East Bay Getting to Zero
SARS-CoV-2 scanning electron microscope image from NIAID
The SARS-CoV-2 virus (NIAID)

We are working together to slow the spread of the novel coronavirus 2019 (COVID-19). Below are this week’s East Bay COVID and HIV updates. This page is compiled by Sophy S. Wong, MD with data and resources gathered from many collaborators in Alameda County, Contra Costa County, Solano County, CA state, and many CBOs.

Click on these links for face covering FAQs, guidance on prevention, testing and wellness, resources and links, archived weekly updates and the weekly PDF summary. East Bay HIV service organizations are providing services by phone and/or video.


Key updates for this week:

Many thanks to those who joined us on Tuesday for “The Low-down on Masking Up for COVID-19” session. The video recording and slides are already available on our website. Please check out this important information here.

The AIDS2020 Virtual conference also started this week, and we hope that you’ve been able to join our East Bay organizations at conference sessions or at the Global Village, which is free and open to the public. We have also compiled the daily digests that have been sent out so far into this document for your reference. Lastly, the Center for AIDS Research has put together a folder with important and compelling highlights from the conference so far.

California state and counties have paused reopening plans due to a rapid rise in cases and hospitalizations. Alameda County reached a new high of 157 hospitalized patients confirmed for COVID-19 on July 3 and a new high of 51 patients in the ICU with confirmed COVID-19 on July 7. Cases in Alameda County have increased by 35% in the past week with a total of 7,245 cumulative reported cases on July 7. Contra Costa County’s cases increased by 43% in the past week with a total of 4,092 cases.  

Outbreaks in California state prisons continue to devastate inmates and staff, with over 1,500 cases at San Quentin and 7 deaths as of July 9, 2020. Some eligible inmates within 180 days of release have returned to the East Bay. 57 have returned to Alameda County so far, and Dr. Kathleen Clanon reports that they are doing well at the Project Roomkey hotels during their quarantine period. Resources for people serving people post-release are located on UCSF Amend’s COVID-19 webpage.

If cases and hospitalizations continue to increase at the same rate in Alameda County, our hospital bed capacity is projected to be overwhelmed by late August. The current transmission rate (Re) in Alameda County is estimated to be about 1.07 and in Contra Costa County about 1.19. This means each person with COVID-19 on average spreads the virus to 1.07 or 1.19 people.

We need improve our preventive measures to get the Re back down below 1 and keep the case numbers safely manageable. It’s more important than ever for everyone to wear face coverings and maintain distance when outside our homes. Wearing face masks or coverings is one of the simplest and most effective ways to stop the spread of COVID-19. Show love for the community by masking up!

Avoid methanol-based hand sanitizers: The FDA has issued a warning on methanol-based hand sanitizers. Methanol is toxic when absorbed by the skin or swallowed.

Free COVID testing sites: Click here for Alameda County and Contra Costa County testing sites.

Please share this new job opportunity: Ending the HIV Epidemic program specialist at the Alameda County Public Health Department. Please share with your networks!

HIV services during COVID-19: Click here for Contra Costa HIV services and see our online directory for Alameda County HIV services.

If your organization is in Alameda County and needs COVID-related supplies or staffing, please go to the Emergency Medical Services website to request PPE, request staffing and request testing supplies.


Progress on the COVID-19 Indicators

The Bay Area has 5 indicators with measurable goals to track progress in containing COVID-19. San Francisco Chronicle’s Indicator Checklist (updated weekly):

The State and Alameda County have paused reopening plans due to a substantial rise in cases and hospitalizations. If cases and hospitalizations continue to increase at the same rate, our hospital bed capacity is projected to be overwhelmed by late August. Alameda County may be added to the State Monitoring list at any time due to this trend. Alameda County residents should prepare to scale back on some activities, particularly those that include gathering in groups.

Newly formed “Strike Teams” of state inspectors have been contacting businesses across California and issuing citations to businesses failing to meet the new statewide requirement to wear face coverings. 


