Category: Uncategorized

San Mateo County Beach and Creek Postings for October 15, 2026, based off samples collected October 13, 2026

 

BEACH (PACIFIC-SIDE) POSTINGS:

• Linda Mar #5 (Linda Mar Blvd.)

CREEK POSTINGS:

• San Vicente Creek (at Fitzgerald)
• Frenchman’s Creek (at Venice-North)
• Pomponio Creek

BEACH (BAYSIDE) POSTINGS:

• Erckenbrack Park

Respiratory virus season is starting in San Mateo County, with early influenza activity already increasing. COVID-19 activity remains elevated but is decreasing, while RSV activity is currently low.

Now is a good time to get vaccinated. It takes about two weeks for protection to develop after vaccination. Updated 2026-27 influenza and COVID-19 vaccines are available and can be given at the same time.

Where to Get Vaccinated

To find a vaccine near you:

• Talk to your doctor.
• Visit MyTurn.
• Check with local pharmacies.

Current Respiratory Virus Activity

As of Oct. 3, 2026, respiratory virus activity in San Mateo County shows:

• Influenza: Activity is increasing.
• COVID-19: Activity remains elevated but is decreasing.
• RSV: Activity is low but is expected to increase in the coming weeks.

Respiratory illness activity is currently high in the Bay Area. When respiratory viruses are circulating at high levels, it is important to take steps to stay healthy and protect those around you.

Weekly Respiratory Virus Dashboard

The San Mateo County Health Office of the Health Officer maintains a Respiratory Virus Dashboard, updated every Friday, with information on COVID-19, influenza and RSV activity.

Latest data: Week ending Oct. 3, 2026
Updated: Oct. 9, 2026

The following snapshots show the latest available data. Select an image to view it at full size.

COVID-19

Influenza (Flu)

Respiratory Syncytial Virus (RSV)

View the latest Respiratory Virus Dashboard

Overdose prevention is about more than responding to emergencies. It is about building trust and sharing reliable information. It is also about supporting families, reducing stigma and making sure people know where to turn for help so they can live longer, better lives. One way San Mateo County Health is advancing that mission is through the San Mateo County Overdose Prevention Coalition (OPC), a community partnership focused on preventing overdoses, reducing stigma and connecting people to life-saving information and support.

The Coalition brings together community members, families, youth, people with lived experience, educators, service providers, health professionals, public safety partners and local organizations. Together, we are working toward a shared vision: a San Mateo County free of overdose, through an empowered community.

How We Began

The Coalition began by listening to the community.

From September 2024 through January 2025, Behavioral Health & Recovery Services, a division of San Mateo County Health, hosted focus groups across the county and virtually, hearing from community members who shared their concerns, hopes and ideas for preventing overdoses. Needs for more education, better access to services, stronger partnerships, and support before, during and after a crisis were named. That input became the foundation for the Coalition’s work.

The Heart of Our Mission

The San Mateo County Overdose Prevention Coalition works to reduce drug overdoses throughout the county by focusing on education, outreach, access to services, youth and policy advocacy, and community-driven solutions.

In practice, that means the Coalition helps partners:

• Share clear information about overdose prevention, fentanyl, naloxone and available resources.
• Reduce stigma so people feel safer asking for help.
• Strengthen connections between schools, community organizations, health care providers, public safety partners, public transportation agencies and people directly impacted by overdose.
• Support youth-centered prevention efforts.
• Improve access for unhoused and vulnerable populations to naloxone and other overdose prevention resources.
• Use local data and community feedback to guide action.

The Coalition is guided by shared community agreements that encourage respectful and thoughtful conversations. Members commit to listening to learn, allowing all voices to be heard, protecting confidentiality, and engaging without judgment.

What We’ve Accomplished So Far

Since its start, the Coalition has grown from a listening effort into an active countywide partnership, developing its charter and bylaws, launching action teams, hosting community meet-and-greet events, holding general membership meetings, supporting naloxone distribution, and continuing to build partnerships across San Mateo County.

At a Steering Committee meeting in May, members reflected on the Coalition’s first year using words such as impact, collaboration, inspiring, lived experience, insightful, difference, perspective, learned, motivational, growth and networking. These words reflect both the progress made and the spirit of the work ahead.

