If you’ve ever wondered where we are with the pandemic now, you may need to look no further than California announcing it will end mask mandates and COVID vaccine requirements for many workers and settings.
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The state, once known for having some of the strictest restrictions around COVID-19 mitigation, will now no longer be requiring face masks to be worn indoors, even in high-risk settings. Additionally, CA will no longer be mandating the COVID-19 vaccine for healthcare workers and anyone who tests positive for the virus will have a reduced isolation time as well. All changes will go into effect on April 3rd. The move follows other states, like Oregon and Washington, which also lifted mask mandates in healthcare settings.
“We stand before Californians today with a humble message of thanks for taking the hard steps to help manage COVID-19, and with an ongoing commitment to be prepared for what comes next," said CDPH Director and State Public Health Officer Dr. Tomás Aragón in a statement. “Our communities did a lot of the hard work by getting vaccinated and boosted, staying home and testing when sick, requesting treatments when positive, and masking to slow the spread. With these critical actions and a lot of patience and persistence, we have now reached a point where we can update some of the COVID-19 guidance to continue to balance prevention and adapting to living with COVID-19."
California's New Guidance on Face Maskscdpa.ca.gov
The state of California announced the updates about face masks and vaccines in an official release from the CA Department of Health and Human Services called “Guidance for Face Coverings.”
The release came stamped with the Seal of Approval from CA Governor Gavin Newsom and explained that because the state had ended its State of Emergency from COVID-19, it made sense to also review accompanying restrictions including the use of face masks and vaccinations.
While the guidelines outlined several different scenarios in which masks were still recommended and noted that the framework for mask guidance will also be based on the updated circulating levels of community COVID-19 transmission updated by the CDC, it also ended all indoor mask requirements.
In other words, while masks are encouraged for anyone who wants to wear them and especially for high-risk settings and individuals, and if COVID-19 starts to circulate in high levels again, masks are no longer required by state law. High-risk settings were defined as:
Healthcare settings
Long-term care settings
Adult and senior care facilities
Homeless shelters
Emergency shelters
Cooling and heating centers
State and local correctional facilities and detention centers
“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,” the release explained.
The release also noted that no one should be stopped from entering any activity or entry into a venue or business, including schools or childcare, for wearing a mask, “unless wearing a mask would pose a safety hazard.”
Like other states, mask requirements will now move to individual county-wide decisions, as well as personal decisions among healthcare workers who want to continue masking.
In addition to ending mask mandates, the state also released separate guidance on vaccination mandates for healthcare workers. The release kicked off by detailing CA’s overall high level of vaccinations, noting that 80% of state residents 12 years and older have completed a primary series of COVID-19 vaccinations and adding that the “proportion of unvaccinated workers is low.”
Levels of primary vaccination and boosters were high in California because the state not only mandated the initial vaccine series but boosters for “covered workers” as well. Workers were defined as all “paid and unpaid individuals who worked in indoor settings where they either directly cared for patients or who had access to patients.
The original mandate noted that this included healthcare and non-healthcare workers, including:
Nurses
Nursing assistants
Physicians
Technicians
Therapists
Phlebotomists
Pharmacists
Students and trainees
Contractual staff
Anyone in a healthcare setting who could be exposed, such as clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel
The original order was issued by Tomás J. Aragón, MD, DrPH, Director and State Public Health Officer, California Department of Public Health, and went into effect on August 5, 2021. But the new release states that the governor is “ rescinding the August 5, 2021, State Public Health Officer Order.” In other words, there is no longer a vaccine requirement for any worker in the state, nurse, healthcare worker, or other as of April 3, 2023.
The declaration also may end the suspected plans the governor had to add COVID-19 vaccination to the list of required school vaccinations, although no official word on that has yet been released.
Nurses React to the Changes
The California Nurses Association (CNA) condemned the decision to end the mask mandate in the state, pointing out that the requirement would come only days after the state would see a milestone of over a total of 100K deaths from COVID-19. In a March 3, 2023 press release posted on National Nurses United, Bonnie Castillo, RN and executive director of the California Nurses Association stated:
“In no uncertain terms, this is a failure of public health leadership. Abandoning these standards is a counterproductive and unscientific approach to curbing the spread and evolution of Covid-19. This decision endangers the health and safety of nurses and other health care workers, hurts their ability to access personal protective equipment from employers, and ultimately exacerbates the health care staffing crisis that political leaders have vowed to tackle.”
Cathy Kennedy, RN and president of CNA, called the move an “attack” on frontline healthcare workers, adding that nurses and other healthcare workers will now face a greater risk of Covid-19 infections, reinfections, and long Covid.
“The more Covid infections someone has had, the more likely they are to develop long Covid,” she said. “It’s surreal that political leaders would put nurses, patients, and community members at greater risk of developing chronic conditions like heart disease, stroke risk, diabetes, pulmonary embolism, cognitive impairment, and long-term immune dysfunction.”
The CNA listed several complications and risks of developing long COVID, including an increased risk of heart disease, stroke, PEs, diabetes, and neurological disorders as well as having a negative impact on several other body systems, such as kidney function, immune system function, and GI health.
“We need leadership from the state,” added Castillo, in response to the state allowing individual counties to make masking decisions. “They want to pretend Covid is over, but it’s not over. Infections are still going up, and we know that’s an undercount because people aren’t testing. Nurses and patients do not live in a world of make believe.”
Some CA residents are also upset at the change; there’s even an online petition circulating demanding Bay Area medical facilities continue masking. And a quick perusal of the news making its way around TikTok also shows a wide variety of very mixed reactions, with some applauding the decision and others claiming they will continue masking on their own.
Chaunie Brusie
BSN, RN
Nurse.org Contributor
Chaunie Brusie, BSN, RN is a nurse-turned-writer with experience in critical care, long-term care, and labor and delivery. Her work has appeared everywhere from Glamor to The New York Times to The Washington Post. Chaunie lives with her husband and five kids in the middle of a hay field in Michigan and you can find more of her work here.
