Data curation, North Dakota, for example, made few efforts to contain the virus. Mask mandates are associated with reductions in COVID-19 case and hospitalization growth rates (6,7), whereas reopening on-premises dining at restaurants, a known risk factor associated with SARS-CoV-2 infection (2), is associated with increased COVID-19 cases and deaths, particularly in the absence of mask mandates (8). In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. 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. But "few studies assessed compliance to mask wearing policies or controlled for the possible influence of other preventive measures such as hand hygiene and physical distancing.". High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. No, Is the Subject Area "Conservation science" applicable to this article? https://doi.org/10.1371/journal.pone.0249891, Editor: Wen-Jun Tu, Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA, Received: January 12, 2021; Accepted: March 26, 2021; Published: April 14, 2021. Yes But a new study examines how the value of these actions also came with costs. More could be on the way. We abstracted daily percentages of the population who say they always wear a mask in public. Experts interviewed by USA TODAY said the One America News Network had "misinterpreted" or "mischaracterized" the findings of the CDC study. States and D.C. were categorized as having policy if it was issued for at least one day of a given month. Its a difficult addiction to overcome, according to the Japanese therapists who specialize in treating itbut a simple remedy might help some maskaholics. Even Greenpeace now admits the obvious: recycling doesnt work. We thank Drs. | Sources: Oxford Covid-19 Government Response Tracker, closing bars, restaurants, gyms, theaters and schools, one in 10 North Dakotans have tested positive. When Can I Visit a Friend's House After I'm Fully Vaccinated? 3.1.2023 9:15 AM, Joe Lancaster Of note, there were no states with 75% in September. 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. Rhode Island. The 10th Amendment's anti-commandeering provision bars "the federal government from . Yes Jacob Sullum is a senior editor at Reason. 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. The pandemics second year saw slight deviations in both directions, but those reflected the seasonality of the virus and the geography of mask mandates, which remained more common in northern states. Meantime, the medias favorite experts kept predicting doom for states that never mandated masks, like Florida, or that ended the mandates early in 2021, like Iowa, whose policy shift was denounced as reckless and delusional in a Washington Post article headlined, Welcome to Iowa, a state that doesnt care if you live or die. Iowas Covid death toll plummeted right after the article appeared. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. Five states are rolling back mask mandates. Thus, policy and adherence levels in a given month were contrasted with lagged COVID-19 case rates in the subsequent month. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". Overall, there is no obvious difference between states with mask mandates and states without them. 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. | Iowa, which has enacted a school mask mandate ban, had a relatively low case rate per 100,000 people of 144.7. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. 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. What theyre looking at here is efficacy of mask mandates. Note: Cases and hospitalizations are data from Nov. 16. The announcement comes one day after Joe Biden pleaded with state and local leaders to maintain or reinstate mask mandates, due to recent alarming trends in US coronavirus case numbers. | 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. When Can I Dine Indoors Again After Being Fully Vaccinated? The authors determined that there was a statistically significant decrease in the rate of new infections and deaths after the mandates began compared with the 20 days before. 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. Without strong national guidance, states containment policies have varied widely. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. Visualization, 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. 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. Immediately after these mandates were instituted, these declines were statistically significant.. 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. The same basic pattern was seen in nearly every state. The CDC says people who are fully vaccinated can go outside without a mask, but the important caveat here is except in certain crowded settings and venues,'" senior study author Martha M. Werler, DSc, professor of epidemiology at Boston University School of Public Health, tells Verywell. 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 same study found that cloth masks did not have a statistically significant effect. Many Americans went maskless in public on Friday for the first time in months a day after the . 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. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. + Caption. 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. Doug Burgum reopened the state nearly fully in May. 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. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. 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). 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. 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). "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. Vermont. 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. PLoS ONE 16(4): 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. The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals for high case rates in the subsequent month associated with average mask adherence (as a continuous variable). Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. 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. The data we now have conclusively show that widespread use of masks is a very effective way to reduce the spread of COVID-19, CDC spokeswoman Jasmine Reed wrote in an email to USA TODAY. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. here. Thank you, {{form.email}}, for signing up. 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). Texas locked down in the spring, when it had relatively few cases, then reopened quickly. Formal analysis, And the more swiftly they can act, the shorter any lockdown-style policies need to be. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. 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. 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. Higher mask use (rather than mandates per se) has been argued to decrease COVID-19 growth rates. Larry Hogan called on the State Board of Education to . However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. 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. That section finishes:"Daily case and death growth rates before implementation of mask mandates were not statistically different from the reference period.". https://doi.org/10.1371/journal.pone.0249891.t001. We utilized the COVID-19 US State Policy Database, created by Dr. Julia Raifman at Boston University School of Public Health [14], for policy and demographic information. We recommend renewed efforts be employed to improve adherence to mask wearing. Yes 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. In fact, the researchers calculated that for every 1% increase in wearing a mask in September, the odds of having high state-wide COVID-19 rates dropped by 26%. Came with costs renewed efforts be employed to improve adherence to mask wearing policy than in states and D.C. strict! 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