Current Action Teams

The Steering Committee has established two action teams:

1. Youth and Schools Action Team: focuses on prevention efforts for young people, schools, and families. Youth voices have already shaped the coalition’s work. Young people from San Mateo shared honest reflections about substance use, overdose, and mental health. They encouraged adults to have real conversations with youth and include people with lived experience in solutions. The team is participating in the California Overdose Prevention Network Accelerator 7.0 Cohort. In June, San Mateo County students participated in the Youth Substance Use Prevention and Advocacy Academy, a project of the Youth and Schools Action Team. This work builds on a key message youth have already shared with the coalition: young people want honest conversations, trusted information, and solutions that include their voices.
2. Unhoused and Other Vulnerable Populations Team: focuses on people who may face a higher risk of overdose, including those experiencing homelessness. Early work has included connecting with shelter providers, identifying resource needs, distributing naloxone to outreach workers, participating in San Mateo County’s One Day Homeless County, and supporting access to overdose prevention training. The team continues to explore ways to bring overdose prevention resources into places where people may need them most.

Expanding Access To Naloxone

Naloxone is a life-saving medication that can reverse an opioid overdose. Expanding access to naloxone is one of the coalition’s key priorities. County Health has supported naloxone distribution at community events and through partnerships across the county. Coalition partners have helped distribute naloxone at:

• The 3rd Annual H.O.P.E. Memorial Walk and Resource Fairs
• Naloxone Awareness and Community Safety events with samTrans
• SamTrans 50th Celebration
• Pride Festivals
• Fentanyl High Movie Screening at Carlmont High School
• Voices of Recovery Picnic
• Summer Fest
• 21st Anniversary Disaster Preparedness Day
• Colma Night Out

The OPC also launched the Naloxone Stand Box (NSB) program to provide newspaper-like stand boxes that can hold between 60-74 boxes of naloxone. These boxes are provided at no cost to eligible community-based organizations that serve people at risk for opioid overdose. These stand boxes are designed to make naloxone more visible and accessible in community settings.

As of October 2026, there are eight active naloxone stand boxes in the community, located at SamTrans Sequoia Station, Sitike Counseling Center, Puente de la Costa Sur, Streetlife Ministries, Job Train Menlo Park, two shelters, and at a youth mental health support center. Additional applications have been approved or are in progress, and 1,471 boxes of naloxone have been restocked to date since reporting began in February 2026.

How To Get Involved

No single organization can prevent overdoses alone. The Coalition creates a space for people across San Mateo County to work together, learn from one another, and take practical steps to save lives.

Community members, organizations, schools, service providers, and local partners are invited to learn more about the San Mateo County Overdose Prevention Coalition and join the work. Members can attend meetings, share ideas, support action teams and help bring prevention resources to the people and places that need them.

To learn more or become a member, fill out the general membership form or visit the overdose prevention webpage. Click here to subscribe to the San Mateo County Overdose Prevention Coalition Newsletter.

Together, we can prevent overdoses, support recovery, and help build a safer, healthier San Mateo County.

Fentanyl is a powerful synthetic opioid. According to provisional data from the CDC, the majority of drug overdoses in 2025 included synthetic opioids, including fentanyl. While medical professionals prescribe pharmaceutical fentanyl for severe pain, most fentanyl-related overdose deaths are linked to illicitly manufactured fentanyl circulating in the illegal drug supply. Fentanyl overdoses pose a serious risk to people across ages, backgrounds, and communities who share overlapping vulnerabilities – including stress, trauma, mental health challenges, substance use, social isolation, unstable housing, mismanagement of prescription medication, and limited access to information or services.

The good news is that fentanyl overdose deaths are preventable. Learning about illicit fentanyl, understanding the risk of fake pills, carrying naloxone, and knowing how to respond to an overdose can help save lives.

What Is Fentanyl?

Prescribed by doctors, fentanyl is a synthetic opioid that has been around since the 1960s and used for legitimate medical purposes as a pain reliever and anesthetic. Pharmaceutical fentanyl can be used to treat severe pain, such as in cases of advanced cancer or surgery, in emergency departments, or for individuals experiencing chronic pain that does not respond to other treatments. Typically, patients are given a fentanyl patch, lozenges, or shots and are monitored by a physician.

What Is Illicit Fentanyl?

Illegally made fentanyl, however, is produced and distributed through the illicit drug market and is up to 50 times stronger than heroin and 100 times stronger than morphine. It is commonly found as a powder, mixed with other drugs such as cocaine or methamphetamine, or pressed into counterfeit or fake pills made to resemble authentic prescription medication. Fentanyl is incredibly strong without a distinct smell or taste, making detection difficult. According to the Drug Enforcement Agency (DEA), just 2mg, similar to the amount of just a few grains of table salt, can be potentially lethal. Illicit fentanyl has substantially increased the risk of fatal overdose because of its potency, unpredictable presence/concentration, and widespread mixing with other drugs.

