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Association of Mask Mandates and COVID-19 Case Rates, Hospitalizations, and Deaths in Kansas

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

This study examined the association between mask mandates in Kansas counties and COVID-19 cases, hospitalizations, and deaths. The Kansas executive order that took effect on July 3 was adopted by only 15 counties, and 68 counties did not have a mandate through October. A second mask mandate order took effect on November 25, and 40 additional counties adopted it.

For this case-control study, data for the daily number of cases and deaths per county were from the New York Times1 and hospitalizations by county of residence were collected from the Kansas Department of Health and Environment2 (eMethods and eReferences in the Supplement). We adjusted the number of cases, hospitalizations, and deaths by each county’s 2019 population to obtain the rate per 100 000 and took a 7-day moving average of these variables. We refer to these population-adjusted rates as cases, hospitalizations, and deaths for the remainder of this report. This study was deemed not human subjects research by the University of Kansas institutional review board and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

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Article Information

Accepted for Publication: April 22, 2021.

Published: June 23, 2021. doi:10.1001/jamanetworkopen.2021.14514

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Ginther DK et al. JAMA Network Open.

Corresponding Author: Donna K. Ginther, PhD, Director, Institute for Policy & Social Research, University of Kansas, 1460 Jayhawk Blvd, 333 Snow Hall, Lawrence, KS 66045-7594 (dginther@ku.edu).

Author Contributions: Drs Ginther and Zambrana had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Obtained funding: Ginther.

Supervision: Ginther.

Conflict of Interest Disclosures: None reported.

Funding/Support: Drs Ginther and Zambrana are supported by a CARES Act Supplemental Award for University Centers Recipients (grant No. ED20DEN3070059) from the US Department of Commerce Economic Development Administration.

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank Laura Mussulman, MA, MPH, University of Kansas Medical Center, for collecting the hospitalization data. We thank Lindsay Jorgenson, MPH, MSW, University of Kansas Institute for Policy & Social Research, for the figure. We thank Carolyn Caine, AM, University of Kansas Institute for Policy & Social Research, for manuscript preparation and editorial assistance. These contributions were not compensated beyond employment.

References
1.
nyt-covid-19-bot. Coronavirus (Covid-19) Data in the United States. nytimes/covid-19-data. Updated May 17, 2021. Accessed on October 12, 2020. https://github.com/nytimes/covid-19-data
2.
Kansas Department of Health and Environment. COVID-19 Cases in Kansas. Updated May 17, 2021. Accessed May 18, 2021. https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas
3.
Kansas Health Institute. County official actions in response to COVID-19 as of December 9. Accessed May 18, 2021. https://www.khi.org/assets/uploads/news/15015/40830_table1sc.pdf
4.
Wooldridge  JM, .  Econometric Analysis of Cross Section and Panel Data. MIT Press; 2010.
5.
Van Dyke  ME , Rogers  TM , Pevzner  E ,  et al.  Trends in county-level COVID-19 incidence in counties with and without a mask mandate—Kansas, June 1–August 23, 2020.   Morb Mortal Wkly Rep. 2020;69(47):1777-1781. doi:10.15585/mmwr.mm6947e2Google ScholarCrossref
6.
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
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