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. 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. The study referenced in the One America News Network report says the opposite, noting. In conclusion, we show that mask wearing adherence, regardless of mask wearing policy, may curb the spread of COVID-19 infections. 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. 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. 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.. Yes 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]. 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. Yes broad scope, and wide readership a perfect fit for your research every time. But the "reference period" is defined by the report as the 20 days before mask mandates started. Former Arizona AG Found No Evidence of 2020 Election Fraud. "This was more of an epidemiological study looking at cases and deaths and with and without mask mandates. Our study accounted for temporality by staggering COVID-19 outcome data after adherence measures. But there are still settings where wearing your mask is crucial. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. 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). [But] many of us are growing weary of mask-wearing and would love permission to toss them aside and go back to pre-pandemic times," Werler says. Here's what it could mean for all of us. This protective effect of mask wearing was evident across four months of the pandemic, even after adjusting the associations for mask policy, distance policy, and demographic factors. 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.. Thank you for supporting our journalism. 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. 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. Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. Over a third of states are ending COVID-19 mask mandates. Brooks JT & Butler JC. The claim: CDC study found that face masks have a negligible effect on the spread of COVID-19. 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. Writing original draft. The requirement is expected to be lifted on March 1. They continued to fall over the 100 days analyzed in the study. 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. Instead, it links mask mandates to statistically significant decreases in county-level daily COVID-19 case and death growth rates within 20 days of implementation.. Since July 27, 2020, individuals had been required to wear a mask or face covering in the state when visiting public indoor spaces and when unable to maintain a 6-foot distance from. When Can I Visit a Friend's House After I'm Fully Vaccinated? Mr. Hale said the Oxford data makes it clear that acting quickly and forcefully is the best shot governments have to combat the virus. Our fact check work is supported in part by a grant from Facebook. New York. To reduce the rate of COVID-19 cases nationwide, Werler says people need to wear their masks. At the beginning of November, most states were scoring in the 40s and 50s. 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. 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. 2 minute read. The claim that a CDC study found face masks to have a negligible effect on the spread of COVID-19 is FALSE. 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. 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. 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 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. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. 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. Coronavirus cases are rising in almost every U.S. state. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. 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. 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. 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. Further analyses of more granular geographic regions would be a logical next step. "Unfortunately, the virus hasnt gone away and is still easily transmissible. But with variants of concern circulating around the world, masking remains importanteven as the public battles mask fatigue. 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. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. 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). We thank Drs. 3.1.2023 9:30 AM, Damon Root Of course, many other factors are could be at play, like the possibility of cooler weather driving non-adherent persons to indoor gatherings. All reviews and studies included in this document report on data collected in a time period prior North Dakota, for example, made few efforts to contain the virus. 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. No, Is the Subject Area "Public policy" applicable to this article? 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.". We recommend renewed efforts be employed to improve adherence to mask wearing. 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. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. The current study . But the researchers found no clear relationship between mask mandates and mask use. 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. Its Legacy Is Disastrous. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Now, nearly one in 10 North Dakotans have tested positive about a third of those in the past two weeks and one in 1,000 have died of the virus. No, Is the Subject Area "Conservation science" applicable to this article? But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. https://doi.org/10.1371/journal.pone.0249891.t001. Its been piecemeal, Dr. El-Sadr said. By Jocelyn Solis-Moreira While the downtrend could also have been a result of other countermeasures like social distancing, Kansas' findings mirror observations from other states and countries. 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. 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. 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. 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. 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. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. Vermont. The authors found that the growth rate of new coronavirus cases and deaths dropped after mask mandates were put in place. States that have kept more control policies in a more consistent way New England states, for example have avoided a summer surge and are now having a smaller fall surge, as opposed to states that rolled them back very quickly like Florida or Texas, Mr. Hale said. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. 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. 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). 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. By contrast, Florida has no statewide restrictions. The mandate will still require masks where . When the outbreak slammed the New York City area in March and April, leaders locked down. Vaccinated persons can carry and spread the virus.". 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. 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. We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. 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. Across the country, indoor mask requirements in blue states are falling like dominoes as COVID cases drop. Conceptualization, No, Is the Subject Area "Public and occupational health" applicable to this article? Like the debate about lockdowns, the debate about mask mandates will continue. After reopening early, some Sun Belt states, including Arizona and Texas, imposed restrictions again after case counts climbed. 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. Yes OAN spokesman Charles Herring said the outlet linked to the study "so viewers could read the CDC report in its entirety. When Youve Been Fully Vaccinated. "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". Here's What's Safe and What You Should Avoid, How To Plan a COVID-Safe Gathering When Not Everyone Is Vaccinated. John Bel Edwards emergency order will . Yes The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. What theyre looking at here is efficacy of mask mandates. 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. Eleven states had no stay-at-home order, 15 had no mask policy, and four states had low adherence throughout this six-month period. 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. All the state does is encourage Alaskans to do their part to limit the spread of Covid-19, recommending that residents practice social distancing and wear a mask, without any mandate. 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). Thailand, Japan, Taiwan, Hong Kong, the Philippines, Uruguay, Chile, Poland, and Hungary were all hailed as models of scientific enlightenment for their low infection rates and strict mask policiesuntil, as usual, the masks suddenly lost their magical power. Rhode Island, where I live, has had a mask mandate since mid-December; nonetheless, we saw our January surge rise far higher than any other state. Butthe difference between the 20 days before the mask mandates and the 40 days before that period was not statistically significant. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. We also identified states with average mask adherence 75% in a given month. Over the course of the pandemic, the scientific evidence and our understanding of masks have grown. Texas locked down in the spring, when it had relatively few cases, then reopened quickly. "Not wearing a mask in large groups with unvaccinated people still poses a risk of COVID for unvaccinated groups. 2021. Among states and D.C. with no mask wearing policy, 50 to 73% had high COVID-19 rates in the subsequent month. Overall, there is no obvious difference between states with mask mandates and states without them. + Caption. Because high COVID rates were reported by only eight states in May and four states in June, we did not examine mask adherence or policy in the preceding April or May. Most states in the low quartile had high COVID-19 rates in the subsequent month. He adds that the two states "had nearly identical infection rates.". 18, 2020. here. Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. PLoS ONE 16(4): Swedens initial Covid surge was blamed on those lax policies, but Sweden stuck to them and actually discouraged masks in most situations. 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. https://doi.org/10.1371/journal.pone.0249891.g002. Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. Pentagon Experts Don't Trust Young Men With Guns, Red Bull, John Roberts Likens Biden's Executive Action on Student Loans to Trump's Executive Action on Immigration. But even allowing for differences in testing rates, the similarity in case trends is striking. A couple weeks into those lockdowns, countries with new restrictions may be seeing results: The rate of new daily cases has begun to level off or drop in France, Spain, Germany and Italy, though it continues to rise in the United Kingdom. Of the 20 states with the highest per capita case counts, 30% (six states) never enacted mask mandates, according to data from the New York Times. 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. But as Flam notes, "the benefits of universal masking have been difficult to quantify" in the real world, where cloth models predominate and masks may not be clean, well-fitted, or worn properly. 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. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. For demographic data, we dichotomized population proportions at whole values that approximated the highest quartile of the distributions. Charlie B. Fischer, 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. Because stay-at-home order, mask wearing policy, mask adherence, and COVID-19 rates can vary from month to month, we listed those states with consistent classifications across the period April through September (or May through October for COVID-19 rates). "Lifting of mask mandates across the board without consideration of the caveats does open the opportunity for another wave," Werler says.

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