Updates for Alameda County in each COVID Strategy Area:


Trends in Cases and Hospitalizations

Case and hospitalization rates have continued to increase over the past week. Alameda County reached a new high of 157 hospitalized patients confirmed for COVID-19 on July 3, with the 7-day rolling average of daily hospitalizations increasing 18.2%. On July 7, we also reached a new high of 51 patients in the ICU confirmed for COVID-19 since the start of the pandemic. Our goal is for cases to be flat or decreasing. This indicator remains a two. 

  • As of July 7, there were 7,245 reported cases of COVID-19 and 142 deaths. This represents 8.5 deaths per 100,000 people, compared to 16.5 deaths per 100,000 people in California State overall.
  • As of July 7, there were 145 hospitalized patients (the highest was 157 on 7/3), including 51 ICU patients (a new peak) with confirmed COVID.

The county is analyzing where new cases are coming from. So far, the data suggests that most cases are younger adults in their 20s to 40s with workplace and crowded household transmissions, especially in Latinx communities, as well as from gatherings in which people were not distanced enough and not enough were wearing face coverings. 

County-level transmission rates and predictions from the California COVID Assessment Tool (Cal-CAT) and Local Epidemic Modeling for Management & Action (LEMMA) are now both publicly available. Cal-CAT is estimating the effective reproduction number (Re) to be 1.07 for Alameda County, which means each person who is infected will on average infect 1.07 other people. The state-wide Re is currently estimated to be 1.09. When the Re is greater than 1, cases increase in an exponential fashion. 

The LEMMA model predicts that our current hospital capacity of 2,551 staffed beds will be exceeded by about mid-August if the transmission rate (Re) remains the same, with a median peak of nearly 5,000 cases on a given day in October. The Cal-CAT Johns Hopkins model shows a similar prediction following a slow reopening schedule, while a faster reopening schedule would overwhelm our hospital capacity within a month.

This data emphasizes the importance of having preventive measures securely in place, such as universal face coverings and distancing modifications, along with a careful resumption or discontinuation of activities based on case and hospitalization trends.

We will need to improve the rate of universal face covering to at least 80% or higher and ensure everyone is following distancing modifications in order to get the Re back down to 1 or below and flatten this case curve. 

Trends of COVID-19 cases in Alameda County:

Disparities and Equity

Updated race and ethnicity data in Alameda County as of July 7 show persistent and significant disparities. Latinx people have 6.4 times the rate of COVID-19 diagnoses and 1.6 times the death rate of Whites. Black/African American people have almost twice the case rate and 2.1 times the death rate of Whites. Native Americans have 2.3 times the rate of cases compared to Whites. Pacific Islanders have 2 times the case rate compared to Whites. These data continue show the persistent and urgent need to address racial and socioeconomic inequities in workplace safety, education and access to precautions, rapid access to testing, safe isolation, quarantine and medical care.    New partnerships with community-based organizations in the Fruitvale District and Hayward have been formed to provide outreach to day laborers and Latinx communities. 

Testing

Alameda County reached and exceeded the goal of conducting 3,100 tests per day. The positivity rate has increased over the past month to 4.7%, within our goal of having a 8% or lower positivity rate but still a concerning trend. Much higher positivity rates persist in disproportionately impacted communities. This indicator remains a four. 

New testing sites opened in the Fruitvale District last week at Native American Health Center and La Clínica to serve disproportionately impacted communities. Updated testing locations and appointment links are posted the COVID-19 testing webpage and searchable in this interactive map of COVID-19 services (click to filter for COVID-19 testing). 10 sites offer free tests for any community member with symptoms and all essential workers regardless of symptoms.

The COVID-19 Testing Vendor Pool RFQ (Request for Quotation) continues to be available for clinics, hospitals and organizations to provide COVID testing as part of the Alameda County response to the pandemic. $20 million has been allocated for this effort, and the goal is to get the testing services funded and set up quickly.

Providers are reminded to:

  • submit complete contact information for positive case reports,
  • distribute isolation orders for all people getting tested,   
  • remind people to stay home until they get test results, and
  • pick up and return calls from the Health Department. 

