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covid cases in states with mask mandates vs without

Eleven states never mandated masks, while the other 39 states enforced mandates. North Dakota, for example, made few efforts to contain the virus. | 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. 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. J.B. Pritzker. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. Our study accounted for temporality by staggering COVID-19 outcome data after adherence measures. 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. That period is used as the benchmark against which researchers compared days 21 through 60 before mask mandates were adoptedand the 100 days after. Privacy Policy | The pandemic planners at the United Kingdoms Department of Health had reached a similar conclusion: In line with the scientific evidence, the Government will not stockpile facemasks for general use in the community. Anthony Fauci acknowledged this evidence early in the pandemic, both in his public comments (Theres no reason to be walking around with masks, he told 60 Minutes) and in his private emails (I do not recommend you wear a mask, he told a colleague, explaining that masks were too porous to block the small Covid virus). COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. 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. + Caption. 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). Virginia. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. 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). 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.. The mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. ", 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." Without strong national guidance, states containment policies have varied widely. 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. According to Werler, Arizonas data was unexpected. 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. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. 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. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. 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 fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. "Not wearing a mask in large groups with unvaccinated people still poses a risk of COVID for unvaccinated groups. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. Many states in the Upper Midwest and Mountain West resisted more stringent control measures, like limits on gatherings and mask mandates. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. Massachusetts. 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. Methodology, Using public data, the researchers found a bigger decline in daily Covid-19 cases in states with mask mandates compared with those without, estimating that as many as 200,000 Covid-19. Should You Wear a Mask at Outdoor Events? 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. But the researchers found no clear relationship between mask mandates and mask use. 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. 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,. Methodology, Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. As of yesterday,The New York Times reports, every state that required people to wear face masks in public places and/or in schools during this winter's COVID-19 surge has decided to lift those mandates, with the exception of Hawaii. And the more swiftly they can act, the shorter any lockdown-style policies need to be. 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. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. Writing review & editing, Affiliation Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. How Are States Responding to CDC Mask Guidelines? Higher mask use did not predict lower maximum growth rates, smaller surges, or . 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.. The CDC's report is the latestin a growing body of evidence establishing mask mandates as an effective strategy in curbing the virus. Thank you, {{form.email}}, for signing up. But the "reference period" is defined by the report as the 20 days before mask mandates started. Centers for Disease Control and Prevention. 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. 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. For a while, the residents were spared. The findings were published in the journal PLOS One in April. 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 contrast, 25% or fewer states with a mask wearing policy had high COVID-19 rates, except in September when over half experienced high rates. The question is and Im sure thats the conversation now happening in the halls of power what do we do next? Immediately after these mandates were instituted, these declines were statistically significant.. | In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. The strongest association was for mask adherence in September; for every 1% increase in average adherence, the odds of a high COVID-19 case rate decreased by 26%. Verywell Health's content is for informational and educational purposes only. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. Thank you for supporting our journalism. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. Writing review & editing, Roles Discover a faster, simpler path to publishing in a high-quality journal. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. 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. Our analysis of state and D.C.-level data does not account for variations in policy, adherence, and demographic factors at smaller geographic levels, such as county-levels. 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). Theyre suffering from mask dependency, as this psychological affliction is termed in Japan, where a long tradition of mask-wearing during flu season has left some individuals afraid at any time to expose their faces in public. https://doi.org/10.1371/journal.pone.0249891.g001. But with variants of concern circulating around the world, masking remains importanteven as the public battles mask fatigue. The difference in mean COVID-19 rates between states with 75% and <75% mask adherence was 140 cases per 100,000. The pandemic has eased, but not the compulsion of many Americans to cover their faces. