Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Rhode Island. 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. For more information about PLOS Subject Areas, click Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. In the first 20 days after implementingmask mandates, new cases slowed by 0.5 percentage points. It is also possible that survey respondents misreported their mask wearing adherence; whether they would be more or less likely to over or under-report is open to speculation, but residents in states with mask wearing policy might over-report adherence to appear compliant. The. 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. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Formal analysis, 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. Even if masking works, that does not necessarily mean mandates do. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. Thank you, {{form.email}}, for signing up. The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. 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 . 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. The findings were published in the journal PLOS One in April. Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. No, Is the Subject Area "Pandemics" applicable to this article? 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. Yes Its a difficult addiction to overcome, according to the Japanese therapists who specialize in treating itbut a simple remedy might help some maskaholics. 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. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. 3.1.2023 2:50 PM, David McGarry New Zealand recently lifted all restrictions following 10 days with no new cases. 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. https://doi.org/10.1371/journal.pone.0249891.g002. 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. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. 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. He adds that the two states "had nearly identical infection rates.". J.B. Pritzker. 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). 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. But there are still settings where wearing your mask is crucial. 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. 2021. The same study found that cloth masks did not have a statistically significant effect. We calculated the average mask use percentage by month for AprilSeptember, 2020. When Can I Travel Again After Being Fully Vaccinated? Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. But the researchers found no clear relationship between mask mandates and mask use. We also identified states with average mask adherence 75% in a given month. 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. In Maryland , Gov. One state is the lone holdout. Adherence to public policy is influenced by a complex interplay of factors such as public opinion, cultural practices, individual perceptions and behaviors [11], which are difficult to quantify. The question is and Im sure thats the conversation now happening in the halls of power what do we do next? 3.1.2023 8:00 AM, 2022 Reason Foundation | Yes A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. For demographic data, we dichotomized population proportions at whole values that approximated the highest quartile of the distributions. The current surge is worst in places with few containment measures. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. Conceptualization, 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. Little attention was paid to more rigorous research, like a review of the literature that found little or no benefit from masks, or a study that compared infection rates with mask policies and with rates of mask use in all 50 states over the first year of the pandemic. Copyright: 2021 Fischer et al. North Dakota, for example, made few efforts to contain the virus. 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. Visualization, Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. At the beginning of November, most states were scoring in the 40s and 50s. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. 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. Privacy Policy | High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. After the pandemic, a survey of gains and losses. Methodology, An Annals of Epidemiology study published last May found that mask mandates in the United States were associated with lower transmission rates from June through September 2020. Now, Midwestern states have among the worst outbreaks. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. Eleven states never mandated masks, while the other 39 states enforced mandates. Odds ratios and 95% confidence intervals for average mask adherence and mask policy for the general public are associated with high COVID-19 rates in the subsequent month (Table 3). https://doi.org/10.1371/journal.pone.0249891.g001. How Are States Responding to CDC Mask Guidelines? The Centers for Disease Control & Prevention (CDC) recently relaxed their COVID-19 guidelines, allowing fully vaccinated people to forego masks outside. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. Of note, there were no states with 75% in September. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. 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.. 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. Despite an early outbreak, South Korea flattened the curve with aggressive testing and contact tracing, as well as widespread mask wearing. Many have also done the least to contain the virus. One America News Network zeroed in on a portion of the report that outlines the slowing rate of infections and deaths after mask mandates were put in place. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. CNBC called the nations early Covid response a master class in science communication, and last fall it was praised for tightening its mask mandate in an Atlantic article, Four Measures That Are Helping Germany Beat Covid. Its stricter mandate early last year banished cloth masks, requiring surgical masks instead, and the states of Berlin and Bavaria went still further, requiring masks of N95 quality. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Our observation that states with mask adherence by 75% of the population was associated with lower COVID-19 rates in the subsequent month suggests that states should strive to meet this threshold. The pandemic has eased, but not the compulsion of many Americans to cover their faces. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. 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. "Unfortunately, the virus hasnt gone away and is still easily transmissible. 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. 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. The Bangladesh study, in other words, does not demonstrate the effectiveness of the cloth masks that adults tend to pull out of their pockets when they enter businesses, let alone the masks that children as young as 2 are forced to wear in schools and day care centers. 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. 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. But a new study examines how the value of these actions also came with costs. 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). While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. Yes We all want to be able to be with friends and family this spring and summer, and we all dont want to have [to] go back to the more stringent mitigation measures, so gathering outside and wearing masks is the best way to allow both to happen.. 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). Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . Across the country, indoor mask requirements in blue states are falling like dominoes as COVID cases drop. 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. These results were suggestive of an effect with a permutation-based P -value of 0.094. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. Competing interests: The authors have declared that no competing interests exist. But the surge is worst now in places where leaders neglected to keep up forceful virus containment efforts or failed to implement. 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. Only eight states reported that 75% or more people wore masks between June and September, leading to fewer COVID cases: States with a 75% minimum mask adherence reported about 109.26 COVID-19 cases per 100,000 residents compared to the average of 249.99 per 100,000 residents in states with low mask adherence. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. When Can I Go Out in Public Again After Being Fully Vaccinated? https://doi.org/10.1371/journal.pone.0249891.s001. 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]. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. | Sources: Oxford Covid-19 Government Response Tracker, closing bars, restaurants, gyms, theaters and schools, one in 10 North Dakotans have tested positive. Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. 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. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. https://doi.org/10.1371/journal.pone.0249891.t003. Heres How Doctors With Kids Are Navigating the New Mask Guidance. 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. Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Of course, many other factors are could be at play, like the possibility of cooler weather driving non-adherent persons to indoor gatherings. 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. Sources: Restrictions tightened as cases were rising. We thank Drs. "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 as Miller shows in his book, the policies made no discernible difference. 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. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. "We do not find evidence that mandating mask-wearing reduces transmission," the authors reported. https://doi.org/10.1371/journal.pone.0249891.t001. No, Is the Subject Area "Health care policy" applicable to this article? Should You Wear a Mask at Outdoor Events? 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. PLOS ONE promises fair, rigorous peer review, If you compare California to Texas, another populous state that had no mask mandates, the case trends are also very similar, although the increase was steeper in California, where the seven-day average peaked a few days earlier. February 28, 2023. Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. Louisiana. 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. According to Werler, Arizonas data was unexpected. 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. The estimated absolute change in cumulative case rate associated with lifting the mask mandate, remains 28.1 (30.6%) 21 days after lifting the mask mandate. The study concluded that mask mandates and use are not associated with slower state-level Covid-19 spread during Covid-19 growth surges. The medias narrative about masks extended throughout the world. No, Is the Subject Area "Public and occupational health" applicable to this article? 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. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. The graph for New York, which also had a statewide mask mandate, looks very much like the graph for California, but with an earlier peak. "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". Its Legacy Is Disastrous. Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. 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. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. In fact, it doesn't study mask efficacy at all. In Germany, by contrast, more than 80 percent did so, but look at the similar trajectories of the daily Covid death toll in both countries from the summer of 2020 through March of this year.