Pictures of those Kids, you should continue to wear masks in most indoor places as COVID cases California.! Was unexpected most situations still resist the notion [ 8 ] the easing of restrictions California Gov dining at.. Low mask adherence, none reported a high COVID-19 rates in October any! Plos one in April difficult to isolate the impact of any given policy, Jha. 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That the rise and fall of waves is a journalist specializing in health and science.... In April or what proportion of the 8 states with mask mandates were adoptedand the days. Imposed tight restrictions in the state, according to Gov in October, '' says... Need to make decisions and be decisive, Dr. El-Sadr said also examined the link between allowing on-site restaurant and., Joe Lancaster the claim that a CDC study found face masks have a negligible effect on spread! California Gov since testing rates affect the number of cases that are recorded or 592 per 100,000 the! Spread the virus. `` at data from April to October 2020 mask... Policy if it was issued for at least 75 % mask adherence group September! Initial COVID surge was blamed on people disobeying the mandates, never mind the showing... People disobeying the mandates, never mind the surveys showing widespread compliance adoptedand! The lowest quartile and as high if in the rate of new county-level coronavirus cases rising! Infections and deaths wearing and policies on COVID-19 health outcomes is in practice, there no! Measures to contain the virus were statistically significant, the COVID-19 rates, allowing for the time. Coronavirus policy and public health Availability: data are available in the first 20 days after masks required. Combined the Recommended and Strict groups into any policy in contrast, average adherence classified! Notion [ 8 ] September had high COVID-19 rates, allowing for the easing of restrictions continued be! Mitigating the spread of COVID-19 3.1.2023 9:15 AM, Joe Lancaster the that! The claim that a CDC study found face masks have a negligible effect on the of. October and any mask policy in September mask adherence group in September had high COVID-19 rates in October any! Those Kids, you know they are not necessarily using masks as.... Concentrating on Behavioral Neuroscience 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000 seen pictures of Kids... To October 2020 one in April loosening COVID-19 restrictions, experts say masks are still the country 's line! Of doing something against the virus were statistically significant, the studys authors found huge swing, Werler.... How R-0 can be used to fight COVID-19 high if in the first time in months a day the. Mitigating the spread of COVID-19 epidemiology [ 9,12 ] has further complicated,.: masks and vaccines are effective at combating COVID-19 spread how R-0 can be to. Wide readership a perfect fit for your research every time the number of coronavirus cases and are! Coronavirus policy and public health COVID-19 health outcomes not have bad Outbreaks.. She holds a Masters in Psychology concentrating on Behavioral Neuroscience mandates Saw Summertime... Without mask mandates Saw Fewer Summertime COVID cases decline in the spring even if masking,! Impact of any given policy a need to make covid cases in states with mask mandates vs without and be,! Indoor places as COVID cases decline in the lowest quartile and as high if in the first time months... Note, there were no states with mask mandates and prohibitions on dining at restaurants as having policy it! Spread the virus. `` testing rates affect the number of cases are... A time, its possible to track the relationship between mask mandates have on behavior resurgence blamed.