Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. 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. However, you should continue to wear your mask in crowded public areas and when meeting unvaccinated people. 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]. May 16, 2021 / 7:07 AM / CBS News. Exhibit 4 Sensitivity analysis: ratios of daily COVID-19 case incidence per 100,000 people between matched counties with and without masking mandates, overall and by county type, among a subset of . The resurgence was blamed on people disobeying the mandates, never mind the surveys showing widespread compliance. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. Yes Yes 2021;325(10):998-999. doi:10.1001/jama.2021.1505. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. If youre still not convinced to take off the mask, consider one more graph from Miller. 18, 2020. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. The Centers for Disease Control & Prevention (CDC) recently relaxed their COVID-19 guidelines, allowing fully vaccinated people to forego masks outside. 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. 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. 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). 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.. | 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. In contrast, allowing on . Among states and D.C. with no mask wearing policy, 50 to 73% had high COVID-19 rates in the subsequent month. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. Yes So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. 3.1.2023 9:30 AM, Damon Root 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. And the more swiftly they can act, the shorter any lockdown-style policies need to be. Heres How Doctors With Kids Are Navigating the New Mask Guidance. "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. 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. (Though todays ruling by U.S. District Judge Kathryn Kimball Mizelle in Tampa, declaring the Biden administrations mask mandate for public transportation unlawful, comes as welcome news.) 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. Vaccinated persons can carry and spread the virus.". 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. Nevertheless, adherence is essential for policy effectiveness. 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%. https://doi.org/10.1371/journal.pone.0249891.t002. 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. Virginia. e0249891. "Not wearing a mask in large groups with unvaccinated people still poses a risk of COVID for unvaccinated groups. 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. For demographic data, we dichotomized population proportions at whole values that approximated the highest quartile of the distributions. In fact, it doesn't study mask efficacy at all. Several other states have implemented or tightened. States with mask mandates saw higher mask adherence. The study referenced in the One America News Network report says the opposite, noting that mask mandates were linked to statistically significant decreases in COVID-19 case within 20 days of implementation. JAMA. At its highest level of containment efforts, New York state scored an 80 on the index. "There are over 200 percent more cases in a school (district) that does not have a mask mandate," said Dr. Catherine Troisi, an. Both mask policy and mask adherence for states and D.C. were cross-tabulated with high case rates in the subsequent month. 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. 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. 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. 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. Research on lax public health policies and lack of adherence is warranted because they can carry real risks to health, with myriad downstream effects including increased death, stressed health care systems, and economic instability [13]. 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]. The cumulative rate of infection over the course of the pandemic was about 24 percent in the mandate states as well as in the non-mandate states. Even Greenpeace now admits the obvious: recycling doesnt work. Thank you for supporting our journalism. Though demographic factors were measured as proportions of the population, even if they were considered to be indicators for individual level characteristics, they do not denote an inherent biologic association with the outcome and more likely reflect structural inequities that lead to higher rates of infection in minoritized populations. Maskaholics in the press are calling for permanent masking on trains, planes, and buses. 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. While it controlled for other policies that have been used to try to mitigate new infections from the coronavirus including bar closures, stay-at-home orders and bans on gatherings of 10 or more people it did not account for some others, such as physical distancing recommendations and other types of business closures. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. Weak recent containment measures and many cases. https://doi.org/10.1371/journal.pone.0249891.t001. https://doi.org/10.1371/journal.pone.0249891.g001. A recent study shows that states with high levels of mask-wearing reported fewer COVID-19 cases last summer. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". The CDC's report is the latestin a growing body of evidence establishing mask mandates as an effective strategy in curbing the virus. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. The. For each month, the distributions of mask adherence across all 50 states and D.C. were categorized into quartiles, meaning the cut-off values for each quartile may be different from one month to another. A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. Like the debate about lockdowns, the debate about mask mandates will continue. It also examined the link between allowing on-site restaurant dining and the number of coronavirus cases and deaths. 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. A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson. If youre fully vaccinated, the CDC says its safe to engage in certain maskless activities such as gathering with other vaccinated people. Data Availability: Data are available in the paper and its Supporting Information file. The Department of Homeland Security Turns 20. We thank Drs. According to Werler, Arizona's data was unexpected. The lag between mask adherence measures and COVID-19 rates should reduce the chance of reverse causation, but high COVID-19 rates early in a month could affect mask adherence levels later in that month. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." 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. 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. But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. 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. 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. "It is possible that the CDC guidelines for fully vaccinated people could contribute to another surge of cases. 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 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. How Are States Responding to CDC Mask Guidelines? Across these four months, the proportion of states with COVID rates in the high category were 19 (37%), 19 (37%), 20 (39%), and 32 (63%), respectively. We abstracted daily percentages of the population who say they always wear a mask in public. Over the course of the pandemic, the scientific evidence and our understanding of masks have grown. 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. Writing original draft, Even as more and more states encourage mask wearing [7], many citizens still resist the notion [8]. 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. 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. ", 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.. "Our results suggest that mask-wearing is strongly affected by factors other than mandates. The current study . Nor did it look at actual mask wearing, as opposed to legal requirements. Even as more and more states encourage or even mandate mask wearing, many citizens sti Germanys stringent policies have made it a consistent media darling. I think timing really matters for the decisions.. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . 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. 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. 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. 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. 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. North Dakota, for example, made few efforts to contain the virus. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. 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. 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. 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. 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). 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,. 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). No, Is the Subject Area "Health care policy" applicable to this article? The study also did not measure compliance with and enforcement of mask mandates and prohibitions on dining at restaurants. Gov. Several cities and large counties, including Miami-Dade, Palm Beach and Hillsborough (which includes Tampa), had mask requirements, but Gov. 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. Prior to adopting mask mandates, those municipalities that eventually adopted mandates had higher transmission rates than the rest of the state, with the mean case rate difference per 100,000 people increasing by 0.32 cases per day (slope of difference = 0.32; 95% CI 0.13 to 0.51). Now, Midwestern states have among the worst outbreaks. Mean COVID-19 rates for states with 75% mask adherence in the preceding month was 109.26 per 100,000 compared to 249.99 per 100,000 for those with less adherence. Former Arizona AG Found No Evidence of 2020 Election Fraud. 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