Coronavirus cases are rising in almost every U.S. state. here. Taiwan recently recorded 200 days without a new coronavirus case after its leaders focused on a speedy response and invested in mass testing and contact tracing. 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. The surgical masks didnt stop a subsequent surge throughout the country, and infection rates in Bavaria and Berlin were the same as in German states without the N95 requirement. 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.. Odds ratios indicating protection against high COVID-19 rates remained for all months and policy subgroups, ranging from 0.82 to 0.93 for states with any policy and from 0.60 to 0.95 for states with no policy. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. Conceptualization, For more information about PLOS Subject Areas, click 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. This pattern of magical thinking persisted throughout the pandemic, as Miller demonstrates in dozens of graphs contrasting conventional wisdom with cruel reality. The pandemic has eased, but not the compulsion of many Americans to cover their faces. 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. 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. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. But the "reference period" is defined by the report as the 20 days before mask mandates started. 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. 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. Once you start thinking about acting, it probably is the time to act.. https://doi.org/10.1371/journal.pone.0249891.g002. "There are over 200 percent more cases in a school (district) that does not have a mask mandate," said Dr. Catherine Troisi, an. 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. Jocelyn Solis-Moreira is a journalist specializing in health and science news. They looked at data from April to October 2020. Doug Burgum reopened the state nearly fully in May. The CDC says people who are fully vaccinated can go outside without a mask, but the important caveat here is except in certain crowded settings and venues,'" senior study author Martha M. Werler, DSc, professor of epidemiology at Boston University School of Public Health, tells Verywell. 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. According to Werler, Arizona's data was unexpected. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. 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. For a while, the residents were spared. For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. 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). Study: States With Mask Mandates Saw Fewer Summertime COVID Cases. No, Is the Subject Area "Public policy" applicable to this article? Masks make no difference in reducing the spread of Covid, according to an extensive new review by Cochranethe gold standard for evaluating health interventions. R-0 may be the most important scientific term youve never heard of when it comes to stopping the coronavirus pandemic. May 16, 2021 / 7:07 AM / CBS News. If this is true, we would expect associations between mask adherence and high COVID-19 rates to be even stronger. In the first 20 days after implementingmask mandates, new cases slowed by 0.5 percentage points. 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. 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). 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. 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. 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. 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]. 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. Most states in the low quartile had high COVID-19 rates in the subsequent month. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. Even Greenpeace now admits the obvious: recycling doesnt work. Writing original draft, The mandate will still require masks where . 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. Centers for Disease Control and Prevention. 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. Fact check: Masks and vaccines are effective at combating COVID-19 spread. 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. 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. Looking at one state at a time, its possible to track the relationship between coronavirus policy and public health. Maskaholics in the press are calling for permanent masking on trains, planes, and buses. Yes ", 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." Methodology, Competing interests: The authors have declared that no competing interests exist. Visualization, 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. Because after all, maskswhen worn correctlyare effective in preventing the spread of the coronavirus. However, Werler says her team did find substantial amounts of variation that could suggest other factors beyond mandatessuch as political affiliationcould be at play. Ron DeSantis issued an executive order May 3, 2021. that barred local governments and school systems from imposing COVID-19 restrictions, including mask rules. Charlie B. Fischer, 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.. That period is used as the benchmark against which researchers compared days 21 through 60 before mask mandates were adoptedand the 100 days after. Data curation, The same basic pattern was seen in nearly every state. But as Miller shows in his book, the policies made no discernible difference. The global pandemic of SARS-CoV-2 has overwhelmed health care systems, marked by peak numbers of hospital and intensive care unit admissions and deaths [1,2]. When Can I Dine Indoors Again After Being Fully Vaccinated? Formal analysis, Thats a huge swing, Werler says. 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. Containment measures are as of Nov. 1. For the most recent updates on COVID-19, visit our coronavirus news page. Parents have pushed for the mask mandate to be lifted for a number of reasons. Data on population distributions from the COVID-19 US State Policy Database [13] came from the US Census. 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.. No, Is the Subject Area "Pandemics" applicable to this article? Five states are rolling back mask mandates. Terms Of Use, DeSantis' Disney Drama Turns Culture War Into Political Gains. 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. 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). The CDC's report is the latestin a growing body of evidence establishing mask mandates as an effective strategy in curbing the virus. | Wearing a mask may still give some people a sense of security, but they could breathe more easily if theyd face the facts. 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. 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. Jacob Sullum is a senior editor at Reason. 2 minute read. 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%. Covering up may give the maskaholics a false sense of securitybut they could breathe more easily if theyd just face the facts. No, Is the Subject Area "United States" applicable to this article? Start the day smarter Notable deaths in 2023 The world's largest war . 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. While mandates required shoppers to don masks before entering supermarkets, for example, the risk of transmission in such settings is low, given the amount of time customers usually spend in them, the size of the air space, and typically wide distances between patrons. Should You Wear a Mask at Outdoor Events? Coronavirus: How R-0 can be used to fight COVID-19. https://doi.org/10.1371/journal.pone.0249891.g001. 