Before I start, I always wear a mask indoors when at a public place and currently don’t eat inside restaurants. Stating that so people don’t think I am anti-mask, anti-science.
I find it interesting that the non-mandated counties have roughly 30% less prevalence than the mask mandated counties. Now that data is back from August and things have definitely changed so it’s quite possible those non mask mandated counties have caught and surpassed the other counties. Good case study for everyone to keep following.
On the Sweden thing, most of the people I heard from didn’t say anything about Sweden and masks wearing, it was more Sweden and keeping the economy open as much as possible.
hopefully people can hunker down as much as possible for the next three months, government can get economic money into the system, and we can all open up fully late spring.
Lockdowns are problematic. I think short term lockdowns (on the order of two weeks or so) were probably an effective idea early in the process to slow down rate of spread (e.g., when New York's hospitals were being overwhelmed).
However there is a difference between total lockdown and restrictions - e.g., no indoor dining vs "everyone stays at home and only allowable trips are to the grocery store, etc.". I tire of the extremist response among many that "masks = total lockdown = communist state" that is sent out by many on the anti-mask side. (see the anti maskers that had planned to shop at HyVee a couple weeks ago)
The irony is that masking is used to PREVENT total lockdowns. I agree we cannot sustain a total lockdown (as in one where no one goes anywhere, with the exception of designated people that deliver food/necessary prescriptions to everyone's door - that would be total lockdown).
I think the fact the non-mask counties started with approximately the same positive rate (4 to 3) then didn't increase as much (up to 6 instead of up to 17) prior to the mask mandate counties mandating things is primarily due to population density. The 24 counties that installed mandates represent ~2/3 of the population. Thus population density is much lower in the other 81 counties - leading to what I'd call "natural social distancing". There is a reason the very rural ranching counties of Nebraska filled in last with positive cases and deaths (several Nebraska counties still don't have any deaths due to COVID).
However, once it starts to reach a certain point, then the limited close contacts outside your normal bubble (e.g., the rancher goes to town to get some supplies) starts to increase the rate and we end up with them still increasing slightly from June to July, then increasing at a higher rate from July to August (when they went from 6 to 12 - doubling the number). This is a core of exponential growth. It is altered somewhat by being exponential growth separated by "islands".
Of course, this type of behavior was pretty much predicted by all medical experts I heard during the April/May/June time frame - that it wasn't in rural areas yet, but unless they were vigilant it would be and it would possibly be worse, since they don't have the resources to handle it as well as the large cities.
To me what it shows is that pure social distancing without any other protection works well - sort of a duh thing that has been used since some of the small pox and typhoid outbreaks in the old West. However, if you don't also augment, with things like masks and have any interactions, eventually it will spread to even sparsely populated rural areas.
When the data cuts off, the rural counties were still increasing, while the populated counties had started to decrease (at least until Labor Day hit and people repeated the same errors from Memorial Day and 4th of July). I think it is interesting that the 24 counties reduced their rate despite the 4th of July holiday while the 81 counties doubled over the same period. We can't be sure it is entirely seeded by close 4th of July social gatherings, but it would be interesting to overlay holidays with surges over the next month - when the initial exposure occurs and the next month when 2nd or 3rd generation exposures (from that holiday) are happening.
I was interested in seeing how the cases had evolved across the Nebraska and some of its neighbors - South Dakota, North Dakota, Wyoming, Iowa. I live in San Diego, so thought it would be interesting to do a direct comparison to San Diego - since population scale factor is not as steep (as comparing to all of California). San Diego County is large (4200 sq mi), but minuscule compared with the states mentioned above. It also has a larger population than any of those states.
Since mid-March, San Diego has had a mask mandate. It has also had a couple of lockdowns and closed indoor dining for most of the spring/summer, with a brief opening in the last couple months, but now back to being closed. Also, a curfew was just put into place from 10 pm to 5 am. I'm sure all the anti-maskers are lining up to make their "communist state" arguments, but lets look at the data.
I used the worldometer site and looked at 7 day averages on 4 dates separated out over the past several months - May 20, July 20, September 20, and November 20. I took the San Diego data from the county COVID website, which is linked from the worldometer website.
I then calculated each 7 day average vs 1 M people (standard normalization done with most sites) to see what has gone on in each state (and in San Diego County).
So, we see that San Diego, which has had the strictest restrictions has undergone a growth since 2 weeks after Labor Day (which is when things started increasing all around the country), however its growth rate has been much slower.
Again looks like masks help slow the spread, along with limited restrictions - e.g., no indoor dining, no bars, etc.
I realize it sucks for bars and restaurants that can't easily switch to take out mode, but what is the alternative? Fill the hospitals, I guess.
Again, this plot is my pull of data from worldometer and not a full research analysis. However, I think it does at least indicate that masks + some shutdown/restrictions is effective.