Fake Pills Can Look Real

Counterfeit, or “fake,” pills are manufactured to look like legitimate prescription medications. According to the DEA, about 29% of counterfeit pills tested at DEA laboratories contain a deadly dose of fentanyl. They may resemble oxycodone, hydrocodone, Xanax, Adderall, or other medications. But instead of containing the expected medication and dose, they often contain illegally made fentanyl in potentially lethal doses. Fake prescription pills are often bought online, through social media, from friends or acquaintances, or from other unregulated sources rather than a licensed pharmacy.

The DEA warns that medications obtained outside a licensed pharmacy can be dangerous and potentially deadly. Color, shape, markings, or appearance cannot reliably identify counterfeit pills.

This risk is especially important when talking with teens and young adults. The CDC reports that counterfeit pills are a leading source of unintentional fentanyl exposure among youth. From 2020 through 2024, 75% of overdose deaths among young people ages 10–19 involved fentanyl.

Families can help by having open, nonjudgmental conversations about fake pills. A useful message is simple: Never take a pill that was not prescribed to you and obtained from a licensed pharmacy.

Overdose Deaths Can Be Prevented

Knowing the signs of an opioid overdose can make the difference between life and death. Naloxone is a medication that can rapidly reverse an opioid overdose, including an overdose involving fentanyl. It is safe and easy for bystanders to administer. Warning signs of an overdose can include:

Breathing – slow, shallow, irregular, or stopped breathing
Lips – blue, gray, or purple lips or fingernails
Unresponsive – unable to wake up, limp body
Eyes – very small, “pinpoint” pupils

Other warning signs may include:

• Choking, snoring, or gurgling sounds
• Pale, cold, or clammy skin

If you think someone may be experiencing an opioid overdose, treat it as an emergency and follow these steps, according to the California Department of Public Health:

→ Give naloxone, and call 911.
→ If needed, provide a second dose of naloxone (using a new naloxone container) after 2-3 minutes.
→ Keep the person awake and breathing.
→ If the person is not breathing, you can perform rescue breathing or CPR.
→ Lay the person on their side to prevent choking.
→ Stay with the person until 911 responders arrive.

Be Prepared. Share What You Know.

You do not need to know someone who uses opioids to carry naloxone. Having it available means you may be prepared to help a friend, relative, coworker, neighbor, or stranger experiencing an overdose.

San Mateo County is expanding access to free naloxone through vending machines and Naloxone Stand Boxes located throughout the county. Naloxone is also available at local pharmacies and major retailers without a prescription.

Overdose is preventable, and each of us can be prepared to help save a life. Visit the overdose prevention page to find free naloxone near you, watch training videos, and learn how to get involved with the San Mateo County Overdose Prevention Coalition.

Since 1990, the Service League of San Mateo County’s Hope House has provided 24/7 residential substance use disorder (SUD) treatment and mental health services for pregnant, postpartum and new mothers. The program houses up to 16 women and four infants in two side-by-side homes in Redwood City. 

Our evidence-based, gender-specific groups offer up-to-date tools to address SUD and other harmful behaviors, focusing on overall client health. We work closely with courts, probation, parole and Children and Family Services to resolve legal issues and reunify clients with their children. 

Many clients are introduced to Hope House while incarcerated at the San Mateo County jail. Through the Service League’s in-custody group “Hope Inside,” they learn that a new life in recovery is possible. Potential clients are interviewed while incarcerated and coordinated with after release for a warm handoff into the program. 

“I was interviewed in the jail and offered a spot at Hope House. Even though I had to go to Santa Clara County first, they kept in touch and when I got out, there was a bed waiting for me,” says Alma B., a transitional resident who spent 90 days at Hope House. “Having discipline and structure in my life really helped me, and knowing that there are services after to continue the support like transitional housing.” 

After treatment, graduates can access free services through our groups and open-door policy. Qualifying alumni may move into our transitional housing, which supports residents’ long-term goals with case management and recovery-based involvement in the community. 

Alma now works as Hope House Support Staff and a Bilingual Recovery Coach at Voices of Recovery. “Being part of the Hope House community has opened a lot of doors for me,” she says. “It’s a privilege to give back. I can show clients that if I can do it, they can too.” 

Learn more at serviceleague.org, call 650-364-4664, or email info@serviceleague.org. 

