City and County of
San Francisco

Department of Public Health
Order of the Health Officer

ORDER OF THE HEALTH OFFICER No. C19-05
DATE ORDER ISSUED: March 11, 2020
Please read this Order carefully. Violation of or failure to comply with this Order
constitutes a misdemeanor punishable by fine, imprisonment, or both. (California Health
and Safety Code §§ 120295, et seq.)
Summary: The virus that causes Coronavirus 2019 Disease is easily transmitted,
especially in group settings, and it is essential that the spread of the virus be slowed to
protect the ability of public and private health care providers to handle the influx of new
patients and safeguard public health and safety. Because of the risk of the rapid spread of
the virus, and the need to protect the most vulnerable members of the community, this
Order prohibits all indoor public and private gatherings and outdoor gatherings within an
enclosed space of 1,000 persons or more anywhere in San Francisco beginning at 1 p.m.
on March 11, 2020 and continuing for two weeks through March 25, 2020, subject to the
limited exceptions and under the terms and conditions more particularly set forth below.
For all other gatherings, the Health Officer strongly recommends following the social
distancing protocols attached to this Order, including canceling, rescheduling, or not
attending events with more than 250 persons. And organizations that serve high-risk
populations should cancel gatherings of more than 10 people.
UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE
SECTIONS 101040, 101085, AND 120175, THE HEALTH OFFICER OF THE CITY AND
COUNTY OF SAN FRANCISCO (“HEALTH OFFICER”) ORDERS:
1. Effective as of 1:00 p.m. on Wednesday, March 11, 2020, and continuing until 11:59
p.m. on March 25, 2020, public or private Mass Gatherings (as defined in Section 8
below) are prohibited anywhere in the City and County of San Francisco (the
“City”).
2. In addition, the Health Officer strongly recommends that all persons within the City
follow the social distancing practices issued by the San Francisco Department of
Public Health on March 6, 2020 and updated on March 11, 2020 (the “Social
Distancing Recommendations”), a copy of which is attached to this Order and
incorporated by this reference, as well as the “Implementation of Mitigation
Strategies for Communities with Local COVID-19 Transmission” issued by the
United States Centers for Disease Control and Prevention (“CDC”) on or around
March 11, 2020 (available online at www.cdc.gov/coronavirus/2019ncov/downloads/community-mitigation-strategy.pdf). The Health Officer urges
people to not attend non-essential gatherings during the duration of this Order in
order to help slow down the spread of the COVID-19 virus. The CDC guidance
cited in this paragraph includes recommendations to cancel or avoid large
gatherings (those in excess of 250 people) and for organizations that serve high-risk
populations to cancel gatherings of more than 10 people. For sake of clarity, large

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 City and County of
San Francisco

Department of Public Health
Order of the Health Officer

ORDER OF THE HEALTH OFFICER No. C19-05
non-essential entertainment or social gatherings should be postponed or canceled.
3. This Order is issued based on evidence of increasing occurrence of Coronavirus
Disease 2019 (“COVID-19”) within the City and throughout the Bay Area, scientific
evidence and best practices regarding the most effective approaches to slow the
transmission of communicable diseases generally and COVID-19 specifically, and
evidence that the age, condition, and health of a significant portion of the population
of the City places them at risk for serious health complications, including death,
from COVID-19. Some individuals who contract the COVID-19 virus have no
symptoms or have mild symptoms, which means they may not be aware they carry
the virus. Because even persons without symptoms can transmit the disease, and
because evidence shows the disease is easily spread, large gatherings can result in
preventable transmission of the virus. The scientific evidence shows that at this
stage of the emergency, it is essential to slow virus transmission as much as possible
to protect the most vulnerable and to prevent the health care system from being
overwhelmed. One proven way to slow the transmission is to limit mass gatherings
in the early stages of the emergency. By reducing the spread of the COVID-19
virus, this Order helps preserve critical and limited healthcare capacity in the City.
4. This Order also is issued in light of the existence of 14 cases of COVID-19 in the
City, as well as 99 reported cases and at least one death in the Bay Area, as of 8 a.m.
on March 11, 2020, including a significant and increasing number of assumed cases
of community transmission and likely further significant increases in transmission.
Widespread testing for COVID-19 is not yet available but is expected to increase in
the coming days. This moratorium is necessary to slow the rate of spread and will
be re-evaluated as further data becomes available.
5. This Order is issued to prevent circumstances often present in Mass Gatherings that
are likely to exacerbate the spread of COVID-19. Those circumstances include,
without limitation: (a) the increased likelihood that Mass Gatherings will attract
people from a broad geographic area; (b) the prolonged time period during which
large numbers of people are in close proximity; (c) the difficulty in tracing exposure
when large numbers of people attend a single event; and (d) the inability to ensure
that attendees follow adequate hygienic and social distancing practices like those
described in the attached Social Distancing Recommendations.
6. This Order is issued in accordance with, and incorporates by reference, the March
4, 2020 Proclamation of a State of Emergency issued by Governor Gavin Newsom,
the February 25, 2020 Proclamation by the Mayor Declaring the Existence of a
Local Emergency issued by Mayor London Breed, and the March 6, 2020
Declaration of Local Health Emergency Regarding Novel Coronavirus 2019
(COVID-19) issued by the Health Officer, each of them as they may be
supplemented.