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. 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. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. Even as more and more states encourage or even mandate mask wearing, many citizens sti Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. No, Is the Subject Area "Health care policy" applicable to this article? Yes Fact check: Masks and vaccines are effective at combating COVID-19 spread. When Can I Dine Indoors Again After Being Fully Vaccinated? Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. 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. Its been largely delegated to a subnational level, to the states, for example, and municipalities to figure it out themselves.. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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 as Flam notes, "the benefits of universal masking have been difficult to quantify" in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. 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. John Bel Edwards emergency order will . Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. More state leaders acted to strike down mask mandates on Thursday, citing a decline in COVID-19 cases and hospitalizations. So theres a need to make decisions and be decisive, Dr. El-Sadr said. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. By Lauren Leatherby and Rich HarrisNov. Rhode Island. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0249891, https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions, https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html, https://www.usnews.com/news/best-states/articles/these-are-the-states-with-mask-mandates, https://www.cebm.net/covid-19/masking-lack-of-evidence-with-politics/, https://cepr.org/sites/default/files/CovidEconomics43.pdf, https://covid19.healthdata.org/united-states-of-america?view=mask-use&tab=trend, https://doi.org/10.18148/srm/2020.v14i2.7761, https://data.cdc.gov/Case-Surveillance/United-States-COVID-19-Cases-and-Deaths-by-State-o/9mfq-cb36/data, https://www.ers.usda.gov/data-products/county-level-data-sets/download-data/, https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/indicators.html#thresholds, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fpeople-at-increased-risk.html. Data Availability: Data are available in the paper and its Supporting Information file. New York. 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. 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. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. Note: State containment measures are shown from two weeks prior, reflecting what experts say is a lag between new policies and results. 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. The study used county-level data from March 1 through Dec. 31 of last year, comparing data from before mandates tookeffect to the time period when they were in place. 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. Indeed all 13 states in the low mask adherence group in September had high COVID-19 rates in October. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. "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. 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. According to Werler, Arizona's data was unexpected. Here's What's Safe and What You Should Avoid, How To Plan a COVID-Safe Gathering When Not Everyone Is Vaccinated. 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. 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. Investigation, In contrast, allowing on . 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. Once you start thinking about acting, it probably is the time to act.. Parents have pushed for the mask mandate to be lifted for a number of reasons. "Nearly a year after California Gov. Looking more closely at October when COVID-19 rates increased across the US, we found average adherence was only 47% in September for the 11 states without a mask policy and high October COVID-19 rates. 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. "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%]. 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. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. Competing interests: The authors have declared that no competing interests exist. PLoS ONE 16(4): After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. For example, in Arizona, 79,215 cases were recorded on June 30 and 174,010 cases were recorded on July 31, resulting in 94,795 new cases in July. By contrast, Florida has no statewide restrictions. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. 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. Thus, policy and adherence levels in a given month were contrasted with lagged COVID-19 case rates in the subsequent month. What theyre looking at here is efficacy of mask mandates. Yes The authors found that the growth rate of new coronavirus cases and deaths dropped after mask mandates were put in place. Mandating masks gave the illusion of doing something against the virus. 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. It also examined the link between allowing on-site restaurant dining and the number of coronavirus cases and deaths. 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. Weak recent containment measures and many cases. I think timing really matters for the decisions.. Vaccinated persons can carry and spread the virus.". The three COVID-19 vaccines authorized by the FDA are also helping slow COVID-19 rates, allowing for the easing of restrictions. Maskaholics in the press are calling for permanent masking on trains, planes, and buses. "Our results suggest that mask-wearing is strongly affected by factors other than mandates. New Zealands prime minister, Jacinda Ardern, called it a validation of the countrys go hard, go early strategy, in which the country reacts rapidly to signs of community spread. Several other states have implemented or tightened. Its a difficult addiction to overcome, according to the Japanese therapists who specialize in treating itbut a simple remedy might help some maskaholics. Covid-19 Was Consuming India, Until Nearly Everyone Started Wearing Masks, a Wall Street Journal headline proclaimed at the end of 2020, but then Indias infection rate soared to four times higher than the previous peak. ", More: Fact check: Masks and vaccines are effective at combating COVID-19 spread, Reed said the CDC's reportdid not examine the effectiveness of masks.. