The decision to not wear a mask is not a constitutional right, and universal mask use could save about 130,000 lives in the United States by February, according to a recent study.

However, eight of the top ten states with highest new cases per capita in October did not have a widespread mask mandate, Vox reports.

South Dakota Gov. Kristi Noem defended those
who choose not to wear a mask in public, even though the state’s been dealing with one of the worst coronavirus outbreaks in the nation.

Since the beginning of the pandemic, South Dakota has seen at least 92,603 cases and 1,300 deaths, according to data from the Centers for Disease Control and Protection.

State governments hold more power than the federal government in responding to a health crisis. States can issue shelter-in-place orders and opening or closing schools, whereas federal officials cannot.

North Dakota, the only state with worse death and new case rates, issued a statewide mask mandate mid-November, with limits on the size of gatherings in businesses, Associated Press reports.

Although Noem hasn’t enforced a statewide mask mandate, several cities in the state require masks in public spaces.

Masks are not a substitution for social distancing, but they should be worn in addition to maintaining six feet distance, according to the CDC.

They protect the person wearing them and those around as a simple barrier to prevent respiratory droplets from reaching others.

As of Thursday, 38 state governments require people to wear face coverings in public to curb the spread of COVID-19.

“There are generally exceptions for people with disabilities or medical conditions that prevent the use of face coverings, and allowances for certain situations where masking is difficult,” AARP reports. “Some state rules also include exemptions for people attending religious services.”

For children around the age of two, some people with disabilities or those in specific working conditions for whom wearing masks may not be feasible, CDC recommends getting in touch with healthcare providers for advice.