Original Article

Analysis of the Effects of a Texas State-Wide Mask Mandate (Executive Order GA-29) on Case Load, Hospitalizations, and Mortality

Authors: Michael D. April, MD, DPhil, Jason F. Naylor, PA-C, Brit Long, MD

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hospitalizations, ventilator use, and deaths. Because of concerns for resource utilization and surges in hospital capacity use, Texas Executive Order GA-29 required statewide mask wear beginning July 3, 2020. Our objective was to compare COVID-19 case load, hospital bed use, and deaths before and after implementation of this mask order.

Methods: This was a retrospective observational study using publicly reported statewide data to perform a mixed-methods interrupted time series analysis. We compared outcomes before and after the statewide mask wear mandate per Executive Order GA-29. The preorder period was from June 19 to July 2, 2020. The postorder period was July 17 to September 17, 2020. Outcomes included daily COVID-19 case load, hospitalizations, and mortality.

Results: The daily case load before the mask order per 100,000 individuals was 187.5 (95% confidence interval [CI] 157.0–217.0) versus 200.7 (95% CI 179.8–221.6) after GA-29. The number of daily hospitalized patients with COVID-19 was 171.4 (95% CI 143.8–199.0) before GA-29 versus 225.1 (95% CI 202.9–247.3) after. Daily mortality was 2.4 (95% CI 1.9–2.9) before GA-29 versus 5.2 (95% CI 4.6–5.8). There was no material impact on our results after controlling for economic activity.

Conclusions: In both adjusted and unadjusted analyses, we were unable to detect a reduction in case load, hospitalization rates, or mortality associated with the implementation of an executive order requiring a statewide mask order. These results suggest that during a period of rapid virus spread, additional public health measures may be necessary to mitigate transmission at the population level.
Posted in: Infectious Disease143

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