By Anna Zaretski, MPA, Executive Director 

An overdose can happen to anyone. It may involve prescription medication, fentanyl, alcohol, or a combination of substances. Because fentanyl can be present in other drugs without a person knowing, an opioid overdose may occur even when someone did not intend to use an opioid. 

Overdose risk is not limited to people who have a diagnosed substance use disorder or who fit common stereotypes about drug use. A person may be at risk while taking an opioid prescribed after an injury or surgery, when combining an opioid with alcohol or certain medications, or after a period of not using opioids when their tolerance has decreased. Young people may also unknowingly take a substance containing fentanyl, and children can be harmed by medications that are not stored securely. 

These shared vulnerabilities cross ages, incomes, neighborhoods, professions and family backgrounds. Recognizing that overdose can affect people throughout our community helps reduce stigma and encourages more people to carry naloxone, learn the warning signs, and respond without judgment. Knowing what to look for – and acting quickly – can help save a life. 

How to recognize the signs

During an opioid overdose, breathing can become dangerously slow or stop. The person may be unresponsive and unable to wake up, even when you call their name and tap their shoulders. Remembering the BLUE acronym can help remember the key signs of an opioid-related overdose: 

Breathing – slow, shallow, irregular, or stopped breathing

Lips – blue, gray, or purple lips or fingernails

Unresponsive – unable to wake up, limp body

Eyes – very small, “pinpoint” pupils 

Other warning signs may include: 

• Choking, snoring, or gurgling sounds 

• Pale, cold, or clammy skin 

Not every person will show every sign. When in doubt, treat the situation as a possible overdose. Responding is safer than waiting. 

How to respond according to the California Department of Public Health:

1. Give naloxone and call 911.
2. If needed, provide a second dose of naloxone (using a new naloxone container) after 2-3 minutes.
3. Keep the person awake and breathing.
4. If the person is not breathing you can perform rescue breathing or CPR.
5. Lay the person on their side to prevent choking.
6. Stay with the person until 911 responders arrive.

How to prepare

Even if you think you’ll never find yourself in a situation where you’re confronted with an overdose, being prepared can save lives. Keep naloxone at home, at work, or in a bag you carry. Tell others where it is. San Mateo County residents can get free naloxone from vending machines and naloxone stand boxes located throughout the county. Naloxone is also available without a prescription at pharmacies and major retailers, and by mail from calrxnaloxone.com.  

Visit the overdose prevention page to find free naloxone near you, watch training videos, and learn how to get involved with the San Mateo County Overdose Prevention Coalition. 

By the San Mateo County Overdose Prevention Coalition

On July 30, 2026, the San Mateo County Phoenix Garden community celebrated the graduation of 17 young adults from the Phoenix Garden Summer Internship Program. 

The graduates represented youth from vulnerable communities who have experienced behavioral health challenges, involvement with the criminal justice system and/or other challenges such as poverty and homelessness. The ceremony highlighted their resilience, accomplishments, partnerships and growing pride in themselves and their work. 

The graduation included a tour led by the youth participants, where they shared about their experience in the garden. Several interns shared how the program helped them build confidence, develop healthier ways to care for themselves, and experience the healing benefits of working outdoors. They described the garden as a place where they could feel calm, connected, supported and hopeful. Through meaningful work and trusted relationships, interns strengthened skills in teamwork, responsibility, creativity, leadership, and self-advocacy. 

The participants also presented projects they completed over the summer. These projects were designed and led by small teams of youth. They included: 

• Creating a welcoming circle at the garden entrance with native and culturally meaningful plants.
• Partnering with the San Mateo County Native and Indigenous Peoples Initiative (NIPI) to enhance the NIPI garden area with California native plants.
• Designing a mural that honors that celebrates the Phoenix Garden, including the Ohlone people, the original stewards of the land, as well as native plants and animals.

The mural also reflects the youths’ journeys and their ability to “break the chains” of past challenges, harmful systems, and limiting expectations as they create new possibilities for their lives. 

The Phoenix Garden Internship Program is an important example of early behavioral health intervention. It reaches young people who are already navigating significant challenges and provides timely support before those challenges become more severe. Through mentorship, structure, employment experience, cultural connection, and opportunities to succeed, the program helps strengthen protective factors and connects youth to positive relationships and pathways. 

The program demonstrates that early intervention can take place outside traditional clinical settings. Healing happens through connection to the land, creative expression, supportive relationships, meaningful responsibility and a sense of belonging. These experiences help young people recognize their strengths, manage stress, build confidence, and envision a hopeful future. 