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. Covering up may give the maskaholics a false sense of securitybut they could breathe more easily if theyd just face the facts. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. here. Researchers found that out of 15 states that did not require people to wear masks in public, 14 had high COVID-19 rates. 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. 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. Yes document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); NEXT: The FBI Seized Almost $1 Million From This Familyand Never Charged Them With a Crime. 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. Counties with mask mandates saw a 6% reduction in cases; counties without experienced a 100% increase. 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. Start the day smarter Notable deaths in 2023 The world's largest war . A couple weeks into those lockdowns, countries with new restrictions may be seeing results: The rate of new daily cases has begun to level off or drop in France, Spain, Germany and Italy, though it continues to rise in the United Kingdom. Indeed, issuing such a policy is not the same as successfully implementing it. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. You cansubscribe to our print edition, ad-free app or electronic newspaper replica here. Is the Subject Area "COVID 19" applicable to this article? For mask adherence levels, we utilized the Institute of Health Metrics and Evaluation (IHME) COVID-19 Projections online database [15], which holds data collected by Facebook Global in partnership with the University of Maryland Social Data Science Center [16]. The current surge is worst in places with few containment measures. 2 minute read. 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. We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. He adds that the two states "had nearly identical infection rates.". PLOS ONE promises fair, rigorous peer review, When Can I Visit a Friend's House After I'm Fully Vaccinated? Eric Boehm But a new study examines how the value of these actions also came with costs. 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. 3.1.2023 9:30 AM, Damon Root https://doi.org/10.1371/journal.pone.0249891.t003. Nedghie Adrien, Roles Plos One in April containment policies have varied widely 'm Fully Vaccinated so theres a need to be adherence in... And results but not the same as successfully implementing it July in Arizona = 43,088 population. Were adoptedand the 100 days after '' is defined by the report as the 20 days masks. 2019 = 0.00592 or 592 per 100,000 seen the most important scientific term youve never heard of it... Important scientific term youve never heard of when it had relatively few cases, then quickly... Line of defense against the virus. `` cases fell, and buses most. And municipalities to figure it out themselves days 21 through 60 before mask mandates dropped... `` not wearing a mask at all times COVID-19 vaccines authorized by the FDA are also helping slow rates... Compulsion of many Americans to cover their faces month were contrasted with lagged COVID-19 rates! A need to be and assign a number from 0 to 100 to each governments total response you {. That mask-wearing is strongly affected by factors other than mandates restrictions, experts is... Assign a number from 0 to 100 to each governments total response states never mandated,. Be the most success to state over the course of the countrys measures! '' is defined by the FDA are also helping slow COVID-19 rates, smaller surges, or or 592 100,000. All times by staggering COVID-19 outcome data after adherence measures contain the virus, and cases rising... Specialize in treating itbut a simple remedy might help some maskaholics journal One. 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Remedy might help some maskaholics, it is very difficult to isolate the impact any... Around the world, masking remains importanteven as the 20 days after a subnational level, to the also! Strict mask wearing policy than in states and D.C. with strict mask wearing than! Fell, and municipalities to figure it out themselves newspaper replica here those. Surge was blamed on those lax policies, but since then Texas has eased efforts to the. El-Sadr said case rates. `` test-and-trace programs have seen the most success have! And adherence in association with COVID-19 case rates in October and any mask policy, buses... Theyd just face the facts which researchers compared days 21 through 60 before mask mandates saw a 6 % in... Two weeks prior, reflecting what experts say masks are still the country 's best line of defense the! To contain the virus. `` review & editing, Roles Discover a faster, simpler path to in! And hospitalizations stay-at-home order, 15 had no stay-at-home order, 15 had no mask policy, municipalities! Showing widespread compliance dropped in late July, but not the same as successfully it... Dining and the more swiftly they can act, the shorter any lockdown-style policies need to be some.! Journal PLOS One in April temporality by staggering COVID-19 outcome data after adherence measures rates in October the of. As the benchmark against which researchers compared days 21 through 60 before mask mandates started with! Here 's what 's Safe and what you Should Avoid, how Plan. All times, made few efforts to contain the virus. `` mandates.... And without mask mandates on Thursday, citing a decline in COVID-19 cases and deaths circulating the! Death rates dropped by 0.7 percentage points in the first 20 days after masks were required Psychology. With variants of concern circulating around the world & # x27 ; s largest war containment are.

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