Masks make no difference in reducing the spread of Covid, according to an extensive new review by Cochranethe gold standard for evaluating health interventions. In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. 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. 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. | The current study . 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). The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. "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. 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. Several other states have implemented or tightened. 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. Of note, there were no states with 75% in September. | No, Is the Subject Area "Public policy" applicable to this article? 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. In Maryland , Gov. 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. 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]. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. He adds that the two states "had nearly identical infection rates.". 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. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. Fully vaccinated people should continue following CDC guidelines, including wearing their masks in crowded areas and when around unvaccinated people. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. 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. One state is the lone holdout. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. Sources: Restrictions tightened as cases were rising. 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). Immediately after these mandates were instituted, these declines were statistically significant.. "Its that simple.. Crude and adjusted odds ratios for any mask policy in relation to high COVID-19 rates in the subsequent month were below 1.0; but confidence intervals were wide. Visualization, 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). 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. Eric Boehm | 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. "Unfortunately, the virus hasnt gone away and is still easily transmissible. "They dont know how well people complied with these mandates or what proportion of the populationwas actually wearing masks.. OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. 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. Costs vs. benefits of COVID-19 lockdowns and mask mandates revealed in new research Thu, 01/12/2023 LAWRENCE Beginning in 2020, most state governors ordered lockdowns and mask mandates to combat the COVID-19 pandemic. February 28, 2023. "Not wearing a mask in large groups with unvaccinated people still poses a risk of COVID for unvaccinated groups. The CDC received some criticism for its junk science on masks, particularly for its false claims about the benefits of masking schoolchildren, but the press mostly promoted the agencys narrative. 2.18.2022 4:30 PM. We abstracted data on whether the state issued a mandate of mask use by all individuals in public spaces, and if so, the dates of implementation and whether the mandate was enforced by fines or criminal charge/citation(s). 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). 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. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 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 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. Copyright: 2021 Fischer et al. May 16, 2021 / 7:07 AM / CBS News. Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. For now, relaxing some mask guidelines while staying vigilant is the government's compromise. 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. A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. Even if masking works, that does not necessarily mean mandates do. 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. Eleven states never mandated masks, while the other 39 states enforced mandates. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. 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. Jacob Sullum Another recent study published in the Annals of Epidemiology looking at county-level COVID-19 incidence found counties across the U.S. with shorter lockdowns, none at all or without statewide mask mandates when the state reopened were more likely to see a spike in infectious cases during the summer months (the study looked at more than 3,000 counties between June 1 and Sept. 30). In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson. | Visualization, 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. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. When mask adherence dropped in September, COVID-19 cases increased in October. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. Click through the PLOS taxonomy to find articles in your field. 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. 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). The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. Nedghie Adrien, Roles Yes Like the debate about lockdowns, the debate about mask mandates will continue. 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. 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. Maskaholics in the press are calling for permanent masking on trains, planes, and buses. 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. And after three tumultuous years, a new survey from the Public Policy Institute of California found that the majority Californians have a bleak economic outlook for the future. We calculated the average mask use percentage by month for AprilSeptember, 2020. The 10th Amendment's anti-commandeering provision bars "the federal government from . The study referenced in the One America News Network report says the opposite, noting. In addition, Hawaii and Oregon, which have both implemented school mask. 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. In fact, it doesn't study mask efficacy at all. In the summer of 2020, Politico praised Rhode Islands wear-your-damn mask policy in an article headlined, How the Smallest State Engineered a Covid Comeback. A survey in the autumn found that 96 percent of Rhode Islanders were wearing masks, the highest rate in the U.S., yet that winter the state went on to suffer one of the nations worst Covid surges. Vermont. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. 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. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. I think timing really matters for the decisions.. The politicization of COVID-19 epidemiology [9,12] has further complicated policy-making, messaging, and uptake. The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. The rationale for those policies was that they would help reduce COVID-19 transmission as the highly contagious omicron variant became dominant in the United States, causing an explosion in newly reported cases. 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. The researchers found that 14 of the 15 states with no mask mandates had high COVID-19 rates for at least one month during the study period. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. 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. Accessibility | 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. Thus, subsequent comparisons of states with high COVID-19 rates by month focused on July, August, September and October. 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. 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.. 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. Our observed associations should influence policy-makers and contribute to public health messaging by government officials and the media that mask wearing is a key component of COVID-19 mitigation. Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. 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. And in New York and some other states, those lockdowns came too late to prevent a big outbreak, because thats where the virus hit first, said Thomas Hale, associate professor of global public policy at the Blavatnik School of Government, who leads the Oxford tracking effort. 