Odds ratios and 95% confidence intervals for average mask adherence and mask policy for the general public are associated with high COVID-19 rates in the subsequent month (Table 3). Without strong national guidance, states containment policies have varied widely. Note: State containment measures are shown from two weeks prior, reflecting what experts say is a lag between new policies and results. New York. 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. 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. Yes No, Is the Subject Area "Public policy" applicable to this article? But as Miller shows in his book, the policies made no discernible difference. Here's what it could mean for all of us. Eric Boehm PLoS ONE 16(4): 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. 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. 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. But the "reference period" is defined by the report as the 20 days before mask mandates started. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. But the researchers found no clear relationship between mask mandates and mask use. 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). Methodology, 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. 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. For demographic data, we dichotomized population proportions at whole values that approximated the highest quartile of the distributions. The same study found that cloth masks did not have a statistically significant effect. 3.1.2023 11:20 AM, Elizabeth Nolan Brown 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. Virginia. 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]. 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. 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. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. According to Werler, Arizona's data was unexpected. 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. Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2. According to Werler, Arizonas data was unexpected. 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. 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. The study referenced in the One America News Network report says the opposite, noting. The. The current surge is worst in places with few containment measures. PLOS ONE promises fair, rigorous peer review, Writing original draft, Methodology, Some countries that implemented fast, early restrictions and robust test-and-trace programs have seen the most success. For a while, the residents were spared. 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. 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.". broad scope, and wide readership a perfect fit for your research every time. Nor did it look at actual mask wearing, as opposed to legal requirements. 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. here. 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%. https://doi.org/10.1371/journal.pone.0249891.g002. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. No, Is the Subject Area "Conservation science" applicable to this article? More state leaders acted to strike down mask mandates on Thursday, citing a decline in COVID-19 cases and hospitalizations. "Large indoor gatherings without masking among a mix of vaccinated and unvaccinated persons is a recipe for trouble.". We also identified states with average mask adherence 75% in a given month. Weak recent containment measures and many cases. "Arizona surprised me because they went from having the second-lowest mask adherence in May and June [less than 22%] to the highest level in July and August [greater than 80%]. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. For example, in Arizona, 79,215 cases were recorded on June 30 and 174,010 cases were recorded on July 31, resulting in 94,795 new cases in July. https://doi.org/10.1371/journal.pone.0249891.t002. Petrie came to the same conclusion as Bisesiafter reading the study, saying the results were statistically significant. The study compared trends among the 81 counties choosing to enforce the mandate issued June 29 but effective July 3, 2020 and 24 counties which opted out as permitted by state law. Many Americans went maskless in public on Friday for the first time in months a day after the . John Bel Edwards emergency order will . 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. Since the spring, Maine mandated masks and had strict travel restrictions for out-of-state visitors; South Dakota, meanwhile, has never had a mask mandate and welcomed nearly half a million people to the Sturgis motorcycle rally, as well as its state fair, which attracted more than 100,000 visitors. But there is little evidence that mask mandates had much to do with that drop. The pandemic has eased, but not the compulsion of many Americans to cover their faces. No, Is the Subject Area "Pandemics" applicable to this article? States with mask mandates saw higher mask adherence. 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.. A relationship between policies and the outbreaks severity has become more clear as the pandemic has progressed. The adoption of universal masking policies is increasingly polarized and politicized, demanding that public health authorities balance the values of health and individual liberty. Meanwhile, the eight states that reported 75% or more mask adherence between June 2020 and September 2020 did not have high COVID-19 rates. 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. Our fact check work is supported in part by a grant from Facebook. We calculated the average mask use percentage by month for AprilSeptember, 2020. 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. 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. The Department of Homeland Security Turns 20. On November 8, Utah implemented a mask mandate, as new daily Covid-19 cases continue to rise in the state and across the country. "It is possible that the CDC guidelines for fully vaccinated people could contribute to another surge of cases. February 28, 2023 at 5:55 am EST. Once you start thinking about acting, it probably is the time to act.. 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. Former Arizona AG Found No Evidence of 2020 Election Fraud. 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. This pattern of magical thinking persisted throughout the pandemic, as Miller demonstrates in dozens of graphs contrasting conventional wisdom with cruel reality. 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. Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. When Can I Travel Again After Being Fully Vaccinated? 2.18.2022 4:30 PM. Heres How Doctors With Kids Are Navigating the New Mask Guidance. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. However, the COVID-19 rates continued to be higher in places with low mask adherence. No, Is the Subject Area "Hispanic people" applicable to this article? Visualization, Even as more and more states encourage or even mandate mask wearing, many citizens sti When Can I Dine Indoors Again After Being Fully Vaccinated? 3.1.2023 2:50 PM, David McGarry 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. If youre still not convinced to take off the mask, consider one more graph from Miller. Beyond the question of how effective masking is in practice, there is the question of what impact mask mandates have on behavior. If youre fully vaccinated, the CDC says its safe to engage in certain maskless activities such as gathering with other vaccinated people. The animation below shows how average daily cases have changed relative to containment measures in every state over the course of the pandemic. 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