The impact extends beyond the internship. The skills, relationships, and sense of accomplishment developed through the program may support interns in their education, employment, well-being, and continued connection to their communities. Their projects have also created a more welcoming, culturally meaningful, and healing space for future garden visitors. 

The program was developed and led by the University of California 4-H, a youth development program with the goal of helping all California youth thrive. Throughout the program, 4-H partnered closely with San Mateo County Behavioral Health and Recovery Services, Public Health, Policy and Planning, the County Office of Education and the Juvenile Probation Department. 

Congratulations to all the graduates for their hard work, courage and creativity. Special thanks to Public Health Policy and Planning, Health Administration, the Regents of the University of California Phoenix Garden Team, intern and intern leads, families, mentors, and community partners for investing in youth healing, leadership, and new beginnings. 

By Maria Lorente-Foresti, Office of Diversity and Equity Director

10/3 – NAMI Walks San Mateo County – Walk for Mental Health  

NAMI is hosting their annual Walk for Mental Health on Saturday October 3, 9 a.m. – 12:30 p.m. at Coyote Point Park in San Mateo. NAMI has an important mission that is aligned with BHRS – to enhance the quality of life for individuals and families affected by mental illness and help others understand mental illness. At the link here, you can individually donate and share the BHRS team link with your network to raise funds. The event is free to attend and no matter how you are able to participate, you’ll contribute to increasing mental health awareness.   

10/15 – Global Peer Support Day 

The BHRS Office of Consumer and Family Affairs and One New Heartbeat, Inc. are hosting the 2026 Global Peer Support Celebration Day on October 15 from 10:00 a.m. – 2:00 p.m. at the Chan Zuckerberg Community Space. This special event honors the meaningful contributions of Peer and Family Peer Supporters across San Mateo County. Throughout the event, we will explore the many ways peer support promotes wellness, resilience, advocacy, healing and belonging through interactive sessions, shared stories and opportunities to connect with others who are passionate about the power of peer support. 

Please RSVP by October 10, 2026, to confirm your attendance. 

10/21 – Housing Heroes Awards   

Join us for the 19th annual Housing Hero Awards on Wednesday October 21, 2026, 2:00 – 4:30 p.m. at the Redwood Shores Library Community Room in Redwood City. The Housing Hero Awards honors our community partners and colleagues who have demonstrated exceptional leadership in providing and/or maintaining housing for San Mateo County residents with co-occurring mental health and substance use issues. 

More News:

BHRS Director Dr. Jei Africa has been presented with the Outstanding Service to Division VII award from the California Psychological Association for going above and beyond in his service to the Division, its mission, and social-justice related topics. Jei has been awarded, “for his devoted years of service to Division VII. He was the previous 2024 Diversity Delegate to CPA’s executive board, helped spearhead CPA’s first walk in the SF Pride Parade, brought the concept of doing a Land Acknowledgements to CPA Speakers during presentations, and was integral in creating the Division VII student awards beginning in 2024. Dr. Africa’s commitment to social-justice shows in his work in the community as the San Mateo County Director of Behavioral Health and Recovery Services where he has increased outreach to underserved communities and expanded-care for justice-involved individuals.” 

Congratulations, Jei! 

 

Fostering Wellness Program Accepting Volunteers and Referrals

The Fostering Wellness Program is accepting volunteers and referrals. The program, which is a partnership between Behavioral Health and Recovery Services (BHRS) and Public Health Policy and Planning (PHPP), provides temporary pet foster care through a network of volunteer foster homes. 

About the program:  

• Provides temporary care (up to 90 days) for pets while owners receive medical or behavioral health treatment. Please note that a client must be connected to a San Mateo County program or county contracted program. 

• A network of safe, trustworthy and vetted volunteer foster homes has been built. 

• Offers owners peace of mind to seek a higher level of treatment while animal companions are well cared for. 

Love animals? Want to make a difference in someone’s life? We’re recruiting foster care volunteers for 30-90 days. Visit smchealth.org/fostering-wellness for more information. 

Providers and case managers can refer a client via the referral form. 

For questions about the program, email fosteringwellness@smcgov.org. 

