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SF enters yellow tier, relaxes outdoor mask rules


People dine in a parklet outside Dolores Park Cafe. Photo: Liz Highleyman
People dine in a parklet outside Dolores Park Cafe. Photo: Liz Highleyman  

Effective May 6, San Francisco enters the state's yellow tier — indicating minimal COVID-19 transmission — allowing many activities to resume for the first time in over a year, Mayor London Breed and Health Director Dr. Grant Colfax announced May 4.

The previous day, the San Francisco Department of Public Health announced that it would relax its outdoor mask mandate for both vaccinated and unvaccinated people, mirroring changes announced last week by the federal Centers for Disease Control and Prevention and the California Department of Public Health.

"This is an incredible milestone for us to hit as we move forward on our path to recovery, and it is possible because of how well we are doing in our efforts to vaccinate everyone we can in this city and how well the people of San Francisco have done listening to public health officials," Breed said in a statement. "The yellow tier means that no longer are there any businesses that are required to keep their doors shut in this city, and it means we are continuing to allow more activities to be done safely with more people."

San Francisco is the first county in the Bay Area to reach the least restrictive tier. (It had briefly been in the yellow tier last October.) The move is made possible by the city's exceptional adherence to COVID-19 precautions and its high vaccination rate. As of May 4, the number of new cases had fallen to 26 per day — the lowest level since last June — and just 15 people were hospitalized with COVID-19.

According to the DPH, 72% of adults in San Francisco have received at least one vaccine dose and 49% have completed vaccination. People are considered fully vaccinated two weeks after they receive the single-shot Johnsons & Johnson vaccine or their second dose of the Pfizer-BioNTech or Moderna vaccines. Everyone age 16 or older is now eligible for vaccination, and the Pfizer vaccine is expected to be authorized for younger teens ages 12 to 15 next week.

Colfax, a gay man, sounded a note of caution, however.

"Our optimism is tempered by the rollbacks happening right now in Oregon and Washington as a result of the decline in vaccination rates, variants, and reopening activities," he said. "We must stay vigilant and get vaccination rates even higher to prevent COVID from spreading in San Francisco."

Most other Bay Area counties remain in the orange tier, although Marin is close to reaching yellow status. Provided things continue to go well statewide, Governor Gavin Newsom has indicated he aims to scrap the tier system and allow California to fully reopen June 15.

Under the yellow tier, indoor bars and restaurants may operate at 25% and 50% capacity, respectively, with patrons seated at tables. Libraries, movie theaters, family entertainment activities, senior community centers, and adult education may operate at 50% capacity. Organized outdoor community sporting events are allowed for up to 1,500 unvaccinated people or 3,000 people with proof of vaccination or a negative COVID-19 test. Gyms can operate at 50% capacity and patrons may remove their masks if they can maintain six feet of distance. Live spectator events, festivals, meetings, receptions, and conventions "will see significant expansions," according to Breed's statement. For more details, click here.

Mask mandate revised
On May 3, the city announced that both vaccinated and unvaccinated people can skip wearing masks outdoors while walking, running, or bicycling alone or with members of their household. They may also remove face coverings while dining outdoors for the duration of their visit, without having to put them back on when not actively eating or drinking. The rules are further relaxed for fully vaccinated people, who no longer need to wear face coverings outdoors except for large events or crowded settings.

"The CDC's announcement that fully vaccinated, and in some instances unvaccinated, people no longer need to wear masks in certain outdoor settings is fantastic news that reflects the science and data we now have on the efficacy of the vaccines in preventing community spread and driving down case rates and the minimal risk of transmission outdoors," said new Health Officer Dr. Susan Philip, whose position the Board of Supervisors made permanent May 4.

"These changes mean fully vaccinated and unvaccinated people can forgo mask-wearing while engaging in outdoor activities such as walking, running, hiking or biking alone or with members of the same household," she added. "And, you will no longer need to pull up your mask when simply passing others by on a sidewalk or trail as the transient passing of people is not a risk of transmission."

People who are not yet vaccinated should continue to wear a mask if physical distancing cannot be maintained, for example while having a prolonged conversation or walking on a crowded sidewalk. This includes children over the age of 2, who are not yet eligible for vaccines. According to Philip, they should wear masks while interacting with youth from different households in outdoor settings such as a park or at school recess.

Everyone — vaccinated or not — is still required to wear a mask at large events, meaning 300 or more people. Face coverings remain mandatory in public indoor settings such as stores, museums, and salons, and federal rules require masks on public transportation. Further information is available here.

In March, the CDC said that fully vaccinated people could gather unmasked in private indoor settings with other vaccinated or low-risk unvaccinated family members and friends. This type of activity was never safer indoors than outdoors, but some health officials felt that universal public mask mandates were simpler than conditional rules based on vaccination status.

Despite a growing body of evidence showing that COVID-19 transmission in uncrowded outdoor settings is rare, the relaxed rules have generated considerable controversy, especially on social media.

Some argue that it is too soon to lift mask mandates before everyone is vaccinated — including children — noting that case levels are still high in some parts of the United States and the pandemic continues unabated in other countries. What's more, they contend that doing so will upend new social norms and send the wrong message that COVID-19 is over.

But others counter that growing evidence about the low risk of outdoor transmission, falling case numbers, and rising vaccination rates support changing social norms to reflect confidence in the effectiveness of the vaccines.

"With more and more San Franciscans getting vaccinated, I commend SF DPH for revising its guidelines to say vaccinated individuals do not need to mask outdoors," Dr. Monica Gandhi, medical director of the Ward 86 HIV Clinic at San Francisco General Hospital, told the Bay Area Reporter. "But we should remember how low the risk of outside transmission is for everybody. Viral particles disperse effectively in the outside air. Given that the World Health Organization states that masks are not necessary outside unless physical distancing cannot be maintained, unvaccinated people should also be able to unmask outdoors in uncrowded conditions."

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