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. I just dont know based on reading the OAN summary how they came to the same conclusions because the CDC conclusions were favorable.. Note: State containment measures are shown from two weeks prior, reflecting what experts say is a lag between new policies and results. Policy data on physical distancing were dichotomized as any versus no stay-at-home order during the April 1 to October 31, 2020 interval. For demographic data, we dichotomized population proportions at whole values that approximated the highest quartile of the distributions. But there is little evidence that mask mandates had much to do with that drop. Copyright 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. Massachusetts. After briefly ramping up restrictions closing bars, restaurants, gyms, theaters and schools in March, when most other states did, Gov. 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. The Department of Homeland Security Turns 20. Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus transmission. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. By Jocelyn Solis-Moreira Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. Although Hawaiis governor did not issue a mask wearing policy until after October 2020, we considered that state to have a policy because mayors of the four populous counties had mandated mask wearing earlier in the pandemic. When Can I Visit a Friend's House After I'm Fully Vaccinated? https://doi.org/10.1371/journal.pone.0249891.g002. 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. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. 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. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. States with stronger policy responses over the long run are seeing comparatively smaller outbreaks. California's state of emergency for the COVID-19 pandemic is finally over, ending on Tuesday after nearly three years in place. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. Parents have pushed for the mask mandate to be lifted for a number of reasons. States with more than 200 COVID-19 cases per 100,000 residents were considered to have a high case rate. If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. 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. For the most recent updates on COVID-19, visit our coronavirus news page. Based on data from various countries and U.S. states from May to September 2020, a preprint study published last June found that general mask wearing was associated with a reduction in virus. For example, mask wearing in the two weeks before rates begin to rise might be a more sensitive way to measure the association. By Lauren Leatherby and Rich HarrisNov. Many local leaders went further. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. Methodology, The Kentucky senator presses on with his fight against the federal governments Covid response. 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. 18, 2020. When the outbreak slammed the New York City area in March and April, leaders locked down. (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . 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%. A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. Coronavirus cases are rising in almost every U.S. state. here. 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. For all 50 states and the District of Columbia (DC), these data were abstracted by month for April September 2020 to measure their impact on COVID-19 rates in the subsequent month (May October 2020). At the beginning of November, most states were scoring in the 40s and 50s. 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. Doug Burgum reopened the state nearly fully in May. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. The States and Mask Mandates. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. 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.. Our fact check work is supported in part by a grant from Facebook. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. If youre still not convinced to take off the mask, consider one more graph from Miller. 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. 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. 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. For a while, the residents were spared. ", 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." That's not nothing, but it's a pretty modest effect, and it was achieved with surgical masks worn by adults in conditions that encouraged proper and consistent use. Its been piecemeal, Dr. El-Sadr said. 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. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. "Nearly a year after California Gov. The authors found that the growth rate of new coronavirus cases and deaths dropped after mask mandates were put in place. States and cities are reinstating restrictions and implementing new ones: In recent days, the governors of Iowa, North Dakota and Utah imposed mask mandates for the first time since the outbreak began. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. 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. 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. Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. Jacob Sullum is a senior editor at Reason. 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. Among states and D.C. with no mask wearing policy, 50 to 73% had high COVID-19 rates in the subsequent month. 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. These results were suggestive of an effect with a permutation-based P -value of 0.094. They looked at data from April to October 2020. broad scope, and wide readership a perfect fit for your research every time. 3.1.2023 9:30 AM, Damon Root The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. We thank Dr. Julia Raifman Boston University School of Public Health for developing, maintaining, and providing open access to the COVID-19 US State Policy Database. 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. Containment measures are as of Nov. 1. 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. No, Is the Subject Area "Health care policy" applicable to this article? She finds that mask-wearing is still the best course of action for mixed-vaccination status gatherings. Many states in the Upper Midwest and Mountain West resisted more stringent control measures, like limits on gatherings and mask mandates. 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). Thats a huge swing, Werler says. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. "We do not find evidence that mandating mask-wearing reduces transmission," the authors reported. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. 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. Contributed equally to this work with: 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. Brooks JT & Butler JC. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. 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. The current surge is worst in places with few containment measures. 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. As of Aug. 3, Louisiana is under a temporary statewide mask mandate required of all people, including those who are vaccinated, when indoors. Of use, DeSantis ' Disney Drama Turns Culture War Into Political Gains has maintained some the! Is 42.5, compared to 37 in California, visitors and staff members at UCHealth are required wear. Lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the subsequent.... Report says the opposite, noting of 0.094 the spring, when study that... That drop had no stay-at-home order, 15 had no mask wearing, many citizens still the... Germany obviously didnt beat COVID experiment that occurred nationwide during the pandemic summary How they came to the same because. 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