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San Francisco Health Network

Core Guidance for COVID-19

Last updated on November 3, 2021

Safer Return Together

On January 10, 2022, Health Order C19-07y was updated to align with new changes from the State of California around Mega-Events thresholds and requirements; and added recommendation to wear higher-quality masks and recommendation for children in schools be up-to-date on vaccination.  The previous revision temporarily suspending certain exemptions to the indoor universal mask requirement remains in effect until February 1, 2022. A Redline is available. C19-07y will continue until amended or rescinded by the Health Officer. Please see the FAQ for more information on C19-07y.

Note: On June 15, 2021, the California Blueprint for a Safer Economy was replaced by statewide COVID-19 guidance for certain settings. The San Francisco Health Officer's declaration of a health emergency arising from the pandemic continues to be in effect.

During the COVID-19 pandemic, it’s extra important for everyone to get their flu shot. In past years, the flu has been responsible for thousands of hospitalizations or death in the United States. We need to prevent as much of the flu as we possibly can, so that our clinics and hospitals can focus on caring for patients who are ill with COVID-19. Frequent hand washing, wearing face masks, and social distancing also help to prevent both the flu and COVID-19. Check with your regular healthcare provider to schedule a flu shot. San Francisco also offers free or low-cost flu vaccines to the public.

After June 15, 2021, many of SFDPH's COVID-19 guidance documents will not be updated unless necessary. All SFDPH COVID-19 guidance documents are clearly marked to indicate the time of the last update. Documents that are no longer applicable will be removed.

Presented here is information about how COVID-19 is transmitted and health and safety measures to protect yourself and your community.

COVID-19 Basics

How does COVID-19 spread?

COVID-19 is mostly spread from person-to-person in the air through virus-containing droplets in the breath of someone with COVID-19. These droplets enter the air when a person breathes. More droplets can get in the air when infected people talk, sing, cough, or sneeze. Some people with COVID-19 have no symptoms, or their symptoms may be so mild that they do not notice them; these people may still be breathing out virus-containing droplets that can infect others.

COVID-19 can also spread if a person touches their eyes, nose or mouth after touching a contaminated surface (also known as a fomite), however this is less common.

People at risk for severe illness with COVID-19, such as unvaccinated older adults and unvaccinated people with certain medical conditions, including pregnant and recently pregnant people should remain very cautious if participating in activities with other people outside their household, especially in indoor, poorly ventilated or crowded spaces and particularly when protective measures such as wearing face masks may not be used.

How can I protect myself against COVID-19?

What should I know about the COVID-19 vaccine?

The vaccine is one of the most important ways to end the pandemic because vaccines are extremely effective at preventing hospitalization and death. Vaccines for COVID-19 are safe, effective, and free. The FDA, CDC, and California’s own Scientific Safety Review Workgroup have reviewed data from clinical trials to ensure the safety and effectiveness of COVID-19 vaccines. We strongly encourage all eligible persons to get vaccinated. Find out more about vaccines, including where and when to get it For up-to-date information about the vaccines, see the CDC’s Key Things to Know about COVID-19 Vaccines web page.

Can I act differently if I am fully vaccinated?

Fully vaccinated people have a much lower risk of hospitalization and death from COVID-19. However, fully vaccinated people  still need to follow guidance at their workplace and local businesses.

If you are fully vaccinated and have a close contact with someone with COVID-19, you should get tested 5-7 days after your exposure, even if you have no symptoms. For more information visit the California Department of Public Health web page.

Is It necessary to check temperatures and COVID symptoms at the door?

No. On-site, pre-entry health checks have limited benefit in preventing spread of COVID-19.  SFDPH does not require that organizations perform on-site pre-entry health checks for patrons or employees. This includes: screening for symptoms of COVID-19, asking about close contact with others who have COVID-19, measuring temperatures, or verifying completion of remote self-screening.

Individuals should monitor themselves for COVID-19 symptoms or exposures, and businesses and governmental entities should ask employees to evaluate their own symptoms before reporting to work. If anyone has symptoms, they should isolate, get tested, and seek medical care when necessary.

Organizations may choose to continue on-site health checks or verify remote self-screening and, in some cases, state and other regulatory agencies may require it.  If an organization conducts on-site health checks, it should be done safely, respectfully, and in accordance with applicable privacy and confidentiality laws. For additional resources see

What happens if I test positive or have been exposed?

Please call the COVID Resource Center (CRC) at 628-217-6101. The CRC provides guidance on how to safely isolate or quarantine and for how long and resources such as food, cleaning supplies, financial assistance, and mental health support if you need to stay away from others for a period of time.

Ventilation of Indoor Spaces

How can I use my building’s ventilation system (HVAC) most effectively?

You can improve the effectiveness of your mechanical ventilation by setting it to maximize the intake of outdoor air and minimize the recirculation of indoor air. Have your HVAC system checked by a professional to make sure that it is operating properly and investigate whether it is possible to use higher efficiency air filters with your system. If you can, keep your ventilation operating even during times when the building is not being used. For more information about ventilation, see California Department of Public Health’s Ventilation guidance.

Should I keep windows and door open?

Yes. Open windows and doors to bring in fresh air from outside, but only when health and safety allow. Do not prop open fire doors and make sure that open windows do not pose a fall risk for children.

Are there other ways to improve ventilation?

Consider using portable air cleaners (“HEPA filters”), especially in spaces that are poorly ventilated. Fans can also help to disperse droplets and particles, but make sure that the fan is not blowing the air from one individual’s space to another’s.