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 City and County of
San Francisco

Department of Public Health
Order of the Health Officer

ORDER OF THE HEALTH OFFICER No. C19-05
7. The Health Officer will continue to assess the quickly evolving situation and may, at
any time or from time to time, modify or extend this Order, or issue additional
orders, related to COVID-19.
8. Definitions:
a. For purposes of this Order, a “Mass Gathering” is any event or convening,
subject to the exceptions and clarifications below, that brings together or is
likely to bring together one-thousand (1,000) or more persons at the same
time in a single room or other single confined or enclosed space, such as, by
way of example and without limitation, an auditorium, theatre, stadium
(indoor or outdoor), arena or event center, meeting hall, conference center,
large cafeteria, or any other confined indoor or confined outdoor space.
b. A “Mass Gathering” includes events in confined outdoor spaces, which
means an outdoor space that (i) is enclosed by a fence, physical barrier, or
other structure and (ii) where people are present and they are within arm’s
length of one another for extended periods.
c. This Order also does not prohibit gatherings of people in multiple, separate
enclosed spaces in a single building such as a multiplex movie theater, so long
as 1,000 people are not present in any single space as the same time. This
Order also does not prohibit use of enclosed spaces where 1,000 or more
people may be present at different times during the day, so long as 1,000 or
more people are not present in the space at the same time. For any gathering
covered by this subsection c., the Health Officer strongly encourages
compliance with the attached Social Distancing Recommendations, including
providing hand sanitizer and tissues and increasing cleaning of commonlytouched surfaces.
d. For purposes of clarity, a “Mass Gathering” does not include the following:
(i) San Francisco International Airport, which is not located within the City;
(ii) public or private schools and places of worship; (iii) museums (so long as
visitors are generally are not within arm’s length of one another for extended
periods); (iv) spaces where 1,000 or more persons may be in transit or
waiting for transit such as bus, ferry, or subway stations or terminals (or
shopping areas associated with the buildings housing those stations or
terminals); (v) office space, hotels, or residential buildings; (vi) grocery
stores, shopping malls, or other retail establishments where large numbers of
people are present but it is unusual for them to be within arm’s length of one
another for extended periods; and (vii) hospitals and medical facilities. In all
such settings, the Health Officer recommends following the attached Social
Distancing Recommendations, and harm reduction measures such as hand
sanitizer and tissues should be provided when possible. However, except for
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 Department of Public Health
Order of the Health Officer

City and Count}' of
San Francisco

ORDER OF THE HEALTH OFFICER No. C19-05
spaces covered by clause (iv) above, any specific large gathering space that is
part of any building included in this subparagraph d. is subject to the
prohibition on Mass Gatherings if the space holds 1,000 or more people. A
"Mass Gathering" also includes events held in a cruise ship while that ship is
docked at any City port.
9. This Order shall be effective until 11:59 p.m. on March 25, 2020, or until it is earlier
rescinded, superseded, or amended by the Health Officer or by the State Public
Health Officer, in writing.
10. Pursuant to 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 City ensure compliance with
and enforce this Order.
11. The City must promptly provide copies of this Order as follows: (1) by posting on
the City Administrator's website (sfgsa.org) and the Department of Public Health
website (sfdph.org); (2) by posting at City Hall, located at 1 Dr. Carlton B. Goodlett
PI., San Francisco, CA 94102; (3) by providing to any member of the public
requesting a copy; and (4) by serving via email on large facilities in the City that are
likely to be subject to this Order (but service by email is not required for
compliance). In addition, the owner, manager, or operator of any facility that is
likely to be impacted by this Order is strongly encouraged to post a copy of this
Order onsite and to provide a copy to any member of the public asking for a copy.
Finally, the owner, manager, or operator of any facility that is subject to this Order
or that receives a copy from the City is ordered to check the City Administrator's
website (sfgsa.org) on a daily basis in order to look for updates to this Order and is
required to comply with any updates until this Order, is terminated.
12. If any subsection, sentence, clause, phrase, or word of this Order or any application
of it to any person, structure, gathering, or circumstance is held to be invalid or
unconstitutional by a decision of a court of competent jurisdiction, then such
decision will not affect the validity of the remaining portions or applications of this
Order.

IT IS SO ORDERED:

~~Qu~
Tomas J. Aragon, MD, DrPH,
Health Officer of the
City and County of San Francisco ·

Date: March 11, 2020

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 City and County of
San Francisco

Department of Public Health

PUBLIC HEALTH RECOMMENDATIONS AS OF MARCH 11, 2020 (revised)

1) Vulnerable Populations: Limit Outings
 Vulnerable populations include people who are:
o 60 years old and older.
o People with certain health conditions such as heart disease, lung disease, diabetes,
kidney disease and weakened immune systems.

o People who are pregnant or were pregnant in the last two weeks.
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For vulnerable populations, don’t go to gatherings (of 10people or more) unless it is essential. If
you can telecommute, you should. Avoid people who are sick.

2) Workplace and Businesses: Minimize Exposure
 Suspend nonessential employee travel.
 Minimize the number of employees working within arm’s length of one another, including
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minimizing or canceling large in-person meetings and conferences.
Urge employees to stay home when they are sick and maximize flexibility in sick leave benefits.
Do not require a doctor’s note for employees who are sick.
Consider use of telecommuting options.
Some people need to be at work to provide essential services of great benefit to the
community. They can take steps in their workplace to minimize risk.

3) Large Gatherings: Cancel Non-essential Events
 Recommend cancelling or postponing large gatherings, such as concerts, sporting events, conventions
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or large community events.
Do not attend any events or gatherings if sick.
For events that aren’t cancelled, we recommend:
o Having hand washing capabilities, hand sanitizers and tissues available.
o Frequently cleaning high touch surface areas like counter tops and hand rails.
o Finding ways to create physical space to minimize close contact as much as possible.

4) Schools: Safety First
 If there is a confirmed case of COVID-19 at a school, DPH will work with the school and the district to
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determine the best measures including potential school closure.
Do not go to school if sick.
If you have a child with chronic health conditions, consult your doctor about school attendance.
Equip all schools and classrooms with hand sanitizers and tissues.
Recommend rescheduling or cancelling medium to large events that are not essential.
Explore remote teaching and online options to continue learning.
Schools should develop a plan for citywide school closures, and families should prepare for
potential closures.

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ATTACHMENT TO ORDER C19-05

 City and County of
San Francisco

Department of Public Health

PUBLIC HEALTH RECOMMENDATIONS AS OF MARCH 11, 2020 (revised)

5) Transit: Cleaning and Protection
 Increase cleaning of vehicles and high touch surface areas.
 Provide hand washing/hand sanitizers and tissues in stations and on vehicles.
6) Health Care Settings: Avoid as possible, protect the vulnerable
 Long term care facilities must have a COVID-19 plan in accordance with DPH guidelines.
 Long term care facilities must screen all staff and visitors for illness and turn away those with symptoms.
 The general public should avoid going to medical settings such as hospitals, nursing homes and long-term
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care facilities, even if you are not ill.
If you are ill, call your health care provider ahead of time, and you may be able to be served by phone.
Do not visit emergency rooms unless it is essential.
Visitors should not go to long-term care facilities unless absolutely essential.

7) Everyone: Do your part
The best way for all San Franciscans to reduce their risk of getting sick, as with seasonal colds or the flu, still
applies to prevent COVID-19:
 Wash hands with soap and water for at least 20 seconds.
 Cover your cough or sneeze.
 Stay home if you are sick.
 Avoid touching your face.
 Try alternatives to shaking hands, like an elbow bump or wave.
 If you have recently returned from a country, state or region with ongoing COVID-19 infections, monitor
your health and follow the instructions of public health officials.
 There is no recommendation to wear masks at this time to prevent yourself from getting sick.
You can also prepare for the possible disruption caused by an outbreak. Preparedness actions include:
 Prepare to work from home if that is possible for your job, and your employer.
 Make sure you have a supply of all essential medications for your family.
 Prepare a child care plan if you or a care giver are sick.
 Make arrangements about how your family will manage a school closure.
 Plan for how you can care for a sick family member without getting sick yourself.
 Take care of each other and check in by phone with friends, family and neighbors that are vulnerable
to serious illness or death if they get COVID-19.
 Keep common spaces clean to help maintain a healthy environment for you and others. Frequently
touched surfaces should be cleaned regularly with disinfecting sprays, wipes or common household
cleaning products.
Keep up to date at www.sfdph.org, by calling 311, and by signing up for the City’s new alert service for official
updates: text COVID19SF to 888-777. Also see the “Implementation of Mitigation Strategies for Communities
with Local COVID-19 Transmission” issued by the United States Centers for Disease Control and Prevention
(“CDC”) on or around March 11, 2020 (available online at www.cdc.gov/coronavirus/2019ncov/downloads/community-mitigation-strategy.pdf).

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ATTACHMENT TO ORDER C19-05