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. High school students in Seattle staged a protest demanding that a mask mandate be reinstated, and psychologists now deal with the anxieties of children who dont want their classmates to see their faces. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. 3.1.2023 11:20 AM, Elizabeth Nolan Brown "Nearly a year after California Gov. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. 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). https://doi.org/10.1371/journal.pone.0249891.t001. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. It compares Germany with Sweden, the medias Covid villain for refusing to lock down or mandate masks. Methodology, These results were suggestive of an effect with a permutation-based P -value of 0.094. Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. 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.. 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. The pandemic has eased, but not the compulsion of many Americans to cover their faces. After the pandemic, a survey of gains and losses. A quarterly magazine of urban affairs, published by the Manhattan Institute, edited by Brian C. Anderson. 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. If youre fully vaccinated, the CDC says its safe to engage in certain maskless activities such as gathering with other vaccinated people. On the other hand, Hawaii and Connecticut had two of the longest mask mandates and also some of the lowest per capita case counts of all the states. 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%. The claim: CDC study found that face masks have a negligible effect on the spread of COVID-19. Visualization, Yes Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. 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. 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. 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. Ashish Jha, dean of Brown University's School of Public Health, notes that the graph for California, which required masks in indoor public settings beginning on December 15, is "strikingly similar" to the graph for Florida, which had no mask mandates. Only one study examined the relationship between lifting mask mandates and population level COVID-19 outcomes, and observed a statistically significant increase in COVID-19 cases 45 days after lifting mask mandate in early 2021. No, Is the Subject Area "Conservation science" applicable to this article? The graph tracks the results of a natural experiment that occurred nationwide during the pandemic. 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 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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). here. 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. Containment measures are as of Nov. 1. The politicization of COVID-19 epidemiology [9,12] has further complicated policy-making, messaging, and uptake. 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. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. When the outbreak slammed the New York City area in March and April, leaders locked down. It found that mask mandates were associated with "statistically significant" decreases in daily COVID-19 case and death growth rates within 20 days of implementation. + Caption. The proportions of states and D.C. with high COVID-19 rates were greatest for those with no mask wearing policy for the general public in the preceding month (Fig 2). https://doi.org/10.1371/journal.pone.0249891.t002. He Kept Quiet. May 16, 2021 / 7:07 AM / CBS News. Competing interests: The authors have declared that no competing interests exist. | 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. While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. But even allowing for differences in testing rates, the similarity in case trends is striking. Thats a huge swing, Werler says. When mask adherence dropped in September, COVID-19 cases increased in October. 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. 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. The wave of new restrictions in the United States follows national and regional lockdowns in Europe, where outbreaks surged past their spring peaks but cases per capita remained lower than many Upper Midwest states. Explaining the justification for lifting mask requirements, governors and public health agencies generally have cited the precipitous decline in daily new cases since mid-January. Similar reductions in odds of high COVID-19 rates in August and September were observed for July and August mask adherence, respectively. https://doi.org/10.1371/journal.pone.0249891.g001. COVID-19 death rates dropped by 0.7 percentage points in the first 20 days after masks were required. | Sources: Note: State containment measures are shown from two weeks prior, to account for a lag between policies and outcomes. 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. By contrast, Florida has no statewide restrictions. 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. As of Aug. 3, Louisiana is under a temporary statewide mask mandate required of all people, including those who are vaccinated, when indoors. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. Coronavirus cases are rising in almost every U.S. state. Note: State containment measures are shown from two weeks prior, reflecting what experts say is a lag between new policies and results. Its Legacy Is Disastrous. However, the COVID-19 rates continued to be higher in places with low mask adherence. Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. | 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. If you add up all the numbers on those two lines, you find that the mask mandates made zero difference. Writing original draft, Illinois will lift its face mask requirement on Feb.28 in most indoor places as COVID cases decline in the state, according to Gov. Writing original draft. Privacy Policy | Indeed all 13 states in the low mask adherence group in September had high COVID-19 rates in October. 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. Investigation, 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). (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.) | Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. 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. Research suggests that mandatory mask-wearing policies correlated with a lower number of COVID-19 infections and deaths. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. 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%. 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.". 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]. 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). 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.. Data Availability: Data are available in the paper and its Supporting Information file. Jacob Sullum (Andy Wong) HONG KONG (AP) Hong Kong will lift its mask mandate on Wednesday, ending the city's last major restriction imposed during the . Immediately after these mandates were instituted, these declines were statistically significant.. Methodology, 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. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. 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. 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 . Nevertheless, it is possible that average mask adherence in a given month does not capture the most effective time period that influences COVID-19 rates. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. 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. Eric Boehm Coronavirus: How R-0 can be used to fight COVID-19. JAMA. 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. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. When we looked at states with 75% mask adherence (Arizona, Connecticut, Hawaii, Massachusetts, Michigan, New York, Rhode Island, Vermont), we found none had experienced a high COVID-19 rate in the subsequent month. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. The Department of Homeland Security Turns 20. We did estimate odds ratios for mask adherence within subgroups of states with and without mask policy. No, Is the Subject Area "Pandemics" applicable to this article? 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