Seven Bay Area counties announced Monday that residents will be required to wear masks in nearly all indoor settings, marking the first major step in reversing a statewide rollback of public health restrictions in June.
The mask mandate, which begins on Tuesday, Aug. 3, comes as COVID-19 cases spike across the Bay Area, with some of the highest case rates since February of this year. Public health officials said at a Monday, Aug. 2, press conference that the delta variant of the virus is far more contagious and now accounts for the vast majority of new cases in the region, requiring protective measures to keep infection rates and COVID-19 hospitalizations under control.
"The delta variant is now the dominant variant in our area," said George Han, Santa Clara County's deputy public health officer. "And because it's more contagious, we need more protection, and that comes in the form of masks as the easiest and best tools that we have."
All of the county public health orders are nearly identical, requiring vaccinated and unvaccinated residents alike to wear face coverings when indoors with people who aren't part of their households. In San Mateo County, the regulations include a short list of exceptions including work in closed rooms or offices; indoor dining while patrons are actively eating or drinking; and swimming and showering at the gym. Residents are strongly discouraged from dining indoors and are asked to mask up in crowded outdoor areas.
The mandate will be simultaneously rolled out in the counties of Santa Clara, San Mateo, San Francisco, Alameda, Marin, Contra Costa and Sonoma. These public health orders do not have a sunset date, and come just days after the California Department of Public Health recommended universal masking in public indoor settings statewide.
In Santa Clara County, there is now an average of 202 new cases per day over the last week, the highest rates since late February, according to county data. That's almost 10 times higher than the low point in June, despite a countywide vaccination rate of 78% among residents age 12 and older. San Mateo County saw a similar large spike to 87 cases per day during the week of July 15.
Sonoma County Health Officer Sundari Mase said the COVID-19 vaccine remains one of the strongest protections against the virus, and that the infection rate among the unvaccinated is six times higher than those who are vaccinated -- a stark difference, given that unvaccinated residents make up just a small minority of the county population. But she said the vaccine alone is not enough to combat the delta variant, which is much more widespread and aggressive opponent.
The California Department of Public Health reported that the delta variant accounts for 84.4% of COVID cases this month, a rapid increase from just 53.1% in June and 5.9% in May. In Sonoma, it accounts for 95% of all new cases.
"It's not the same virus that we were combating last year, or even a few months ago," Mase said.
Fully vaccinated residents are included in the mask mandate because they, too, can get infected with so-called breakthrough cases, and Los Angeles County health officials reported last week that 20% of all new cases were among those who were vaccinated. Though people who are vaccinated are far less likely to suffer severe illness or end up in the hospital, they may spread the virus in public settings like grocery stores and restaurants.
In a statement following the press conference, Scott Morrow, San Mateo County's health officer, described the mask mandate as a less disruptive public health requirement that can reduce community transmission while still allowing higher-risk activities to take place.
"As San Mateo County joins its neighbors in issuing these orders, the goal is to avoid disrupting businesses and residents' everyday activities," Morrow said. "We want our communities to stay open while being as safe as possible."
Like past mask mandates, Han said he recommends people wear a surgical or medical-grade mask and, barring that, a well-fitted cloth mask. Enforcement will largely fall to individual businesses, many of whom made face coverings optional for vaccinated individuals less than two months ago.
Though the new public health orders are even-handed with residents regardless of COVID-19 vaccination status, public health officers were emphatic in encouraging people to get vaccinated. Broad nationwide trends show that 97% of people ending up in the hospital with severe symptoms are unvaccinated, and local hospital admissions for people with COVID are surging. In Contra Costa County, the number of hospitalized COVID-19 patients doubled in just the past 10 days, and are up 400% in the month of July.
In Sonoma, 100% of the ICU patients with COVID were unvaccinated and could have protected themselves from the virus.
"This is really tragic given the widespread availability of vaccines in the area," Mase said. "It's needed now more than ever."