California revives mask mandate as hospitals fear hard winter wave of COVID-19 cases

Shoppers wearing face masks
Black Friday shoppers at the Citadel Outlets in Commerce on Nov. 26, 2021. California is bringing back a statewide indoor mask mandate starting Wednesday.
(Ringo H.W. Chiu / Associated Press)

California’s new mask mandate comes amid growing concerns that a winter surge in COVID-19 cases could once again strain hospitals.

Coronavirus infections are rising quickly in the state, although some officials remain hopeful that another winter spike in cases will be less severe than the devastating surge a year ago, which overwhelmed many hospitals.

Experts hope the new mask requirement for indoor public places will help keep the number of cases in check.

Hospital concerns

With the arrival of recent coronavirus variants, data suggest that people who become severely sick are doing so more quickly, said Dr. Mark Ghaly, California’s health and human services secretary. “So the impact on hospitals might be quicker,” he said.

Also, with state officials not planning to reimpose stay-at-home orders this winter, hospitals will face challenges they did not last year, Ghaly said.

California has announced a statewide mask mandate for indoor public spaces. Here is what you need to know.

Dec. 13, 2021

Ghaly said hospital capacity remains a challenge , particularly in San Bernardino and Riverside counties, across the Central Valley and in the eastern Sierra and the rural north. A number of hospitals throughout the state are busier than usual for this time of year, and staffs are exhausted from battling the nearly 2-year-old historic pandemic. Still looming is the pent-up demand for healthcare needs that have been postponed during the pandemic.

Dr. Regina Chinsio-Kwong, a deputy health officer for Orange County, said that even without factoring in the virus’ newly emerged Omicron variant, the county will need to brace for the possibility of a COVID-19 surge.

“Unfortunately, yes, our hospitals are having to relook at their surge plans with the staffing shortages that they have been experiencing to brace themselves again for a very, very busy winter,” Chinsio-Kwong said Friday.


In Los Angeles County, growing vaccination rates have helped to reduce the burden on hospitals; during last year’s surges, 15% to 20% of coronavirus cases led to hospitalizations, but for this summer’s Delta surge, about 5% to 6% of cases led to hospitalizations.

That “really reflects the power of those vaccines,” Los Angeles County Public Health Director Barbara Ferrer said recently.

“But we worry about a strain on the hospital care system. We have a really noted ongoing staffing shortage issue at many of our hospitals,” Ferrer said.

“So while I don’t anticipate us being hit anywhere near as hard as we were hit last winter, it’s all relative,” Ferrer said. “And our job is to really do our very best to make sure people know what they can do to try and avoid getting a serious illness associated with COVID.”

Rising cases

COVID-19 cases in California have risen by almost 50% in the last 2½ weeks, and hospitalizations for the virus are up by nearly 15%. County health officials across the state said they suspect those numbers could reflect the start of a winter jump in cases.

The U.S. Centers for Disease Control and Prevention ranks California as having a high level of transmission of the coronavirus, the worst classification on the federal agency’s four-tier scale.

California is approaching a statewide COVID-19 death toll of 75,000. The national death total is nearing 800,000.


How masks fit in

Evidence makes it clear that masks help reduce transmission of the virus , Ghaly said. The coronavirus is airborne and can spread from infected people even if they are asymptomatic.

“Even a 10% increase in indoor masking can reduce case transmission significantly,” Ghaly said. “Wearing a mask is going to be one of the most important things to help us get through this period of uncertainty.”

California’s statewide mask mandate for indoor public spaces goes into effect on Wednesday.

The order will affect roughly half the state’s population, including San Diego and Orange counties, the Inland Empire, and swaths of the Central Valley and rural Northern California. The order is currently scheduled to last a month, expiring on Jan. 15.

A number of California counties — including Los Angeles, Ventura and Sacramento — and most of the San Francisco Bay Area already have their own indoor mask mandates that were implemented in the summer and have no end dates.