Decline in COVID-19 Hospitalization Growth Rates Associated with Statewide Mask Mandates - 10 States, March-October 2020

Abstract

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is transmitted predominantly by respiratory droplets generated when infected persons cough, sneeze, spit, sing, talk, or breathe. CDC recommends community use of face masks to prevent transmission of SARS-CoV-2 (1). As of October 22, 2020, statewide mask mandates were in effect in 33 states and the District of Columbia (2). This study examined whether implementation of statewide mask mandates was associated with COVID-19-associated hospitalization growth rates among different age groups in 10 sites participating in the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) in states that issued statewide mask mandates during March 1-October 17, 2020. Regression analysis demonstrated that weekly hospitalization growth rates declined by 2.9 percentage points (95% confidence interval [CI] = 0.3-5.5) among adults aged 40-64 years during the first 2 weeks after implementing statewide mask mandates. After mask mandates had been implemented for ≥3 weeks, hospitalization growth rates declined by 5.5 percentage points among persons aged 18-39 years (95% CI = 0.6-10.4) and those aged 40-64 years (95% CI = 0.8-10.2). Statewide mask mandates might be associated with reductions in SARS-CoV-2 transmission and might contribute to reductions in COVID-19 hospitalization growth rates, compared with growth rates during <4 weeks before implementation of the mandate and the implementation week. Mask-wearing is a component of a multipronged strategy to decrease exposure to and transmission of SARS-CoV-2 and reduce strain on the health care system, with likely direct effects on COVID-19 morbidity and associated mortality.

FIGURE

Estimates of association between implementation of statewide mask mandates and laboratory-confirmed COVID-19–associated hospitalization growth rates,^,†,§ by age group — 10 COVID-19–Associated Hospitalization Surveillance Network sites with statewide mask mandates, March–October 2020 Abbreviation: COVID-19 = coronavirus disease 2019. * With error bars indicating 95% confidence intervals. ^† Relative to <4 weeks before implementation week (reference period, which includes the implementation week). ^§ Reported numbers are coefficients from the regression models, which controlled state, age group, time (week), and statewide closing and reopening. ^¶ California, Colorado, Connecticut, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, and Oregon.