If your facility needs COVID-related supplies, please complete these forms to request PPE and request testing supplies.

Case and Contact Investigations, Isolation and Quarantine

Alameda County currently has 90 case investigators and contact tracers with a goal to reach 300 in the fall. Case investigators and contact tracers have had difficulty keeping up with the recent increase in the number cases and contacts and have had to prioritize outreach to the highest priority cases. This indicator remains a two. 

Last week leases for three additional hotels were approved to provide rooms for the Safer Ground initiative to provide housing for people experiencing homelessness and at risk for severe COVID-19. 

Providers are encouraged to refer people living in crowded conditions or experiencing homelessness who need isolation/quarantine housing to Project Roomkey hotels. There are currently 785 rooms in operation, which is 65% of our goal of 1,203 rooms.

The California Department of Corrections and Rehabilitation (CDCR) is releasing eligible inmates with 180 days or less remaining on their sentence to parole or probation supervision prior to their original release date. All individuals being released early from a facility with positive cases will isolate/quarantine in one of the Operation Comfort facilities in order to protect the individuals returning, their families and the community at large.

Hospital Capacity and Surge Planning

As of July 7, Alameda County’s hospital capacity indicators are:

  • 5.6% of the patients in hospital beds across Alameda County were confirmed COVID-19 positive, which is within our goal of 50% of less. This indicator remains a five.
  • 12% of the patients in ICU beds were confirmed COVID-19 positive. 
  • 50% of the 2,602 total inpatient hospital beds were available and 100% of the 738 surge beds were available. 
  • There were 324 requests for personal protective equipment (PPE) from the county in the last 30 days (up from 158 a week ago), and our goal is zero requests. The increase in PPE demand is thought to be due to the increase in cases and hospitalizations. This indicator is downgraded from a three to a two.    

The medication Remdesivir continues to be in very short supply. Remdesivir is the only antiviral drug shown so far to have activity against COVID-19 in randomized controlled trials. Its allocation program is transitioning from the State to AmerisourceBergen at the direction of the Federal Department of Health and Human Services. Remdesivir will have to be purchased by hospitals at approximately $3,200 per treatment course or $520 per vial under this program. 


Top links:


Alameda County guidance:

Download links for Alameda County community or business guidance on: Face coverings, social bubbles, childcare and camps for all children,  graduations, vehicular gatherings, construction, curbside retail pickups, manufacturing and warehousing, personal services.

Download links for Alameda County clinical guidance on: COVID-19 testing, isolation orders in 7 languages for all people getting tested, reporting COVID-19 cases, Project Roomkey isolation housing, home health agencies, remdesivir allocations, routine vaccines , reporting pediatric Multisystem Inflammatory Syndrome, resumption of non-urgent medical services, and testing in Skilled Nursing Facilities.

If your organization is in Alameda County and needs COVID-related supplies or staffing, please go to the Emergency Medical Services website to request PPE, request staffing and request testing supplies.


Looking for COVID-19 testing?

  • Alameda County COVID testing sites: searchable map (filter for COVID-19 testing) or downloadable PDF. This list includes several community-based sites offering free testing for anyone with symptoms, including people without health insurance.
  • Contra Costa County free drive-through or walk-in COVID testing
  • Please check the listing for updates and call the testing site before you leave your home/shelter/camp/car to make sure they are open for testing, you are eligible, and register if needed.
  • Alameda County COVID-19 testing sites are free and open for testing for all people who have COVID-19 symptoms and health care workers regardless of symptoms. Click on the testing site name to make online appointments: Roots Community Health Center, Allen Temple, REACH Youth Center and Alameda County offices in Hayward.
  • If you don’t have a provider and have COVID symptoms: In Alameda County, call Alameda Health System 510-437-8500 for a phone screen and guidance. In Contra Costa County, call 844-729-8410. In Solano County, the county COVID warmline is 707-784-8988.
  • If you’re having difficulty breathing and unstable, please go to your nearest emergency room.