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Public Health Experts Slam States’ Moves to Ditch Masks

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The Republican governors of Texas and Mississippi announced Tuesday they would lift statewide mask mandates and fully reopen businesses, following similar steps by Republican governors of Montana, Iowa, and North Dakota.

The easing of restrictions flies in the face of scientific evidence that masks and other types of protective behaviors like social distancing curb new cases and reduce deaths.

The moves drew sharp criticism from President Joe Biden, a democrat, who has emphasized the importance of face masks in controlling the pandemic.

Biden has asked all Americans to use masks in public for the first 100 days in office. He has required them in federal buildings. Under his administration, the CDC ordered that masks be worn on all types of public transportation. And next week, the department of Health and Human Services will begin shipping 25 million masks to community centers and food banks to help defray the costs of purchasing them for the neediest Americans.


I think it’s a big mistake,” Biden said in response to reporters’ questions yesterday. While the nation is making progress with vaccines, “the last thing we need is Neanderthal thinking that in the meantime, everything’s fine, take your mask off and forget it. It still matters,” he said.

In response to the announcement, major retailers including Target, Kroger, Macy’s and Starbucks said they would continue to require masks in their stores. Some county health departments, including the one in Lewis and Clark, home to Montana’s state capital, Helena, have said they would still require masks locally.

Though COVID cases in the U.S. have fallen substantially from a January peak of nearly a quarter of a million new infections a day, states are still reporting roughly 60,000 daily cases and more than 2,000 daily deaths.

Texas is lifting mask requirements even as its case counts and the rate of transmission of the virus remains high, according to the COVID Act Now Website. On Tuesday, a team of researchers in Houston announced that city had seen cases of every major COVID variant of concern over the last eight weeks and that those cases represented community spread.

Other states lifting mask orders are trending better, but on Wednesday, CDC Director Rochelle Walensky, MD, said they are not out of the woods, either.

“Please hear me clearly: At this level of cases, with variants spreading, we stand to completely lose the hard-earned ground we have gained,” she said in a press briefing. “These variants are a very real threat to our people and our progress. Now is not the time to relax the critical safeguards that we know can stop the spread of COVID-19 in our communities, not when we are so close,” she said.

Speaking at a Mexican restaurant in Lubbock on Tuesday, Governor Greg Abbott said the success of the vaccines along with falling case counts and declines in hospitalizations made it clear that state mandates were no longer needed.

“Removing state mandates does not end personal responsibility,” he said. “Personal vigilance to follow the safe standards is still needed.”


The problem with that stance, say researchers, is that it’s not enough. The benefit of masks depends on everybody wearing them. Studies have shown that requiring the use of masks makes a difference.

“There’s just overwhelming science on this,” said Jeffrey Levi, PhD, professor of health policy and management at the Georgetown University School of Public Health. “When mask mandates are imposed, infection rates go down and when mask mandates are lifted, infection rates go up. I mean, we’ve had enough natural experiments over the last year for us to see the impact that this has,” Levi said.

“This is a tragic politicization of our response to the pandemic and the consequences will not be limited to those states,” Levi said.

A study published last month by scientists at the CDC compared the rate of growth in COVID cases across more than 3,000 U.S. counties between June and October of last year. Those with mask mandates were 43% less likely to see a rapid growth in their infections compared to those that didn’t have them.

“Mask mandates can play a substantial role in preventing COVID-19 and could be especially important for persons who are required to work in-person, including essential workers and those working in crowded conditions, particularly in nonmetropolitan areas,” the study authors wrote.

A separate study by the same team found counties with mask mandates had slower growth in their hospitalization rates compared to counties that didn’t require masks.

Another study published last month found that counties that waited six months to implement mask mandates, or failed to implement them at all, wound up with twice as many cases as those that issued mask orders within a month of the CDC guidance to wear masks on April 3, 2020.

“Masks work, mask mandates work, and every piece of data we have from public health strongly indicates that ending a mask mandate prematurely will decrease mass use and risk increased spread and increased death,” said Tom Frieden, MD, former director of the CDC and president and CEO of the nonprofit Resolve to Save Lives.

Public health officials appealed to Americans and local leaders to continue to support the use of masks.

“This is not forever,” said Andy Slavitt, Senior Advisor for the White House COVID Response Team, in a press briefing. “We know that it can save tens of thousands of lives if people do this. And we strongly encourage people to continue to wear masks, and mayors, governors, and others, recognizing that they have difficult decisions to make to keep the course.”

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