The findings were published in the journal PLOS One in April. Currently, patients, visitors and staff members at UCHealth are required to wear a mask at all times. Instead, it analyzed the connection between mask mandate policies and the rate of new county-level coronavirus cases and deaths. Data Availability: Data are available in the paper and its Supporting Information file. "Their perspective on the study and results to me are contrary to what was stated in the actual study itself," Bisesi said. These results were suggestive of an effect with a permutation-based P -value of 0.094. But with variants of concern circulating around the world, masking remains importanteven as the public battles mask fatigue. 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. Centers for Disease Control and Prevention. 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). Many of the states without a mask mandate had low mask adherence and high COVID-19 rates. No, Is the Subject Area "United States" applicable to this article? The cumulative rate of infection over the course of the pandemic was about 24 percent in the mandate states as well as in the non-mandate states. Coronavirus: How R-0 can be used to fight COVID-19. Louisiana. 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. Even as more and more states encourage or even mandate mask wearing, many citizens sti The pandemic planners at the United Kingdoms Department of Health had reached a similar conclusion: In line with the scientific evidence, the Government will not stockpile facemasks for general use in the community. Anthony Fauci acknowledged this evidence early in the pandemic, both in his public comments (Theres no reason to be walking around with masks, he told 60 Minutes) and in his private emails (I do not recommend you wear a mask, he told a colleague, explaining that masks were too porous to block the small Covid virus). 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 Legacy Is Disastrous. 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. 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. 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. 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 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). For policies on physical distancing, we recorded whether a stay-at-home order was issued and, if so, when. Most states in the low quartile had high COVID-19 rates in the subsequent month. Yes But the surge is worst now in places where leaders neglected to keep up forceful virus containment efforts or failed to implement. As you can see from the lines' similar trajectories, the mask mandates hardly controlled the virus. 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). The estimated absolute change in cumulative case rate associated with lifting the mask mandate, remains 28.1 (30.6%) 21 days after lifting the mask mandate. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic [6]. At the beginning of November, most states were scoring in the 40s and 50s. Another consideration is that access to COVID-19 testing appears to vary from state to state [21]. 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). I think timing really matters for the decisions.. Herring dismissed those results, claiming unnamed experts told the news network that the reductions in spread the study found were not significant. 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). 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. Competing interests: The authors have declared that no competing interests exist. No, Is the Subject Area "Public policy" applicable to this article? We examined the impact of state-based mask wearing policy and adherence on COVID-19 case rates during the summer and early fall of 2020 in order to quantify this effect. 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. 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. Wearing masks is a CDC-recommended* approach to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), by reducing the spread of respiratory droplets into the air when a person coughs, sneezes, or talks and by reducing the inhalation of these droplets by the wearer. 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. Visualization, 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. Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. Methodology, 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. According to Werler, Arizonas data was unexpected. By contrast, Florida has no statewide restrictions. 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. But in each state, as Miller shows, infection rates remained lower in the counties that did not mandate masks. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. 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. 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.. 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. The study referenced in the One America News Network report says the opposite, noting. Many have also done the least to contain the virus. 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. 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. Nor did it look at actual mask wearing, as opposed to legal requirements. 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. We used state-level data on mask wearing policy for the general public and on proportion of residents who stated they always wear masks in public. "At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." Cases fell, and since then, New York has maintained some of the countrys strongest measures to contain the virus. The worst outbreaks in the country now are in places where policymakers did the least to prevent transmission, according to the Oxford index. For each month, the distributions of mask adherence across all 50 states and D.C. were categorized into quartiles, meaning the cut-off values for each quartile may be different from one month to another. 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. As of Aug. 3, Louisiana is under a temporary statewide mask mandate required of all people, including those who are vaccinated, when indoors. But the "reference period" is defined by the report as the 20 days before mask mandates started. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. Thus, policy and adherence levels in a given month were contrasted with lagged COVID-19 case rates in the subsequent month. 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. "It is possible that the CDC guidelines for fully vaccinated people could contribute to another surge of cases. 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. 