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There Is Little Evidence That Mask Mandates Had an Important Impact During the Omicron Surge
"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. 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. 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. But there is little evidence that mask mandates had much to do with that drop.Nationwide, according to the New York Times database, the seven-day average of daily new cases rose sharply from mid-December to January 17 and has fallen just as sharply since then, which is consistent with the experience in other countries after omicron emerged. The same basic pattern was seen in nearly every state. Overall, there is no obvious difference between states with mask mandates and states without them.
Ashish Jha, dean of Brown University's School of Public Health, notes that the graph for California, which required masks in indoor public settings beginning on December 15, is "strikingly similar" to the graph for Florida, which had no mask mandates. He adds that the two states "had nearly identical infection rates."
That second observation requires a caveat, since testing rates affect the number of cases that are recorded. 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. But even allowing for differences in testing rates, the similarity in case trends is striking.
"At first blush," Jha says, it "looks like their different COVID strategies did not end up mattering much." 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.
If Florida's case numbers understate the true number of infections more than California's do, that could partially explain the difference in COVID-19 deaths per capita. So could age demographics: The median age of Florida's population is 42.5, compared to 37 in California. Jha thinks vaccination rates are another important factor: While "only 59% of eligible Florida seniors have gotten boosted," he notes, the rate for California is 70 percent.
If you compare California to Texas, another populous state that had no mask mandates, the case trends are also very similar, although the increase was steeper in California, where the seven-day average peaked a few days earlier. 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.
"Masks have been the most visible part of America's pandemic response, but one of the least consequential," science journalist Faye Flam writes in a Bloomberg Opinion essay. "The states with mask mandates haven't fared significantly better than the 35 states that didn't impose them during the omicron wave. 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. There's little evidence that mask mandates are the primary reason the pandemic waves eventually fall—though much of the outrage over lifting mandates is based on that assumption. Many experts acknowledge that the rise and fall of waves is a bit of a mystery."
Laboratory studies indicate that masks, especially N95 respirators, can help reduce virus transmission. 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..."
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