Why 15 US states suddenly made masks mandatory

America’s 180 on masks, explained.

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While working in Beijing last year, I regularly bought packs of N95 masks at my local 7-Eleven. Across the city, masks were a common accessory: In packed subway cars and crowded bike lanes, commuters wore them for protection from the smog year-round.

When the coronavirus surfaced in China late in 2019, not only were masks on hand, they were also a familiar tool for fighting a virus: Many people had used them during the SARS outbreak in 2003. Based on this experience as well as government advice, masks quickly became even more widely used, not only in China, but in other East Asian countries.

In contrast, the US, which had little experience with mask-wearing, took a wait-and-see approach. For more than five weeks after community spread was first documented in the US, the Centers for Disease Control and Prevention (CDC) deemed public mask-wearing unnecessary. In early April, it finally reversed its position and advised the public to wear cloth masks in public spaces.

But some experts saw the delay as a mistake even then, arguing that the case for cloth masks — based on evidence from before the pandemic — was strong enough for the CDC to recommend their use earlier.

Now, new research suggests that East Asian countries’ early adoption of masks has played a role in their ability to control the transmission of Covid-19 — and the US government’s hesitation may have cost lives. “If we had masked up sooner, I think we could have prevented a lot of these infections,” says Shan Soe-Lin, a global health specialist at Yale University, who called for universal masking in a March Boston Globe op-ed co-written with Yale epidemiologist Robert Hecht.

The change in CDC guidance led to a jump in mask-wearing in April, and a recent HuffPost/YouGov poll found that two-thirds of American say they always or mostly wear a face mask or other covering when they were near other people in public.

People wear face masks while participating in the annual Memorial Day Parade in Staten Island, New York, on May 25. | Spencer Platt/Getty Images

With the nation now reopening, many experts are pointing to a growing body of scientific evidence, including a perspective published Wednesday in the journal Science, supporting universal mask-wearing in health care settings, airplanes, restaurants, and other crowded places with poor ventilation. And based on this evidence, more experts are arguing that more state and local governments should mandate cloth masks in these places to check the spread of the coronavirus (15 states require them so far).

It’s a remarkable shift for the US to move toward mandatory masks in the span of just a couple months; let’s walk through how we got here.

How the US muddled masks early in the pandemic

When the first case of person-to-person transmission was reported in the US on January 30, the CDC said it didn’t recommend the public use of face masks. US officials were focused on securing masks for health care workers. But in the process, they made contradictory and premature statements that masks were not effective for the public.

On February 27, CDC director Robert Redfield said, “There is no role for these masks in the community,” adding, “These masks need to be prioritized for health care professionals that as part of their job are taking care of individuals.”

In a February 29 tweet, US Surgeon General Jerome Adams further downplayed the utility of masks for the public: