Health Commissioner's Order No. 5 - COVID-19 (2021)

Order number five continues the requirement to wear facial coverings when indoors and enclosed public buildings and spaces, and on public transportation.

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Health Commissioner's Order No. 5 (2021) - COVID-19 (PDF)

Order No. 5

This Order No. 5 shall become effective immediately upon approval of the local governing board and will continue to be in effect for 30 calendar days, subject to extension.

My intent is to ensure that the maximum number of individuals take prudent precautions to reduce the exposure to, and slow the spread of, SARS CoV-2, the virus that causes COVID-19. All provisions of this Order shall be interpreted to effectuate this intent.

Whereas, there is evidence of ongoing transmission of SARS CoV-2 in all City of St. Louis zip codes and across the St. Louis Metropolitan Area. There is ongoing transmission among all age groups, hospitalizations and deaths related to COVID-19 continue to occur, and more than 35% of eligible City of St. Louis residents have not received a single dose of a COVID-19 vaccine and are at risk of severe complications (including hospitalizations and death) if infected with the virus; and

Whereas, on July 27, 2021, the Centers for Disease Control and Prevention (CDC) issued new guidance, recommending all vaccinated individuals (in addition to their previous recommendation for unvaccinated individuals) in “substantial” or “high” transmission areas, with either more than 50 cases per 100,000 people in the area over a seven-day period, or with a COVID-19 test positivity rate higher than 5%, wear masks indoors. According to the CDC, Missouri remains a “high transmission” jurisdiction and St. Louis is a “substantial transmission” jurisdiction as of November 22, 2021.

By the authority vested in me by Article XIII, Section 14-C(c) of the Charter of the City of St. Louis, I hereby order as follows: 

1. Individuals, both vaccinated and unvaccinated, age 5 and older shall be required to properly wear a face covering that covers the wearer’s nose and mouth while in indoor and enclosed public buildings and spaces, and public transportation vessels in the City of St. Louis. While on duty, all City of St. Louis employees shall wear a face covering when riding in City vehicles with one or more other individuals.

2. Exceptions to the required face covering are recognized for:

a. Individuals who have an official order or documentation from a medical or behavioral health provider to not wear face coverings;

b. Individuals who are seated in a restaurant or bar and are actively engaged in consuming food or drink;

c. Individuals who have trouble breathing, or are unconscious, incapacitated, or otherwise unable to remove the face covering without assistance;

d. Individuals who are obtaining a service involving the nose or face for which temporary removal of the face covering is necessary to perform the service;

e. Individuals whose religious beliefs or practices prohibit the wearing of a face covering;

f. Individuals who have disabilities that:

i. Prevent them from wearing or taking off face coverings.

ii. Prevent them from communicating while wearing face coverings. 


Date: 11/23/2021
Dr. Frederick Echols, Commissioner of Health

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