 

Regional Co-Responder Symposium  

The Sheriff’s Office Psychiatric Emergency Response Team (PERT), a co-responder unit that pairs Sheriff’s Office detectives with licensed mental health clinicians from BHRS to de-escalate and respond to community mental health crises, hosted the first ever Regional Co-Responder Symposium in September. The event brought together co-responder teams from across San Mateo County and neighboring counties, and included sessions led by PERT and subject matter experts retired Lt. Glenn Albin and Tammy McCoy-Arballo. The day ended with a consultation group facilitated by PERT, giving teams an opportunity to connect, learn from one another and work through shared challenges. The symposium provided a valuable space to exchange knowledge, best practices, strengthen partnerships and enhance co-response efforts throughout our communities.  

California Releases Guidance on New Federal Public Charge Rule  

Update from the Department of Health Care Services: On September 18, the federal government’s new Public Charge Rule took effect. Public charge is a test that immigration officials use to decide whether a noncitizen is likely to become primarily dependent on the government for support. It can apply when some immigrants seek entry to the United States or apply for a green card. It does not apply to most immigrants already in the United States. The California Health and Human Services Agency released resources explaining the new rule, including what it means and how it may affect individuals and families. 

 

New Video! Residential Substance Use Treatment for Women in San Mateo County  

If you or someone you know is seeking substance use treatment, BHRS is here to help. San Mateo County partners with community-based organizations to provide residential substance use treatment for women. Every program staff member shares a common bond: lived experience and a deep understanding of the journey to recovery. These programs provide a supportive foundation where woman can reclaim their independence and redesign their future. Watch to hear their stories. To learn more about residential programs, call BHRS Alcohol and Other Drug Services at (650) 802-6400.

The San Mateo County Behavioral Health Commission’s Youth Action Board (YAB) is a group of young people (ages 14-24) committed to improving the behavioral health of youth across the County. Founded in 2022 by Behavioral Health Commissioner Frieda K. Edgette and Youth Commissioners Katelyn Chang and Hudson Fox to bring youth leadership, voice and lived experiences to mental and behavioral health decision-making tables, the YAB has evolved into a high-impact collective voice to improve the wellbeing of youth and those who care for them. 

Guided by a North Star that no young person should navigate mental health challenges alone or feel ashamed to ask for support, our initiatives focus on making resources more accessible, relatable and easier to find, while creating spaces where young people feel comfortable sharing their experiences and directly shape the services they need.  

Aligned with the BHRS transformation journey and Behavioral Health Services Act implementation, our 2026-2027 goals fall under Media and Policy: 

• Addressing access and service gaps: Over the past two years, the YAB and Youth Committee have partnered with BHRS to identify service gaps, gather feedback from youth and advocate for systems change. Digitally, we’ve designed a Pathways digital prototype for a “one-stop-shop” of mental health and behavioral health services and peer support communities in the County. This year, we are committed to bringing the Pathways tool to life, exploring a number of options with youth as co-designers. Our Policy Subcommittee examined gaps in youth crisis care and supported a statewide grant application for a Youth Crisis Healing Campus. This year, we are continuing a partnership with the San Mateo County Office of Education and United for Youth Blueprint to redesign a youth-shaped mental health curriculum in schools. 
• Amplifying youth perspectives through digital content: With the support of BHRS, our Media Subcommittee is beginning a partnership with Decoded, including content creation training and technical assistance, and will create regular digital content for the Decoded platform that increases awareness of resources, substance use and co-occurring education, peer support, and ongoing changes in Medi-Cal that impact youth. Follow up on Instagram at https://www.instagram.com/decoded.ca/. 

We’d love for you to join us! Attend the monthly Behavioral Health Commission Youth Committee the third Wednesday of the month from 4-5PM via Zoom. Contact Frieda Edgette at edgette@novosconsulting.com to get involved. 

Dr. Jei Africa with the 2026-2027 Youth Action Board, pictured Left to Right: Maya Canas, Layla Ortiz, Amalia Viator, Luz Martinez, Kristyn Lee, Shaila Gonzalez, Eva Luna, Kaitlyn Ho, Veer Chowdhary, Allison Cerron, Ethan Liu, Sharon Sims Calzolai, Micah Zhou, Dr. Jei Africa, (not pictured: BHRS Project Manager Edith Cabuslay, Behavioral Health Commissioner Frieda K. Edgette, Behavioral Health Commissioner Michael Lim) 

Order No. F26-1 of the Health Officer of the County of San Mateo for the Wearing of Face Masks in Skilled Nursing Facilities

Date of Order: October 1, 2026
Effective Date: November 1, 2026

Summary of This Order

This Order requires all persons, except patients, in Patient Care Areas of Skilled Nursing Facilities to wear a Face Mask during the period deemed the Designated Winter Respiratory Virus Period by the Health Officer, with limited exemptions.

