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Face mask
As we’re all very well aware, last month Governor Greg Abbott issued a statewide mask mandate. COVID-19 cases were spiking. It was a last-ditch effort to avoid another shutdown.
So, a month later, the question we’re all asking is, “Are masks working?”
According to Dr. Rajesh Nandy, a professor of biostatistics and epidemiology at UNT Health Science Center at Fort Worth, who's published a series of studies comparing national and local data regarding mask mandates — yes, they are. From what he’s seen, cases in Texas have stabilized since Abbott issued the mask mandate, and they may even be declining, but he’d still like to see what the next couple weeks bring.
We asked Dr. Nandy a few questions about his studies and the positive impact of masks locally.
FW: Can you give us some background on your studies?
RN: I published a report, and at the time, there was no mandate in Texas or even in Dallas or Tarrant County because there was some indication that the number of new cases were on the rise. So I looked at the rest of the country to see which counties at that time had mandates and how they were doing compared to the counties that did not have a mandate. I found that the counties with mandates were doing a lot better compared to the counties that did not have a mandate.
I looked at the counties that had the largest number of COVID positive cases, and it was about 150 counties across the nation. That was my starting point, studying the efficacy of mask mandates. I indicated in that study that it may be useful to have a similar mandate here. After that, there were local mandates issued in Dallas and Tarrant County.
That was that third week of June. Then I started to study the efficacy of those [Dallas and Tarrant County] mandates in early July. At that time, the state mandate was issued, but it was too early to do a study of the effect of the state mandate because there is typically a two-week lag before you could see any effect, good or bad. But it was kind of a long enough time period since the county mandates were issued.
There was enough evidence that the local mandates were actually quite effective. At that time, it was too early to see whether the number of cases were declining. But we did see evidence that the number of cases indeed stabilized, and I think that study prompted the governor at the state level to promote his mandate.
In the next report, we were trying to see if the state mandate worked. In that study, overall, definitely, if we look all across the state combined, there is clear evidence that the overall number of cases did stabilize. And in fact, there are some signs that they're starting to decline. However, there are some specific counties where the number of cases still needs improving, and that indicates that maybe some more attention needs to be paid for those counties.
FW: As you continue studying the situation, are you seeing cases continue to stabilize or go down?
RN: Yes. The decline is slow, but it certainly is not going up. That's for sure. I would say that we see some evidence of a decline, but again very slow decline. So we probably need to watch out for another week or a couple of weeks to say more definitively that the decline is real.
There is a lot of day-to-day variation, and also, the state changed some criteria in terms of how they define COVID positive or COVID-related deaths. These are issues that we're having with some changes that took place. That's why it's hard for me to conclusively say that there is clear evidence of decline. There is certainly some evidence of decline. But monitoring it for another week or two will give us a clear answer to that question.
And to that I'd also like to add, just like there is a lag in the number of new cases dropping off, there is another lag in observing the daily fatalities. So that's another couple of weeks. What was happening at the end of July, even though the number of new cases was stabilizing or even declining, the number of daily fatalities were still up.
I predicted that the peak would be reached at the beginning of August in terms of fatality count. We are pretty much there. Again, it's hard to say definitively if we have reached the peak or not because there are day-to-day variations, but we will know that soon if we can see a decline in the number of daily fatalities as well.
FW: Do your studies indicate that mask-wearing is effective enough that people can continue day-to-day activities and avoid another shutdown?
RN: Well, that's a tricky question to answer. It depends on your perspective. I was kind of looking at it more from the hospitalization perspective. My biggest concern was at the end of June, because the case numbers were rising so sharply, that very soon our hospital system would be running at full capacity or over maximum capacity. That can be catastrophic because, so far, locally, people were getting the care they needed when they got COVID or another disease. It's not just COVID. Once the hospital is running at full or above capacity, then all patients would be at risk of not getting the treatment they need. So that was my biggest concern. At that time, the hospital system was still able to handle the number of cases that we were having. So from that perspective, because the number of new cases have stabilized or even declining, I would be comfortable to say that, as long as people are observing the social distancing guidelines, we probably don't need more aggressive measures like another lockdown. I think overall, as long as people are vigilant, in terms of observing the social distancing guidelines and wearing masks, we now have a clear path forward. So whether we stick with that path, that's kind of up to us. But my sense by looking at the data is that if we keep doing what we are doing right now, we are in the right trajectory.
FW: Were state officials receptive to your data? Do your findings encourage Governor Abbott to continue the mask mandate?
RN: My understanding is that initially, he was reluctant to issue a mask mandate, but eventually, he was convinced that it would be helpful.
Once I published the study, which showed that the mandates locally in Tarrant and Dallas County seemed to be quite effective, he promoted that study to promote the mask usage statewide. So he is on board in terms of efficacy of mask usage. But it seems that he has some challenges in terms of implementing it properly across the state. That's my understanding.
FW: Is there anything else that people should know about your study or about wearing masks in general that you've observed?
RN: I think it's fairly simple. One of the reasons I focused on masks, apart from the inconvenience that it causes, is that it's a very low cost, easy thing people can do. So I would encourage people to continue to do that. And again, the data speaks for itself. One can argue that how can you specifically prove that it is the masks that are causing it — that would be a legitimate point. It's hard to prove causality like that. However, we do see that there is enough data that shows in the right time frame that we expected to see. Two weeks after the masks mandates, we're seeing a positive trend. It's not the only thing that happened, but it definitely contributed to the positive trend that we're observing.
FW: Is there any other data we should look at?
RN: Right now, we have to look at the fatality counts to see if that is going down as we expect. That's something to take note of because that number rose to a pretty high value. Also, we have to be extremely vigilant just to make sure that we don't let the number of new cases go up again.
