LAUSR

This study compared coronavirus disease 2019 case load, hospital bed use, and deaths before and after implementation of the Texas mask mandate (executive order GA-29). The preorder period was from June 19 to July 2, 2020 and the postorder period was July 17 to September 17, 2020, a period of particularly rapid virus spread. The authors performed both adjusted and unadjusted analyses to compare case load, hospitalization rates, or mortality related to coronavirus disease 2019. 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.