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Vanderbilt Study: TN counties without mask requirements have higher COVID-19 death toll per capita

According to a new study, TN counties that have mask requirements have lower death rates due to COVID-19, in comparison to areas that do not have mask requirements.

TENNESSEE, USA — According to a new study conducted by Vanderbilt's Department of Health Policy, Tennessee counties that have mask requirements have lower death rates due to COVID-19, in comparison to areas that do not have mask requirements. 

"We have a growing body of evidence that shows us very clearly that masks work," said Dr. Melissa McPheeters, research professor and co-author. "We have lab-based evidence, we have epidemiologic evidence in a community, we have population-level evidence, and now we have Tennessee-specific evidence that shows us not only did masks work to reduce hospitalizations, which we’ve shown before, but mask mandates also work to reduce deaths."

Director of the Vanderbilt Center for Health Economic Modeling John Graves found Tennessee counties that started mask requirements earlier began seeing a decline by late July, as seen in the graph below. 

Credit: Vanderbilt

Whereas, counties that later began mask requirements saw declines in August and September, according to the study. 

Additionally, counties that chose not to have mask requirements at all, still continue to see a rise in COVID-19 deaths, researchers found. 

Credit: Vanderbilt

“This analysis shows that strategies, including but not limited to masking while in contact with others, can have real impact on people’s lives,” said Dr. John Graves, director of the center. “Mask mandates are associated with greater mask wearing and other behaviors like limiting close contacts with others, and the combined impact is clear and substantial.” 

According to the study, Tennessee's current view of COVID-19 deaths only represents a clear picture of deaths through the first week of October due to data lags. 

As of Nov. 10, the study found 63% of the state’s residents lived in areas where a mask is required, while the remaining 37% lived in an area where masks were never required (8%) or lived in areas where mask requirements expired. 

In the weeks after the mask requirements were put in place, researchers found there was a sharp decline in deaths per 100,000 population in areas where masks were requirement, versus areas where masks were never required. 

“As of the first week of October, there were more than four deaths per 100,000 population in areas where masks were never required and near or below two deaths per 100,000 in areas that adopted a mask requirement over the summer,” said Melinda Buntin of Vanderbilt's Department of Health Policy.

Research from Carnegie Mellon University reports, as of Nov. 5, 80% of Tennesseans were reporting that they are wearing masks.  

The virus also is deceptive, and some may develop a false sense of security about it, McPheeters said. Because carriers often are asymptomatic, they may think they pose no threat, so they may be less inclined to wear a mask. 

“Individuals may not understand the risk of exposure to friends and family and may ‘let down their guard’ in situations where they are meeting in small groups with close contacts,” the researchers concluded. “Mask ordinances demonstrate leadership by sending a clear signal that behavior must change to mitigate spread of the virus.” 


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