Background and Purpose

Annually, between late fall and spring, San Mateo County data shows higher rates of COVID-19, influenza, respiratory syncytial virus, and other viral infections that can cause severe respiratory disease among people living in the County. This seasonal increase in circulation of multiple respiratory viruses causes a particular risk to populations more likely to experience severe disease and death if infected, including infants, older adults, and people with impaired immune systems.

The seasonal surges also risk overwhelming the existing health care system in the county, jeopardizing the capacity to provide care for these and other diseases. The risk to vulnerable patients of any of these viral illnesses in health care settings, especially skilled nursing facilities, remains significant. Vaccines and boosters that target respiratory viruses continue to be the best protection against severe disease, as well as good ventilation systems and respiratory hygiene.

Another important protection in these settings is the use of a Well-Fitted Mask by Healthcare Personnel and visitors, which reduces both the risk of infection for those Personnel and reduces the risk of them and visitors transmitting respiratory viruses to Patients and Residents. Considering the above, it continues to be important for masks to be used in the Patient Care Areas of these settings when seasonal risk of exposure to one or multiple viruses is at its highest.

This Order introduces a seasonal requirement for use of Face Masks in Skilled Nursing Facilities, as set forth below.

Order

Under the Authority of California Health and Safety Code Section 120175, the Health Officer of the County of San Mateo (“Health Officer”) Orders:

1. Definitions.
   1. “Face Mask” means a surgical mask, KN95, KF94, or N95 that is well-fitted to an individual and covers the nose and mouth. A scarf, ski mask, balaclava, bandana, turtleneck, collar, cloth mask, or any mask that has an unfiltered one-way exhaust valve does not qualify as a Face Mask under this Order. Guidance regarding well-fitted masks may be found at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/types-of-masks.html.
   2. “Skilled Nursing Facility” means a health facility or a distinct part of a hospital which provides continuous skilled nursing care and supportive care to patients whose primary need is for availability of skilled nursing care on an extended basis.²
   3. “Patient Care Area” means any area that patients regularly access in order to receive healthcare within a Health Care Delivery Facility. Patient Care Areas include patients’ rooms, lobbies, waiting rooms, examination rooms, patient wings, elevators, and hallways used by patients. Patient Care Areas do not include administrative offices or staff break areas that are only accessible to personnel of the Health Care Delivery Facility. Patient Care Areas do not include areas such as cafeterias or gift shops that are not used for the provision of healthcare or to access areas where healthcare services are provided.
   4. “Designated Winter Respiratory Virus Period” means the period from November 1 to March 31. The Health Officer may adjust the dates of the Designated Winter Respiratory Virus Period based on respiratory virus surveillance data. If the Health Officer changes the dates of the Designated Winter Respiratory Virus Period, the Health Officer will notify Health Care Delivery Facilities through a Health Advisory and a notice posted on the County Health Department’s website (https://www.smchealth.org/).
   5. “Personnel” means all paid and unpaid people who work in indoor Healthcare Facilities in locations where care is provided to patients. This includes workers serving in healthcare or other settings who have the potential for direct or indirect exposure to Patients, Clients, Residents. Personnel include, but are not limited to, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the Healthcare Facility, and persons who could be exposed to or transmit infectious agents that can be transmitted in the health care or congregate living setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, volunteer personnel and emergency services personnel). “Personnel” does not include Patients, Residents or family members, friends and other individuals who enter healthcare facilities for the primary purpose of engaging in social visitation.
2. Mandatory Requirement to Wear Face Masks in Patient Care Areas of Skilled Nursing Facilities During the Designated Winter Respiratory Virus Period.
   1. Regardless of vaccination status, all persons in Patient Care Areas of Skilled Nursing Facilities must wear a Face Mask during the period deemed the Designated Winter Respiratory Virus Period by the Health Officer, except for the following:
      1. Persons with a medical condition, mental health condition, or disability that prevents wearing a mask. This includes persons with a medical condition for whom wearing a mask could obstruct breathing or who are unconscious, incapacitated, or otherwise unable to remove a mask without assistance.
      2. Persons who are hearing impaired, or communicating with a person who is hearing impaired, where the ability to see the mouth is essential for communication.
      3. Persons for whom wearing a mask would create a risk to the person related to their work, as determined by local, state, or federal regulators or workplace safety guidelines.
      4. Persons who are specifically exempted from wearing face masks pursuant to other CDPH guidance.
   2. All businesses and governmental entities with Skilled Nursing Facilities must enforce this Face Mask Requirement for all healthcare personnel and visitors entering Patient Care Areas within the facility, regardless of vaccination status, except as otherwise provided in this Order. All such businesses and governmental entities must post clearly visible and easy-to-read signage at all entry points to Patient Care Areas to communicate the Face Mask requirements to all personnel and visitors entering the Patient Care Areas of the Facility.
      1. In addition, those responsible for Skilled Nursing Facilities are required to provide Face Masks to individuals who will be in an area where Face Masks are required.
      2. This Order does not require patients or residents to wear masks, although masks remain strongly recommended in healthcare settings for all patients and residents not covered by these requirements when interacting with others.
3. Recommendations from the Health Officer. The Health Officer strongly urges all businesses and governmental entities with Health Care Delivery Facilities such as general acute care hospitals, psychiatric hospitals, correctional health, ambulatory care settings, residential care facilities for the elderly, dialysis and infusion centers to monitor local and internal data that indicate circulating levels of respiratory viruses and impact to the facilities, such as, but not limited to, local virus wastewater monitoring, test positivity rates, bed availability, employee absenteeism due to illness, or rates of clinical care episodes due to respiratory viruses. Those Health Care Delivery Facilities should institute internal policies that require masking of staff and visitors at any time during or outside the Designated Winter Respiratory Virus Period when local or internal data indicate that there is a high level of risk to patients or employees.¹

