State of California—Health and Human Services Agency
California Department of Public Health

March 3, 2023

TO:

All Californians

SUBJECT:

Guidance for the Use of Face Masks

Effective May 11, 2023 the CDC will no longer calculate the COVID-19 Community Levels as a result of the sunsetting of the federal public health emergency. As a result, CDPH is sunsetting its Guidance for the Use of Face Masks and is recommending all Californians consider the following:

Wear a mask around others if you have respiratory symptoms (e.g., cough, runny nose, and/or sore throat),
If you've had a significant exposure to someone who has tested positive for COVID-19, wear a mask for 10 days.
When choosing to wear a mask, ensure your mask provides the best fit and filtration (respirators like N95, KN95 and KF94 are best).

In addition, wearing a mask is increasingly important for those that are at higher risk for getting very sick from COVID-19, and as the risk for transmission increases in the community:

Examples of settings to consider wearing a mask include: indoor areas of public transportation (such as in airplanes, trains, buses, ferries) and transportation hubs (such as airports, stations, and seaports), and other crowded indoor settings, especially where higher risk individuals are present.

Local health jurisdictions and other entities may have requirements in specific settings based on local circumstances.

For more tips and resources for face masks, visit the CDPH resource hub here: Get the Most Out of Masking (ca.gov).

Background

With the end of the California COVID-19 State of Emergency, it is appropriate to revise our current masking framework. California’s path forward will be predicated on our individual, smarter actions that will collectively yield better outcomes for our neighborhoods, communities, and state.

Consistent with the SMARTER Plan and our adaptation of the SarsCoV-2 virus in our lives, California is updating its masking guidance. Effective April 3, 2023, the updated guidance is intended to provide information that each Californian should consider based on their unique circumstances. The updated guidance is unchanged for general community settings and continues to use a framework based on the CDC COVID-19 Community Levels. The updated guidance replaces mandatory masking requirements in high-risk settings with recommendations, which are also based on the CDC COVID-19 Community Levels.

Persons may use information about the current CDC COVID-19 community levels in their county to guide which prevention behaviors to use and when (at all times or at specific times) based on their own risk for severe illness and that of members of their household, their risk tolerance, and setting-specific factors. COVID-19 community levels are based on hospitalization rates, hospital bed occupancy, and COVID-19 incidence during the preceding period.

Masks are especially important in settings where vulnerable people are residing or being cared for, and increasingly important as the risk for transmission increases in the community. Health care facilities and other high-risk setting operators should develop and implement their own facility-specific plans based on their community, patient population, and other facility considerations incorporating CDPH and CDC recommendations.

Regardless of the COVID-19 community levels, CDPH recommends:

Wear a mask around others if you have respiratory symptoms (e.g., cough, runny nose, and/or sore throat),
Consider wearing a mask in indoor areas of public transportation (such as in airplanes, trains, buses, ferries) and transportation hubs (such as airports, stations, and seaports). This is increasingly important as the risk for transmission increases in the community.
When choosing to wear a mask, ensure your mask provides the best fit and filtration (respirators like N95, KN95 and KF94 are best).
If you’ve had a significant exposure to someone who has tested positive for COVID-19, wear a mask for 10 days.

CDC COVID-19 Community Level	CDPH recommendations for individuals	CDPH recommendations in indoor High-Risk Settings**
Low There is lower community spread and impact on healthcare system of COVID-19	Everyone: People can wear a mask based on personal preference, informed by their own personal level of risk. *Vulnerable people:** Consider wearing a mask in crowded indoor public places. If you are a vulnerable person* or live with a vulnerable person*, consider taking additional precautions.	For all staff and residents/patients: Wearing a mask should be considered.
Medium There is medium community spread and impact on healthcare system of COVID-19	Everyone: Consider wearing a mask in indoor public places. Vulnerable people: Wearing a mask is recommended in crowded indoor public places. If you have household or social contact with a vulnerable person, wearing a mask is recommended when indoors with them	For all staff and residents/patients: Wearing a mask is recommended.
High There is high community spread and impact on healthcare system of COVID-19	Everyone: Wearing a mask is recommended in indoor public places. Vulnerable people: Wearing a mask is strongly recommended in indoor public places. If you have household or social contact with a vulnerable person, wearing a mask is recommended when indoors with them.	For all staff and residents/patients: Wearing a mask is strongly recommended.

*Those that are vulnerable include the unvaccinated, those that are immunocompromised, have certain disabilities, or have underlying health conditions, and those at risk of severe illness of death if they are infected with COVID-19. Such persons should consider taking extra precautions.

**High-risk settings include:

Healthcare Settings
Long Term Care Settings & Adult and Senior Care Facilities
Homeless shelters, Emergency shelters and cooling and heating centers
State and local correctional facilities and detention centers

Facilities that are high-risk settings should make respirators (e.g., N95s, KN95s, KF94s) with good fit or surgical masks available to any residents and staff who would like to use them.

In workplaces, employers and employees are subject to either the Cal/OSHA COVID-19 Prevention Non-Emergency Regulations or the Cal/OSHA Aerosol Transmissible Diseases (ATD) PDF Standard and should consult those regulations for additional applicable requirements. In certain healthcare situations or settings and other covered facilities, services and operations, surgical masks (or higher filtration masks) are required.

Finally, no person can be prevented from wearing a mask as a condition of participation in an activity or entry into a venue or business (including schools or childcare), unless wearing a mask would pose a safety hazard. All businesses and venue operators are encouraged to improve ventilation and air quality in their facility to prevent airborne respiratory infections and improve indoor air quality.

Local health jurisdictions and entities can implement additional requirements that go beyond this statewide guidance based on local circumstances.

The following individuals should not wear masks:

Persons younger than two years old. Very young children must not wear a mask because of the risk of suffocation.
Persons with a medical condition, mental health condition, or disability that prevents wearing a mask. This includes persons with a medical condition for whom wearing a mask could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a mask without assistance.
Persons for whom wearing a mask would create a risk to the person related to their work, as determined by local, state, or federal regulators or workplace safety guidelines.

These public health recommendations will be updated as CDPH continues to assess conditions on an ongoing basis. If the CDC revises definitions of the COVID-19 Community Levels, CDPH will reassess these recommendations as well.

Resources

For additional information on the most effective types of masks and ensuring a well-fitted mask for adults, individuals should refer to CDPH Get the Most out of Masking and see CDPH Masking Guidance Frequently Asked Questions. For additional information on the most effective types of masks and ensuring a well-fitted mask for children, individuals should refer to CDPH Masks for Kids: Tips and Resources. For additional considerations for children and masking in childcare settings, see COVID-19 Guidance for Child Care Providers and Programs. For references on the effectiveness of masks and respirators, see CDC Science Brief: Community Use of Masks to Control the Spread of SARS-CoV-2.

Originally published on November 16, 2020