Bay Area public health officials are hoping to prevent the same 'tripledemic' that put a strain on hospitals across the area last year.
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"This situation right now with RSV and other viruses, respiratory viruses is basically our March 2020 -- this is our pandemic," Dr. Jackie Grupp-Phelan, division chief of Pediatric Emergency Medicine at UCSF Benioff Children's Hospitals said in an interview with ABC7 in November 2022.
That was last November in the Bay Area, when the 'tripledemic' of RSV, COVID, and flu pushed healthcare workers to the limits.
It forced at least one hospital to expand into tents on the sidewalk outside.
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But many Bay Area counties are taking measures now to stop history from repeating itself.
"The order in Santa Clara County does require masking for everyone who steps into a health care facility," Dr. Sarah Rudman, Santa Clara County's Deputy Health Officer said. "And that's because we're all at risk during this winter virus season. We all need to play a role in protecting ourselves and protecting each other."
Starting on Wednesday, Santa Clara County will see the biggest change.
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Patients, caregivers and healthcare providers are now required to mask up inside of hospitals, clinics and long-term care facilities.
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But in Alameda, San Mateo, Contra Costa and Sonoma Counties, it's just the healthcare workers and not patients, required to mask up.
That's the same mandate San Francisco has been following all along.
"To be completely honest and open, part of it is the incredible pushback on mask mandates," Dr. Karen Smith, Sonoma County's Interim Health Officer said.
Smith says the population they're most trying to protect are those vulnerable patients.
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"The highest risk that they have when they come into a health care facility is actually from the health care provider, because that's who they're dealing with in an enclosed room close to each other or if they're already in the hospital or, you know, they're already in a state that makes them a little higher at risk," she said.
Healthcare officials are still urging everyone to get their COVID and flu shots. And now, an RSV vaccine is available to vulnerable groups too, including pregnant people nearing their due date.
"Because getting vaccinated when you're pregnant passes immunity to your baby when it's born and helps it be protected during that most vulnerable period right after birth," Rudman said. "In addition, we have vaccines available for people who are 60 and older."
Sonoma County public health officials said they may choose to update their mask mandate later on, in the event that another surge puts a strain on ICU beds available across the county.
The mask mandates inside of hospitals and skilled nursing facilities are expected to last for five months, through the end of March.