Sonoma County’s top health official on Wednesday issued a health order requiring health care personnel and others — regardless of their vaccination status — to wear protective masks while in patient areas of certain health care facilities during flu and cold season.
The move is aimed at protecting people who are most at risk of severe illness and reducing the spread of respiratory viruses during the fall and winter months.
Dr. Mia Shim, Sonoma County’s health officer, said the order will be in effect from 12:01 a.m. on Nov. 1 to March 31, 2027. With a few exceptions, the health order is similar to one issued last year.
The health care facilities that are subject to the order include: skilled nursing facilities; parts of long-term care facilities where nursing care is provided; acute and non-acute rehabilitation facilities; infusion centers and dialysis centers, officials said.
Though not mandated, Shim strongly recommended the use of face masks by employees in all health care facilities during respiratory virus season, regardless of their vaccination status.
Shim pointed out that masking and vaccination are not substitutes but rather provide layered protection.
“Masking reduces transmission in the health care setting while vaccination is very important in reducing severe illness, hospitalization and death,” she said.
According to the order, the masking requirement applies to health care personnel and non-patients, including visitors and other members of the public accompanying patients, in all patient care areas. Those areas include registration desks in lobbies, waiting rooms, examination rooms, therapy rooms, as well as areas where patients and medical staff interact.
Shim said masking helps protect medical staff during flu and cold season, when the health care workforce and medical resources can sometimes become strained. Such health orders have become all too familiar to local residents since the COVID-19 pandemic.
While similar to last year’s masking rule, this year Shim removed language that made the order “apply annually” during respiratory virus season.
“One important change is that this order applies specifically to this respiratory virus season, from November 1st through March 31st, rather than automatically recurring every year,” Shim explained in an email. “I think it’s appropriate to periodically reassess public health measures rather than assume the same approach should continue indefinitely. This also gives us an opportunity to continue conversations with our health care partners about the best approach for future respiratory virus seasons.”
Shim said she’d like to explore using a “more data-informed approach” to determining whether such masking rules are needed. That could include establishing a threshold for emergency department visits related to acute respiratory illness, or ARI, she said.
“We would need to consider which measures best reflect risk, what thresholds would be meaningful, and whether this kind of approach would be practical for health care facilities to implement,” she said. “We want to look carefully at the evidence, our local respiratory virus data and the experience of our health care partners before deciding what future seasons should look like.”
Shim said the spread of respiratory viruses like flu and COVID-19 typically increase during the fall and winter. Patients in certain health care settings are older, have weakened immune systems or have other health conditions that increase their risk of severe illness, she added. Masking both protects health care workers from illness and prevents virus transmission to patients.
The health officer said she also strongly recommends that local residents 6 months of age and older get the updated COVID-19 and flu vaccines. Those who are eligible for the respiratory syncytial virus vaccine should get that as well, she said.
Shim stressed that vaccination doesn’t prevent every single infection. People who are vaccinated can still get sick and even transmit respiratory viruses to others, even if they don’t have symptoms. That dynamic became very apparent during the pandemic.
But getting vaccinated, she said, saves lives and can reduce the need for hospitalization due to severe illness.
“That’s why the masking requirement applies regardless of vaccination status, and why I continue to encourage people to stay up to date on recommended vaccines,” Shim said.
This year’s masking rule is less strict than orders issued during the pandemic and in the years that followed. For example, in 2024, Sonoma County health officials issued a masking order that included general acute-care hospitals, inpatient psychiatric hospitals, as well as outpatient medical clinics.
Staff Writer Marisa Endicott contributed to this report. Staff Writer Martin Espinoza can be reached at martin.espinoza@pressdemocrat.com.