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Mask Mandates, On-Premises Dining, and COVID-19

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Evidence-based prevention strategies can reduce the transmission of SARS-CoV-2, the virus that causes COVID-19. Consistent and correct use of masks can prevent SARS-CoV-2 transmission, which predominantly occurs through inhalation and other exposure to respiratory droplets from infected persons. Mask use is particularly important because presymptomatic and asymptomatic spread is responsible for nearly 60% of COVID-19 cases.1,2 Universal and proper masking results in substantial community benefits.2 To better leverage the prevention benefit of masks on community transmission, many states require that people wear a mask in public. As of March 1, 2021, 36 states and the District of Columbia had a mask mandate in effect.

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Article Information

Corresponding Author: Gery P. Guy Jr, PhD, MPH, CDC COVID-19 Response Team, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30329 (irm2@cdc.gov).

Published Online: April 1, 2021. doi:10.1001/jama.2021.5455

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

References
1.
Johansson  MA , Quandelacy  TM , Kada  S ,  et al.  SARS-CoV-2 transmission from people without COVID-19 symptoms.   JAMA Netw Open. 2021;4(1):e2035057. doi:10.1001/jamanetworkopen.2020.35057PubMedGoogle Scholar
2.
Honein  MA , Christie  A , Rose  DA ,  et al; CDC COVID-19 Response Team.  Summary of guidance for public health strategies to address high levels of community transmission of SARS-CoV-2 and related deaths, December 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(49):1860-1867. doi:10.15585/mmwr.mm6949e2PubMedGoogle ScholarCrossref
3.
Fisher  KA , Tenforde  MW , Feldstein  LR ,  et al; IVY Network Investigators; CDC COVID-19 Response Team.  Community and close contact exposures associated with COVID-19 among symptomatic adults ≥18 years in 11 outpatient health care facilities—United States, July 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(36):1258-1264. doi:10.15585/mmwr.mm6936a5PubMedGoogle ScholarCrossref
4.
Guy  GP  Jr , Lee  FC , Sunshine  G ,  et al.  Association of state-issued mask mandates and allowing on-premises restaurant dining with county-level COVID-19 case and death growth rates—United States, March 1–December 31, 2020.   MMWR Morb Mortal Wkly Rep. 2021;70(10);350-354. doi:10.15585/mmwr.mm7010e3PubMedGoogle ScholarCrossref
5.
Lyu  W , Wehby  GL .  Community use of face masks and COVID-19: evidence from a natural experiment of state mandates in the US.   Health Aff (Millwood). 2020;39(8):1419-1425. doi:10.1377/hlthaff.2020.00818PubMedGoogle ScholarCrossref
6.
Centers for Disease Control and Prevention. COVID-19: what to do if you are sick. Updated March 17, 2021. Accessed March 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
7.
Kaufman  BG , Whitaker  R , Mahendraratnam  N , Smith  VA , McClellan  MB .  Comparing associations of state reopening strategies with COVID-19 burden.   J Gen Intern Med. 2020;35(12):3627-3634. doi:10.1007/s11606-020-06277-0PubMedGoogle ScholarCrossref
8.
Centers for Disease Control and Prevention. Science brief: SARS-CoV-2 and potential airborne transmission. Updated October 5, 2020. Accessed March 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/more/scientific-brief-sars-cov-2.html
9.
Kratzel  A , Todt  D , V’kovski  P ,  et al.  Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols.   Emerg Infect Dis. 2020;26(7):1592-1595. doi:10.3201/eid2607.200915PubMedGoogle ScholarCrossref
10.
Centers for Disease Control and Prevention. COVID-19: variants of the virus that causes COVID-19. Updated February 17, 2021. Accessed March 25, 2021. https://www.cdc.gov/coronavirus/2019-ncov/variants/index.html
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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