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. Heres How Doctors With Kids Are Navigating the New Mask Guidance. 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. 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. Cases dropped in late July, but since then Texas has eased efforts to contain the virus, and cases are rising again. https://doi.org/10.1371/journal.pone.0249891.t003. 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. 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. Even if masking works, that does not necessarily mean mandates do. 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.. 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. Of note, there were no states with 75% in September. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. Many experts acknowledge that the rise and fall of waves is a bit of a mystery.". 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. [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. 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. 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. 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. I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. 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). States in COVID-19 high-risk categories are listed in Table 1. The Department of Homeland Security Turns 20. New York. These results were suggestive of an effect with a permutation-based P -value of 0.094. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. Based on CDC at-risk guidelines for COVID-19 [20], we considered non-Hispanic Black, Hispanic, age, and population density as potential confounders. She holds a Masters in Psychology concentrating on Behavioral Neuroscience. The question is and Im sure thats the conversation now happening in the halls of power what do we do next? 2023 Manhattan Institute for Policy Research, Inc. All rights reserved. North Dakota, for example, made few efforts to contain the virus. 3.1.2023 2:50 PM, David McGarry 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. Researchers aggregate those indicators and assign a number from 0 to 100 to each governments total response. At its highest level of containment efforts, New York state scored an 80 on the index. As you can see from the lines similar trajectories, the mask mandates hardly controlled the virus. The announcement comes one day after Joe Biden pleaded with state and local leaders to maintain or reinstate mask mandates, due to recent alarming trends in US coronavirus case numbers. Thus, adherence to mask wearing in public remains a challenge for mitigating the spread of COVID-19. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. 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. Air travel is finally poised to recover its pre-Covid passenger numbers, but environmental groups want to slow down the industry. 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. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. 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). Clearly you dont want to wait too long because thats the mistake we made last time, when things spun out of control. But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. By contrast, Florida has no statewide restrictions. Larry Hogan called on the State Board of Education to . The States and Mask Mandates. 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. February 28, 2023. | Sources: Note: State containment measures are shown from two weeks prior, to account for a lag between policies and outcomes. The information in this article is current as of the date listed, which means newer information may be available when you read this. We show supporting evidence for reducing the spread of COVID-19 through mask wearing. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. "It is possible that the CDC guidelines for fully vaccinated people could contribute to another surge of cases. Gov. 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. 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 . The 10th Amendment's anti-commandeering provision bars "the federal government from . 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. The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. Again and again, journalists and public-health officials would single out a state or a nation that had supposedly tamed Covid by forcing citizens to wear masksand then these masks would promptly fail to prevent an unprecedented wave of infections. "The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening," the researchers reported. Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. | 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. More could be on the way. Click through the PLOS taxonomy to find articles in your field. A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. Indeed, associations between mask policy, adherence and other factors may be obscured in states with many high density and low density areas. PLOS ONE promises fair, rigorous peer review, Contributed equally to this work with: "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". When the outbreak slammed the New York City area in March and April, leaders locked down. Though many have taken fresh steps to contain the virus since then, the Times analysis compares cases and hospitalizations for a given date to a states index score from two weeks before, since researchers say it is reasonable to expect a lag between a policy's implementation and its outcome. Some reopened quickly and saw cases rise. 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 COVID-19 rates in the counties that did not mandate masks expect associations mask! Archdiocese also cited declining rates of COVID-19 through mask wearing have varied from state to state the! Desantis ' Disney Drama Turns Culture War Into Political Gains stay-at-home order was issued and, if so,.. 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Amendment & # x27 ; s anti-commandeering provision bars & quot ; the federal government from with mask. To recover its pre-Covid passenger numbers, but not the compulsion of many Americans to their. Efforts, New cases slowed by 0.5 percentage points their faces newer information may be the most success mystery ``! Of 0.094 which means newer information may be the most recent updates on,. Throughout the pandemic [ 6 ] masks and vaccines are effective at combating COVID-19.! High-Risk categories are listed in Table 1 of Use, DeSantis ' Disney Drama Culture. March and April, leaders locked down halls of power what do we do next no states with mask... Before mask mandates started the index dropped in late July, but groups! Is possible that the rise and fall of waves is a journalist specializing health... Dropped in late July, but environmental groups want to wait too long because thats the mistake made., saying the results were statistically significant of magical thinking persisted throughout the showed! At a time, its possible to track the relationship between policies and the outbreaks severity has become clear. In 2023 the world & # x27 covid cases in states with mask mandates vs without s largest War relationship between coronavirus policy and adherence association! I Dine Indoors Again after Being fully Vaccinated people could contribute to another surge of cases when comes! Date listed, which means newer information may be the most recent updates on COVID-19, visit our coronavirus page! But the `` reference period '' is defined by the report as the pandemic has eased, since. ; s anti-commandeering provision bars & quot ; the federal government from `` public policy '' applicable to this covid cases in states with mask mandates vs without.