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San Francisco to require universal masking and boosters for large events

In a bid to control the spread of the COVID-19 Omicron variant, San Francisco is reinstating universal masking requirements for indoor settings, as well as booster shots for eligible residents to attend large indoor events. 

The new order rescinds the city’s masking exemption for groups of fully vaccinated people in settings like offices, gyms and facilities for religious activities. The order goes into effect on Dec. 30 and is currently slated to run through Jan. 31 

The city has created an “up-to-date” category for vaccinations which include getting a booster shot if eligible. Starting on Feb. 1, indoor events with 1,000 or more people will require proof of a booster shot received at least one week prior to the event for eligible staff and attendees.

People between 5 and 11 years old must show proof of full vaccination or a negative COVID-19 prior to entry into the event venue, and children between 2 and 4 years old need a negative test. 

The city also “strongly urges” businesses with indoor facilities like restaurants, bars, clubs, and gyms to require patrons and staff to show proof that they are up-to-date on vaccination, including boosters, as soon as possible. But there is no rule requiring them to do so. 

The city will also require booster shots for healthcare workers in line with a recent state order, as well as those in high-risk settings such as skilled nursing facilities, residential care facilities and homeless shelters.

San Francisco has seen a huge spike in numbers of new COVID-19 cases driven by the increased transmissibility of Omicron. The city’s 7-day average case rate as of Dec. 21 was 398, which has surpassed the peak during the previous Delta variant surge earlier this year. Hospitalizations have started to creep up, but remain far lower than previous surges seen during the pandemic. 

“The current threat is very real,” tweeted UCSF Department of Medicine Chair Dr. Bob Wachter in a thread explaining his outlook on Omicron. “But by early February, we could be in a place where Covid is, in fact, ‘like the flu.'”

Wachter cited the federal government’s efforts to ramp up rapid testing, the effectiveness of vaccines and new treatments like Pfizer’s Paxlovid as reasons for optimism.

San Francisco officials say the universal masking requirements coupled with rapid testing technology and expanding vaccine eligibility to those five and older mean schools can remain open for in-person classes for all grades. Masking will also be required for participants in indoor youth sports through Jan. 31.

“The SF Department of Public Health has assured us that San Francisco is relatively well positioned to handle COVID-19 and its variants because of our high vaccination rates, our high booster uptake, and other local health measures such as masking and testing,” the San Francisco Unified School District said in a statement. “SFUSD strongly believes that in-person learning provides the strongest educational experience for our students.”

The district is partnering with health nonprofit Safer Together to offer mobile rapid testing as staff and students return to school.

The San Francisco’s Department of Public Health also plans to update its guidance on quarantines for infected residents to put them in line with the recent recommendations from the Centers for Disease Control. The CDC says that people who test positive for COVID-19 but are asymptomatic are should isolate for 5 days instead of the previously recommended 10 days, with masking for an additional 5 days.

For those who are unvaccinated or are more than six months out from their second mRNA dose (or more than 2 months after the J&J vaccine) and not boosted, individuals are advised to quarantine for 5 days followed by strict mask use for an additional 5 days.

For people who have received their booster shot, the CDC states they do not need to quarantine following an exposure, but should wear a mask for 10 days. 

“We know that our focus in this Omicron surge must be on reducing hospitalizations and maintaining our capacity to care for San Franciscans, and these measures will help ensure this,” Dr. Susan Philip, San Francisco Health Officer, said in a statement. “We do not want to wait until it’s too late to implement these measures to better protect our community.” 

Kevin Truong can be reached at