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NASHVILLE, Tenn. (AP) — A new report says Tennessee counties that haven’t required wearing masks in public are on average seeing COVID-19 death rates double or more compared with those that have instituted mandates.

The Vanderbilt University School of Medicine study released Tuesday focused on three groups of counties: Early adopters with mask mandates as of July 10; late adopters with mandates implemented after July 10; and those that never adopted a requirement.

Researchers found the early and late adopting groups saw declining death rates within a few weeks of requirements, while the group with no requirements continued to see death rate increases.

Researchers stressed that other policies and behaviors are also factors.

Memphis adopted a mask ordinance June 25. Shelby County mandated masks in a health directive July 3. Tipton and Fayette counties issued mask ordinances Aug. 3.