#15,851
This past week the governors of both Texas and Mississippi announced plans to roll back mask mandates and re-open restaurants and other businesses (see tweet below) , and a number of other states have signaled their intentions to loosen pandemic restrictions as well.
The desire to return to some semblance of normalcy after a year of pandemic restrictions is both understandable and expected. The past 12 months have exacted a heavy toll on all of us. This urge is only increased by the approach of spring, economic hardships, and the recent reduction in COVID cases around the country.
But the trade off is we could lose the hard fought gains of the past few weeks, only to see a resurgence of COVID cases and deaths in the weeks and months to follow.
No one has a working crystal ball, and no one can say with certainty what will happen, but we've been down this road before and the results weren't pretty. Indoor dining at restaurants has been linked to increased COVID transmission and superspreader events, while mask mandates have been shown to reduce COVID cases.
Reversing either of these policies prematurely runs the risk of exacerbating the pandemic. Reversing both of them at the same time is a pretty big gamble.
While COVID cases and deaths have declined across much of the United States, we are beginning to see upticks again in Europe, and most notably Brazil, where new emerging variants are rampant. These same variants are already in the United States, and one - B.1.1.7 - is forecast to become dominant here in the next month or two.
We will obviously learn a lot more about the impact of reopening restaurants and repealing mask mandates in the months ahead - and while I'm hoping Texas and Mississippi are right - based on what we know now I won't be abandoning my facemask or going to a restaurant anytime soon.
On Friday the CDC published the following report on the impacts of mandatory mask wearing and opening restaurants to indoor dining on their MMWR site. I've only reproduced some excerpts, so follow the link to read it in its entirety.
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 1–December 31, 2020
Early Release / March 5, 2021 / 70
Gery P. Guy Jr., PhD1; Florence C. Lee, MPH1; Gregory Sunshine, JD1; Russell McCord, JD1; Mara Howard-Williams, JD2; Lyudmyla Kompaniyets, PhD1; Christopher Dunphy, PhD1; Maxim Gakh, JD3; Regen Weber1; Erin Sauber-Schatz, PhD1; John D. Omura, MD1; Greta M. Massetti, PhD1; CDC COVID-19 Response Team, Mitigation Policy Analysis Unit; CDC Public Health Law Program (View author affiliations)View suggested citation
Summary
What is already known about this topic?
Universal masking and avoiding nonessential indoor spaces are recommended to mitigate the spread of COVID-19.What is added by this report?Mandating masks was associated with a decrease in daily COVID-19 case and death growth rates within 20 days of implementation. Allowing on-premises restaurant dining was associated with an increase in daily COVID-19 case growth rates 41–100 days after implementation and an increase in daily death growth rates 61–100 days after implementation.What are the implications for public health practice?Mask mandates and restricting any on-premises dining at restaurants can help limit community transmission of COVID-19 and reduce case and death growth rates. These findings can inform public policies to reduce community spread of COVID-19.
CDC recommends a combination of evidence-based strategies to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 (1). Because the virus is transmitted predominantly by inhaling respiratory droplets from infected persons, universal mask use can help reduce transmission
- Starting in April, 39 states and the District of Columbia (DC) issued mask mandates in 2020. Reducing person-to-person interactions by avoiding nonessential shared spaces, such as restaurants, where interactions are typically unmasked and physical distancing (≥6 ft) is difficult to maintain, can also decrease transmission
- In March and April 2020, 49 states and DC prohibited any on-premises dining at restaurants, but by mid-June, all states and DC had lifted these restrictions.
To examine the association of state-issued mask mandates and allowing on-premises restaurant dining with COVID-19 cases and deaths during March 1–December 31, 2020, county-level data on mask mandates and restaurant reopenings were compared with county-level changes in COVID-19 case and death growth rates relative to the mandate implementation and reopening dates.
- Mask mandates were associated with decreases in daily COVID-19 case and death growth rates 1–20, 21–40, 41–60, 61–80, and 81–100 days after implementation.
- Allowing any on-premises dining at restaurants was associated with increases in daily COVID-19 case growth rates 41–60, 61–80, and 81–100 days after reopening, and increases in daily COVID-19 death growth rates 61–80 and 81–100 days after reopening.
Implementing mask mandates was associated with reduced SARS-CoV-2 transmission, whereas reopening restaurants for on-premises dining was associated with increased transmission. Policies that require universal mask use and restrict any on-premises restaurant dining are important components of a comprehensive strategy to reduce exposure to and transmission of SARS-CoV-2 (1). Such efforts are increasingly important given the emergence of highly transmissible SARS-CoV-2 variants in the United States (3,4).
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