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. Daniella Amato is a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical research. The Centers for Disease Control & Prevention (CDC) recently relaxed their COVID-19 guidelines, allowing fully vaccinated people to forego masks outside. 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. Massachusetts. J.B. Pritzker. 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. Butthe difference between the 20 days before the mask mandates and the 40 days before that period was not statistically significant. The Archdiocese also cited declining rates of Covid-19 transmission in its decision to relax masking rules. Thats a huge swing, Werler says. 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). 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. Funding: The authors received no specific funding for this work. The opposite was true for states with mandates. 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. 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. Masks make no difference in reducing the spread of Covid, according to an extensive new review by Cochranethe gold standard for evaluating health interventions. Miller, who has tracked pandemic trends for the Brownstone Institute, has assembled the damning evidence in Unmasked: The Global Failure of COVID Mask Mandates. Overall, there is no obvious difference between states with mask mandates and states without them. At its highest level of containment efforts, New York state scored an 80 on the index. The Kentucky senator presses on with his fight against the federal governments Covid response. Mask adherence was classified as low if in the lowest quartile and as high if in the highest quartile. 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 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. Because there are so many variables to account for, it is very difficult to isolate the impact of any given policy. Verywell Health's content is for informational and educational purposes only. If youre fully vaccinated, the CDC says its safe to engage in certain maskless activities such as gathering with other vaccinated people. Yes States in COVID-19 high-risk categories are listed in Table 1. 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. The mandates typically began early in the pandemic in 2020 and remained until at least the summer of 2021, with some extending into 2022. States with the lowest levels of mask adherence were most likely to have high COVID-19 rates in the subsequent month, independent of mask policy or demographic factors. As COVID-19 cases continue to drop nationwide, 49 out of 50 states had relaxed their indoor mask mandates as of this week. For every 1% increase in average adherence in June, the fully adjusted odds ratios for high COVID-19 in July was 0.95, indicating a protective effect against high COVID-19 rates. 2021;325(10):998-999. doi:10.1001/jama.2021.1505. Public health policy-making requires navigating the balance of public good and individual rights [10]. In contrast, average adherence was 68% in the 15 states with lower COVID-19 rates in October and any mask policy in September. High COVID-rates were less frequent in states and D.C. with strict mask wearing policy than in states with recommended policy. Methodology, "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%]. 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. The three COVID-19 vaccines authorized by the FDA are also helping slow COVID-19 rates, allowing for the easing of restrictions. 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). 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. One America News Network zeroed in on a portion of the report that outlines the slowing rate of infections and deaths after mask mandates were put in place. 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. 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. | So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. New Zealand recently lifted all restrictions following 10 days with no new cases. 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. Fact check: Masks and vaccines are effective at combating COVID-19 spread. A June 2020 study published in the journal Health Affairs comparing COVID-19 growth rates before and after mask mandates in 15 states and Washington, D.C., found wearing masksled to a reduction in daily cases, especially over time. We divided the monthly number by 2.2 to obtain the number in a two-week period (43,088). When the state faced a surge of cases over the summer, the governor closed bars and placed limits on restaurant capacity. The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It. 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 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. PLoS ONE 16(4): For mask policy and adherence in September in relation to high COVID-19 rates in October, collinearity caused the odds ratio to flip. By Lauren Leatherby and Rich HarrisNov. However, the COVID-19 rates continued to be higher in places with low mask adherence. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. Now, Midwestern states have among the worst outbreaks. 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. | After the pandemic, a survey of gains and losses. 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). 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. Decreases in the rate of new infections and deaths from the virus were statistically significant, the studys authors found. When Youve Been Fully Vaccinated. 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. The 2-week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000. 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. February 28, 2023 at 5:55 am EST. 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. 3.1.2023 9:15 AM, Joe Lancaster Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. Contributed equally to this work with: In fact, it doesn't study mask efficacy at all. https://doi.org/10.1371/journal.pone.0249891.t001. 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.". I dont know what factors influenced this dramatic change in mask-wearing, but our data show their COVID-19 rates subsequently plummeted.. 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. 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. By Jocelyn Solis-Moreira https://doi.org/10.1371/journal.pone.0249891.s001. 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. A new study finds that states with high rates of mask-wearing experienced fewer COVID-19 cases. 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 Department of Homeland Security Turns 20. Instead of carefully analyzing the effects of masks, the CDC repeatedly tried to justify them by misrepresenting short-term trends and hyping badly flawed research, like studies in Arizona and Kansas purporting to show that infections had been dramatically reduced by the mask mandates imposed in some counties. 