{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:12:41Z","timestamp":1789729961944,"version":"4.0.1"},"reference-count":112,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>We extend previous studies on the impact of masks on COVID-19 outcomes by investigating an unprecedented breadth and depth of health outcomes, geographical resolutions, types of mask mandates, early versus later waves and controlling for other government interventions, mobility testing rate and weather. We show that mask mandates are associated with a statistically significant decrease in new cases (-3.55 per 100K), deaths (-0.13 per 100K), and the proportion of hospital admissions (-2.38 percentage points) up to 40 days after the introduction of mask mandates both at the state and county level. These effects are large, corresponding to 14% of the highest recorded number of cases, 13% of deaths, and 7% of admission proportion. We also find that mask mandates are linked to a 23.4 percentage point increase in mask adherence in four diverse states. Given the recent lifting of mandates, we estimate that the ending of mask mandates in these states is associated with a decrease of -3.19 percentage points in mask adherence and 12 per 100K (13% of the highest recorded number) of daily new cases with no significant effect on hospitalizations and deaths. Lastly, using a large novel survey dataset of 847 thousand responses in 69 countries, we introduce the novel results that community mask adherence and community attitudes towards masks are associated with a reduction in COVID-19 cases and deaths. Our results have policy implications for reinforcing the need to maintain and encourage mask-wearing by the public, especially in light of some states starting to remove their mask mandates.<\/jats:p>","DOI":"10.1371\/journal.pone.0252315","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T13:27:01Z","timestamp":1624454821000},"page":"e0252315","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":83,"title":["Association between COVID-19 outcomes and mask mandates, adherence, and attitudes"],"prefix":"10.1371","volume":"16","author":[{"given":"Dhaval","family":"Adjodah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Dinakar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-1929","authenticated-orcid":true,"given":"Matteo","family":"Chinazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel P.","family":"Fraiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Pentland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Bates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Staller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Vespignani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":true,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"issue":"5","key":"pone.0252315.ref001","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S1473-3099(20)30120-1","article-title":"An interactive web-based dashboard to track COVID-19 in real time","volume":"20","author":"E Dong","year":"2020","journal-title":"The Lancet infectious diseases"},{"issue":"4","key":"pone.0252315.ref002","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2014564118","article-title":"An evidence review of face masks against COVID-19","volume":"118","author":"J Howard","year":"2021","journal-title":"Proceedings of the National Academy of Sciences"},{"key":"pone.0252315.ref003","doi-asserted-by":"crossref","first-page":"101751","DOI":"10.1016\/j.tmaid.2020.101751","article-title":"Efficacy of face mask in preventing respiratory virus transmission: a systematic review and meta-analysis","author":"M Liang","year":"2020","journal-title":"Travel Medicine and Infectious Disease"},{"key":"pone.0252315.ref004","article-title":"Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis","author":"DK Chu","year":"2020","journal-title":"The Lancet"},{"key":"pone.0252315.ref005","article-title":"Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2","author":"CDC","year":"2020","journal-title":"Science Briefs"},{"key":"pone.0252315.ref006","article-title":"Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks","author":"CT Leffler","year":"2020","journal-title":"medRxiv"},{"issue":"7","key":"pone.0252315.ref007","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1001\/jama.2020.12897","article-title":"Association between universal masking in a health care system and SARS-CoV-2 positivity among health care workers","volume":"324","author":"X Wang","year":"2020","journal-title":"JAMA"},{"issue":"8","key":"pone.0252315.ref008","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1377\/hlthaff.2020.00818","article-title":"Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US: Study examines impact on COVID-19 growth rates associated with state government mandates requiring face mask use in public","volume":"39","author":"W Lyu","year":"2020","journal-title":"Health affairs"},{"key":"pone.0252315.ref009","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm6947e2","article-title":"Trends in County-Level COVID-19 Incidence in Counties With and Without a Mask Mandate\u2014 Kansas, June 1\u2013August 23, 2020","volume":"69","author":"ME Van Dyke","year":"2020","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"key":"pone.0252315.ref010","doi-asserted-by":"crossref","unstructured":"Mitze T, Kosfeld R, Rode J, W\u00e4lde K. 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