Mask adherence and rate of COVID-19 across the United States

Abstract

Mask wearing has been advocated by public health officials as a way to reduce the spread of COVID-19. In the United States, policies on mask wearing have varied from state to state over the course of the pandemic. Even as more and more states encourage or even mandate mask wearing, many citizens still resist the notion. Our research examines mask wearing policy and adherence in association with COVID-19 case rates. 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. 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). Monthly COVID-19 case rates (number of cases per capita over two weeks) >200 per 100,000 residents were considered high. Fourteen of the 15 states with no mask wearing policy for the general public through September reported a high COVID-19 rate. Of the 8 states with at least 75% mask adherence, none reported a high COVID-19 rate. 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. 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. Our analysis suggests high adherence to mask wearing could be a key factor in reducing the spread of COVID-19. This association between high mask adherence and reduced COVID-19 rates should influence policy makers and public health officials to focus on ways to improve mask adherence across the population in order to mitigate the spread of COVID-19.

The benefits of coronavirus suppression: A cost-benefit analysis of the response to the first wave of COVID-19 in the United States

“…Importantly, the CDC did not recommend the general public wear masks until April 2020 [ 47 ], after the publication of Ferguson et al [ 2 ]. Mask wearing has been shown to be an effective NPI for slowing community spread of COVID-19 [ 48 ], and adherence to policies or health guidance to wear masks has been shown to correlate with reduced COVID-19 case rates [ 49 ]. In addition, compliance with quarantine and social distancing is also treated as a constant.…”

Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults

“…These recommendations are supported by recent research findings showing that mask usage is effective in reducing community transmission of COVID-19 [ 3 – 8 ] and may be most effective when used in conjunction with other CDC guidelines [ 9 ]. However, despite the evidence for the efficacy of these behaviors in limiting COVID-19, adherence has been inconsistent and variable [ 10 , 11 ].…”

Maintaining mask momentum in transplant recipients

“…The use of facemasks is a simple and inexpensive intervention that decreases spread of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) 1 , 2 , 3 and other respiratory virus infections (RVIs). Hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients experience a significant burden of disease due to these pathogens, constituting a major risk to their health.…”