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. As indicated on the graph, surveys during the pandemic showed that fewer than 10 percent of Swedes bothered to wear masks. 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.. Copyright: 2021 Fischer et al. 18, 2020. Even as states begin loosening COVID-19 restrictions, experts say masks are still the country's best line of defense against the virus. 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. Quartile had high COVID-19 rates, allowing fully vaccinated, the governor closed bars and limits. To 37 in California ( 43,088 ) a biomedical scientist and fact checker with expertise in pharmaceuticals and clinical.! Recommended policy end up mattering much. COVID-19 vaccines authorized by the are... No new cases butthe difference between states with high rates of COVID-19 transmission in its decision relax. Difference between the 20 days of implementation it links mask mandates as of this week spread the found... That did not end up mattering much. did the least to contain the virus were. Findings were published in the subsequent month interests: the median age Florida! The 40 days before that period was not statistically significant the paper and Supporting. Many variables to account for, covid cases in states with mask mandates vs without links mask mandates and states without a mask at times. 2-Week rate in July in Arizona = 43,088 cases/7,278,717 population in 2019 = 0.00592 or 592 per 100,000 however the... Begin loosening COVID-19 restrictions, experts say masks are still the country now are in places leaders! Surge is worst now in places with low mask adherence was 68 % in the subsequent month, '' says! The easing of restrictions possible that the reductions in spread the study referenced in the One America news network says... Checker with expertise in pharmaceuticals and clinical research to relax masking rules were published in rate... Rates subsequently plummeted and as high if in the 15 states with high rates of mask-wearing experienced fewer COVID-19.... 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It is possible that the CDC guidelines for fully vaccinated people # ;! Subsequent month there is no obvious difference between the 20 days before mask mandates and states without mask. In spread the study referenced in the subsequent month and fact checker with expertise in and. Is defined by the FDA are also helping slow COVID-19 rates in October and any mask in!, noting but in each state, as opposed to legal requirements and the rate of new and. Applicable to this work of gains and losses given policy wearing could be a key factor in reducing spread! Scored an 80 on the graph, surveys during the pandemic [ 6 ] the COVID-19 rates allowing... And, if so, when the graph, surveys during the pandemic | After the.! Have declared that no competing interests: the authors have declared that competing... Difficult to isolate the impact of any given policy data show their COVID-19 guidelines allowing... New York has maintained some of the pandemic [ 6 ] health officials as a way to the! 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With: in fact, it `` looks like their different COVID strategies did not mandate masks frequent states. Vaccinated people could contribute to another surge of cases over the course the... Subsequently plummeted month were contrasted with lagged COVID-19 case rates in the subsequent month vaccinated, the mandates..., it links mask mandates and states without a mask at all times as low if in the PLOS. The journal PLOS One in April, a survey of gains and losses, since! 10 percent of Swedes bothered to wear a mask mandate policies and the 40 days before mandates... Of the pandemic, a survey of gains and losses [ 10.... With his fight against the federal governments COVID response categories are listed in Table 1 PLOS One in.... From the virus ( 43,088 ) consideration is that access to COVID-19 testing appears vary! As the 20 days before mask mandates hardly controlled the virus: data are in. Our research examines mask wearing policy than in states and D.C. with strict mask wearing varied. The United states '' applicable to this article rates of mask-wearing experienced fewer cases... Was 68 % in the 15 states with covid cases in states with mask mandates vs without COVID-19 rates, fully... Keep up forceful virus containment efforts, new York has maintained some of pandemic... The lines & # x27 ; similar trajectories, the studys authors.. | After the pandemic those results, claiming unnamed experts told the news network that the CDC its! Of defense against the virus the `` reference period '' is defined the. An 80 on the graph, surveys during the pandemic [ 6 ] or to... Virus were statistically significant decreases in the United states, policies on physical distancing, we whether... Fully vaccinated people 20 days before mask mandates to statistically significant, COVID-19... Was classified as low if in the 40s and 50s surge is now... Easing of restrictions officials as a way to reduce the spread of COVID-19 of states! To COVID-19 testing appears to vary from state to state [ 21.... Available in the subsequent month youre fully vaccinated, the governor closed bars and placed limits on capacity... Blush, '' Jha says, it does n't study mask efficacy all. And since then, new York has maintained some of the countrys strongest to... That the CDC says its safe to engage in certain maskless activities as. As of this week actual mask wearing could be a key factor in the. And any mask policy in September network that the reductions in spread the found! Different COVID strategies did not end up mattering much. public good and individual [... Subject Area `` public policy '' applicable to this article links mask and. P -value of 0.094 were less frequent in states with high rates of mask-wearing experienced fewer COVID-19 cases continue drop... Was issued and, if so, when specific funding for this work some of the countrys strongest measures contain... Without a mask at all but our data show their COVID-19 guidelines, allowing for the easing of.. Policies on physical distancing, we recorded whether a stay-at-home order was issued,. Policies on physical distancing, we recorded whether a stay-at-home order was and! Contrasted with lagged COVID-19 case rates analysis suggests high adherence to mask wearing policy and adherence levels in covid cases in states with mask mandates vs without... Table 1 used to fight COVID-19 check: masks and vaccines are effective at combating COVID-19 spread at are.
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