One of California‘s wealthiest and most progressive counties has reinstated its mask mandate, warning residents of a ‘greater risk’ of Covid, flu and other respiratory viruses ahead of the winter months.
Sonoma County, located in the Bay Area and home to 170,000 people, has made face coverings mandatory for staff and visitors to some health care facilities that care for seniors and compromised or frail patients.
Officials have also urged all health care facilities, such as hospitals and urgent care, in the county to ‘strongly recommend’ face masks to staff and visitors.
Dr Karen Smith, the county’s interim health officer, said: ‘The risk to vulnerable patients of Covid, flu and other respiratory viruses in health care remains significant.
‘So, it continues to be important for face masks to be used in patient care areas when the seasonal risk of exposure to one or more viruses is high.’
The new guidelines go into effect November 1 and apply to the following facilities: Nursing facilities, long-term care facilities where nursing is provided, acute and non-acute rehabilitation facilities, infusion centers and dialysis centers.
The county is also now asking all residents aged six months or over to make sure they are up to date on their Covid, flu and respiratory syncytial virus (RSV) vaccinations.
In the notice, it also urged vaccinated and unvaccinated residents to wear face masks in any public indoor setting.
The above shows Gavin Newsom, the governor of California, wearing a face mask in March 2021. The state strongly encouraged residents to mask up during the Covid pandemic
The above shows Sonoma County, California, where the face mask mandate is in place
Since the pandemic, it has become common for counties or healthcare systems to enact mask requirements ahead of the winter cold and flu season – what doctors have called the ‘quad-demic’ – to try and prevent co-occurring outbreaks of the flu, Covid, the common cold and RSV.
Face masks became a mainstay during the Covid pandemic, with pro-maskers arguing they helped prevent infections by catching virus-laden droplets expelled when people sneeze, cough or talk.
But a major review by the Cochrane Collaboration, the ‘gold standard’ for evidence-based investigations, found that coverings made ‘little to no difference’ to Covid infection or death rates.
Some experts have warned that many masks contain holes that are too large to catch droplets, saying people should use medical-grade N95 masks.
Others have raised concerns that failing to wash reusable masks regularly can turn them into a breeding ground for bacteria, increasing the risk of infection.
California had a strict mask mandate during the Covid pandemic, with face masks required statewide in most public settings from June 2020 until June 2021.
In December 2021 to February 2022, the state reimposed mask mandates for indoor areas again amid a surge in Covid cases and hospitalizations. Multiple counties in California also pursued more stringent masking policies.
Federally, face masks were required to be worn on federal property and public transport from January 2021 until June 2021.
During his first term, President Donald Trump and California Governor Gavin Newsom clashed over face masks, with Newsom consistently wearing a mask at briefings during 2020 while Trump notably refused to wear one.
Shown above are pedestrians wearing face masks in San Francisco in June 2022
Announcing the new face mask order, the Sonoma County’s department of health said that it had first required visitors and staff to wear face masks at its health care facilities in 2017.
It said this year’s order covered fewer health care facilities than in previous years, and said the order would apply annually unless it is rescinded.
Covid cases have dropped slightly since August in California, according to wastewater data, when the state was recording ‘very high’ levels of the virus.
Now, Covid activity in California remains ‘high’, above the ‘moderate’ level nationwide.
Nationwide, wastewater surveillance suggests Covid levels dropped from ‘high’ to ‘moderate’ over the week to September 20, the latest available.
Both flu and RSV levels, however, are ‘very low’ in the US and California, according to wastewater surveillance.
However, it is still early in the respiratory virus season, which the CDC says falls between October to mid-May every year, with viruses peaking between December and February.
In the latest complete data for the week to September 6, California had a Covid hospitalization rate of 4.4 per 100,000 people, the same as the previous week, but nearly double the rate of 2.6 nationwide over the same period.
The state’s Covid death rate was around 0.1 fatalities per 100,000 people.
Both hospitalization and death rates are well below the peaks they hit during the pandemic, when hundreds of Covid-linked deaths were recorded in the US every day.
The new mandate, however, comes amid growing concerns over a new Covid variant that appears to be causing cases to surge in the US.
The strain XFG, also known as Stratus, has become dominant nationwide and in every region except the South since its first appearance in the US in March.
Scientists say it is more infectious than previous strains, although it does not appear to be more likely to cause a severe infection.
Concerns over the variant are rising as the US heads into respiratory virus season, when cold temperatures lead people to spend more time crowded indoors, where respiratory viruses spread easily.
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