Americans are expressing their outrage as Covid-era mask rules slowly take hold across California.

Sonoma County, in San Francisco, is the latest region to reinstate its mask mandate in all medical settings for staff but not visitors.

There are more than 20 hospitals and clinics in the area treating over 480,000 residents and visitors, with the largest being the Santa Rosa Memorial Hospital.

Dr Karen Smith, the county’s interim health director, issued the order ‘given the rising risk of respiratory virus-related illnesses, such as COVID and flu.’

The order will be in effect throughout the remaining respiratory virus season, from November 18 through April 30.

Despite Dr Smith’s concerns, the latest report from the California Department of Public Health reveals that Covid and and influenza activity are ‘currently low’ in the state and there were no hospital admissions in the week beginning October 28.

Meanwhile, the CDC states in its latest update that 4.8% of the US population have tested positive for active Covid infection.

In reaction to the recent announcement regarding mask wearing in Sonoma, many people have deemed it ‘stupid’ and a ‘joke’ on social media.

Another Facebook user fumed: ‘Foolish, when they were deemed to do nothing.’

However, some people are in support of the mask-wearing mandate, with one commenter writing: ‘Good. The idea to protect patients is always a good one.’

At the beginning of the month, the Community Hospital of the Monterey Peninsula also reinstated its mask wearing policy for the same reasons.

Meanwhile, other counties with the mask requirements include San Francisco, Alameda, Contra Costa, Santa Clara, Napa and San Mateo.

These areas collectively are home to more than 2.8 million residents.

The rules vary county by county, but in Sonoma, all personnel in patient care areas of health care facilities must wear a face mask through the duration of the order and regardless of their vaccination status.

Additionally, any businesses delivering health care products or goods must  enforce the mandate for any personnel entering patient care areas.

While Sonoma isn’t applying the rule to visitors, other counties such as Santa Clara and San Mateo are requesting that anyone who enters medical facility must wear a mask.

Dr Smith also recommends that both vaccinated and unvaccinated people wear masks in public indoor settings when the Covid or influenza risk is high.

She added: ‘Each year, we see that higher rates of influenza, COVID-19 and other respiratory viruses that can cause severe respiratory infections occur between late fall and spring.

‘Influenza and other seasonal respiratory viruses infect tens of millions in the United States each year and can result in serious medical outcomes, including hospitalizations and death.’

Since at least 2017, Sonoma County has required that all health care facilities establish an influenza vaccination program requiring health care workers providing direct patient care receive an annual influenza vaccine or wear a mask.

The order applies to staff at health care facilities including hospitals, clinics, surgery centers, infusion centers, dialysis centers, skilled nursing facilities, portions of long-term care facilities where nursing care is provided, and other facilities where patient care is provided indoors.

Dr Smith also included guidance for the general public around vaccinations, strongly recommending that everyone six months and older get updated COVID-19 and flu vaccines, and RSV vaccines if they are eligible.

‘Vaccination remains the best protection against respiratory virus infections,’ she highlighted.