   It is also strongly recommended that personnel and visitors in healthcare facilities not listed in this order (e.g., outpatient clinics, mental and behavioral health clinics, therapy clinics, residential care facilities for the elderly, general acute care hospitals, dialysis and infusion centers) wear well fitted masks when interacting with patients or clients during the winter respiratory virus season.

4. Applicability. All individuals, businesses, and other entities in the county are ordered to comply with the applicable provisions of this Order. For clarity, individuals who do not currently reside in the county must comply with all applicable requirements of the Order when they are in the county. Governmental entities must follow the requirements of this Order applicable to Businesses, unless otherwise specifically directed by the Health Officer.
5. Obligation to Follow Any Stricter State Requirements. If a conflict exists between this Order and any order issued by the State Health Officer, the Governor, or a State agency (such as the California Division of Occupational Safety and Health (Cal/OSHA)) related to promotion or protection of public health, the most restrictive mandatory provision controls. For clarity, all individuals and entities must comply with any mandatory requirement imposed by the State to the extent it is stricter than any provision of this Order. Consistent with Health and Safety Code section 131080 and the Health Officer Practice Guide for Communicable Disease Control in California, except if the State Health Officer issues an order expressly directed at this Order and based on a finding that a provision of this Order constitutes a menace to public health, any more restrictive measures in this Order continue to apply and control in this county. In addition, to the extent any federal guidelines are inconsistent with this Order, this Order is controlling.
6. Enforcement. Under Sections 26602 and 41601 of the California Government Code and Section 101029 of the California Health and Safety Code, the Health Officer requests that the Sheriff and the Chief of Police in the County ensure compliance with and enforce this Order. The violation of any provision of this Order constitutes an imminent threat and immediate menace to public health, constitutes a public nuisance, and is punishable by fine, imprisonment, or both.
7. Effective Date. This Order is effective at 12:01 a.m. on November 1, 2026 and shall expire at 12:01 a.m. on April 1, 2027 unless otherwise extended by the Health Officer.
8. Copies. Copies of this Order shall promptly be: (1) made available at 500 County Center, Redwood City, California; (2) posted on the County Health Services website (https://www.smchealth.org/health-orders-updates); and (3) provided to any member of the public requesting a copy of this Order.
9. Severability. If any provision of this Order or its application to any person or circumstance is held to be invalid, the remainder of the Order, including the application of such part or provision to other persons or circumstances, shall not be affected and shall continue in full force and effect. To this end, the provisions of this Order are severable.

Violation of, or failure to comply with, this Order is a public nuisance subject to citation, abatement, or both, as well as a misdemeanor punishable by fine, imprisonment, or both. (California Health and Safety Code § 120295 et seq.; California Penal Code § 69, 148(a)(1)).

It Is So Ordered

/Signed/
Kismet Baldwin-Santana MD, MPH
Health Officer of the County of San Mateo

Dated: October 1, 2026

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Footnotes

1. For data regarding the County’s wastewater surveillance, visit: https://skylab.cdph.ca.gov/calwws/. ↑
2. https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/ELRU_SNF-ICF.aspx ↑