Advocates for Evidence-Based Health Policy Speakers
“Do You Feel in Charge?”
Despite the COVID-19 pandemic being a national crisis, the United States has had extreme difficulty coordinating an effective national response. The country’s fragmented and contentious approach to public mask wearing has made a political problem out of a public health crisis. “Anti-maskers” have vocally resisted masks, citing personal liberties and claiming fake news despite the release of scientific studies demonstrating that masks prevent the spread of COVID-19. So why have mask mandates, a health and safety measure created for the benefit of the public good, been so divisive? The violent distrust and misunderstanding of science during this pandemic are a harbinger, if not manifestation, of the tenuous state of public health in the United States.
A recent study by Lyu and Wehby sought to model how state mask mandates affected the change in daily growth rates of COVID-19 cases. Controlling for pre-event trends in COVID-19 rates before mask mandates were issued, population density, socioeconomic and demographic factors, and the impact of social distancing and mitigation policies, their model showed that mask mandates were responsible for a greater decline in daily COVID-19 growth rates when compared to states without a mask mandate. The authors emphasized that mask mandates serve as a tool in reducing COVID-19 cases but are no substitute for additional social distancing measures. Ultimately, the authors provide statistical support that validates mask mandates as an effective virus-controlling policy to introduce during this pandemic.
Perhaps the most important takeaway is that there is no uniformity of policy—that the “language on enforcement and penalties for noncompliance…vary”. The heterogeneity of mask mandate language not just reflects the United States’ fragmented federalist system but also the extent to which partisan politics has infiltrated public health. If policymakers weren’t already, they must now seriously consider partisan politics in their public health efforts. The great American political divide, exacerbated by the Trump Administration’s response to the pandemic, is apparent in the nation’s response to mask mandates. This study should be a reminder that a policy’s greatest impact can only be achieved with widespread social acceptance and public adherence.
This Health Policy Journal Club review is written by Caroline Bay as part of our collaboration with the Health Policy Journal Club at Baylor College of Medicine where she is a medical student.
Abstract
State policies mandating public or community use of face masks or covers in mitigating the spread of coronavirus disease 2019 (COVID-19) are hotly contested. This study provides evidence from a natural experiment on the effects of state government mandates for face mask use in public issued by fifteen states plus Washington, D.C., between April 8 and May 15, 2020. The research design is an event study examining changes in the daily county-level COVID-19 growth rates between March 31 and May 22, 2020. Mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0 percentage points in 1-5, 6-10, 11-15, 16-20, and 21 or more days after state face mask orders were signed, respectively. Estimates suggest that as a result of the implementation of these mandates, more than 200,000 COVID-19 cases were averted by May 22, 2020. The findings suggest that requiring face mask use in public could help in mitigating the spread of COVID-19.
PMID: 32543923
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