San Francisco quietly changes child COVID mask guidance

San Francisco’s Department of Public Health quietly updated its mask guidance for children ages 2 to 9 on Wednesday. 

The change was first noticed after a health department spokesperson reached out to SFGATE regarding an op-ed that ran Wednesday titled “San Francisco should be like Europe when it comes to COVID, kids, masks and schools.” The op-ed, submitted by 41 Bay Area parents and residents, contained the line, “It’s incredibly illogical that SFDPH doesn’t mandate face coverings for children under 10 in indoor public buildings, yet requires them for children ages 2 and up in child care and school settings, where learning and socialization are key components,” and linked to San Francisco’s mask guidance page.

When three separate SFGATE editors fact-checked that line in the op-ed Tuesday before publication, the city’s guidance for children specified that children 2 to 9 must wear masks in settings such as school or child care, but said only that children over 10 must wear masks in public buildings, as shown in this copy of the page captured by the Wayback Machine in September:

The version of San Francisco's mask guidance for children that SFGATE editors accessed Tuesday.

The version of San Francisco’s mask guidance for children that SFGATE editors accessed Tuesday.

San Francisco Department of Public Health

But on Thursday, an SFDPH spokesperson wrote to SFGATE in an email, “The op-ed incorrectly states that children under 10 do not have to wear masks in indoor public buildings, such as grocery stores and restaurants. In fact, it is required that children over 2 wear masks in these settings,” and provided a link to the same mask page, which now said children 2 and over must wear masks in public buildings. SFDPH said the change happened Wednesday. The SFGATE op-ed was published at 4 a.m. that morning.

The current version of San Francisco's mask guidance for children.

The current version of San Francisco’s mask guidance for children.

San Francisco Department of Public Health

Gone from the original version is the line stating that children ages 2 through 9 must only wear face coverings outside of school and child care settings “if they can.” Added is the requirement that “children 2 and older must wear face coverings in indoor public buildings” — which is seemingly a significant change to the city’s mask rules. 

When SFGATE asked SFDPH when and why that change happened, a spokesperson directed us to the text of the city’s official health order, which states, “Children age two to nine years must wear Well-Fitted Masks to the greatest extent feasible” in settings where masks are required of everyone, such as grocery stores and restaurants.

However, “to the greatest extent feasible” more so mirrors the original “if they can” language than it does the “must wear face coverings in indoor public buildings” update.


The SFDPH spokesperson said that the site containing the mask guidance — as opposed to the city’s official health order — “is designed to be easily accessible to a wide public audience” and “since the language appeared to be causing confusion we clarified it.”

When SFGATE asked whether the language in the official health order will also be tightened to reflect the new language on the guidance page, the department said that the “to the greatest extent feasible” language only applies to “well-fitted masks” as defined in the order, and that masks have always been required in indoor public buildings for children ages 2 through 9 if one reads between the lines of the health order.

“Children age two to nine can were an alternative type of face covering to a well-fitted mask if their parent or caregiver determines it will improve the child’s ability to comply with this Order,” the department said in a statement. “Such an alternative is still a face covering and still required. An example of an alternative face covering is a face shield with a drape on the bottom edge. To recap, the health order has always required a face covering for children age two to nine years old in indoor public buildings. Children of that age must wear a well-fitted mask to the greatest extent feasible. If that’s not feasible in certain situations, the child must still wear a different type of face covering.”

The mask guidance page has never — and still does not — draw any distinction regarding “well-fitted masks” and masking alternatives for children, but the page does say lower down, in a section for everyone, “If you can’t wear a medical or fabric mask, use other options,” and, “You are still required to wear something over your nose and mouth to block droplets, such as a gaiter with 2 layers.”

The health order itself does not specify some type of face covering must be worn if well-fitted masks are not possible; it only contains the line in the SFDPH statement that “children may wear an alternative face covering if their parent or caregiver determines it will improve the child’s ability to comply with this Order.”


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