Many areas of the US are set to bring back face masks this winter, experts warn, as respiratory virus cases begin to rise across the country.
This week, Sonoma County in California was among the first to bring back coverings for visitors and health workers in certain health care settings, including in nursing homes, long-term care facilities and dialysis centers.
County officials also said masks were ‘strongly encouraged’ in hospitals, and urged everyone to get their COVID, flu and RSV vaccines.
Now, doctors have told the Daily Mail that other areas of the country will likely soon follow suit. They pointed to the at least 12 states which have brought back similar COVID-era restrictions during the 2024-2025 respiratory virus season.
Since the pandemic, these requirements have become common, especially ahead of winter to try and prevent co-occurring outbreaks of the flu, COVID, RSV and norovirus – a combination season doctors have dubbed the ‘quad-demic.’
Dr Todd Ellerin, an infectious diseases specialist at Harvard University, told the Daily Mail: ‘There are many [health care] systems, including around Boston, where when certain metrics are hit – like when the rate of influenza-like illnesses exceeds a certain threshold – then the systems will have the providers within hospitals wear masks.
‘Mask mandates will not be unique to California. When you are working in places where there are vulnerable patients, it makes sense to consider mask mandates.’
But not everyone thinks it will be as strict everywhere as it is in some counties.
Dr Bill Schaffner, an infectious disease expert at Vanderbilt University, told the Daily Mail: ‘I would not think we would see widespread face mask mandates. [But] there might be recommendations or encouragements to wear masks…
‘There is such an aversion, generally, across the country to mandates, I would not think there would be very many of those.
Both experts said it is likely that face masks will return in areas experiencing viral outbreaks that strain hospital systems, adding that residents will probably be urged to wear the coverings in an attempt to drive down cases.
Many pro-maskers argue that face masks help prevent infections by catching virus-laden droplets expelled when people sneeze, cough or talk.
But a major review by the Cochrane Collaboration – which has been called the ‘gold standard’ for evidence-based investigations by Alberto Merchante-González, chief of public health for the Spanish Ministry of Health – found that cloth coverings and surgical masks made ‘little to no difference’ to COVID infection or death rates.
Some experts have warned that many coverings contain holes that are too large to catch droplets, saying people should instead opt for the medical-grade N95 masks.
Others have raised concerns that failing to wash reusable masks regularly can turn them into a breeding ground for bacteria, increasing the risk of infection.
As of today, at least six counties in California’s Bay Area – Contra Costa, Santa Clara, Sonoma, Napa, San Mateo and Santa Cruz – have reimposed mask mandates in some health care settings.
Experts told the Daily Mail it was likely that face masks would return in areas experiencing viral outbreaks that strain hospital systems (stock image)
Starting November 1, each will require health workers and, in some cases, visitors or patients, to wear face coverings in medical settings used by frail, ailing or vulnerable patients.
Dr Karen Smith, Sonoma County’s interim health officer, told the Daily Mail: ‘The risk to vulnerable patients of COVID, flu and other respiratory viruses in health care remains significant.
‘So, it continues to be important for face masks to be used in patient care areas when the seasonal risk of exposure to one or more viruses is high.’
The mandate in Sonoma County has been set to be renewed every year unless it is repealed.
There are scant reports of other counties considering face mask mandates at present, although experts say this may shift as cooler weather approaches.
COVID cases have recently dropped in California, CDC wastewater data suggests, falling from ‘high’ to ‘moderate’ levels statewide. Both flu and RSV levels are also very low.
But the state does have a higher COVID hospitalization rate than the national average – 4.4 per every 100,000 people were hospitalized with the disease in the week of September 6 – compared to 2.6 per every 100,000 nationwide.
During last year’s flu season, from October 2024 to May 2025, officials saw COVID-era restrictions return in 12 states, although these were focused on certain settings and were not statewide.
In California, Massachusetts, New Jersey, New York, Pennsylvania and Wisconsin, face mask restrictions returned in some health care settings. In Illinois, Indiana, Minnesota and North Carolina, some officials brought back both mask mandates and visitor restrictions for health care facilities.
Officials in Michigan and South Carolina only brought back visitor restrictions to hospitals.
From 2024 to early 2025, the US experienced a worse respiratory virus season than average, with the CDC classing the season as ‘high severity’ and the most severe since the 2017-2018 season.
Overall, an estimated 47 million people were sick, while 610,000 were hospitalized and 26,000 died from the flu.
Dr Tyler Evans, former chief medical officer for New York City, told the Daily Mail: ‘Broad mandates may not be necessary right now, but we shouldn’t shy away from common-sense measures in higher-risk settings, like hospitals, nursing homes and public transit during surges.
The above shows the most recent COVID levels in wastewater in each state. Wastewater is one way to track the activity of a virus in communities
‘We know masks work, especially when layered with vaccination. The key is flexibility, clear guidance, and empowering people to make informed choices based on local trends.’
Nationwide, wastewater surveillance suggests COVID levels dropped from ‘high’ to ‘moderate’ over the week of September 20. But they were ‘very high’ in four states: Connecticut, Delaware, Nevada and Utah.
Both flu and RSV levels remain ‘very low’ across the US, although experts say this could be because the nation is at the early stages of the winter virus season.
Norovirus outbreaks also remain low. Only one outbreak of the stomach virus was recorded nationwide in August, according to the CDC.
Experts said levels are likely low because it is still early in the season, and warned cases could soon rise as colder weather forces more people indoors.
There are also concerns over a new COVID variant, named XFG or ‘Stratus,’ that has become the dominant strain in the US since first arriving in March.
Officials say it is not more likely to cause severe disease than previous strains, but is more transmissible than previous variants.
This article was originally published by a www.dailymail.co.uk . Read the Original article here. .