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-19 and HIV updates. This page is usually updated on Wednesday evenings by Sophy S. Wong, MD with data and resources gathered from many collaborators in Alameda County, Contra Costa County, Solano County, CA state.

Click on these links for masks and face coverings, 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:

Please note that the emailed HIV+COVID-19 newsletter will move to a bi-weekly schedule after the October 7th edition. COVID data updates will still be posted to this page on most Wednesday late afternoons and new studies will be continuously added to our summary of COVID-19 harm reduction strategies. You can also sign up for Alameda County updates here.

East Bay strategic planning process: Our next meeting on writing the strategic plan will be held on Friday, October 23, 10-11:30 am. Please join us. Your voice is important. Please register for the meeting here.

Truvada went generic today! The availability of generic FTC/TDF PrEP will hopefully create more affordable access to PrEP. The Teva Pharmaceutical company has exclusive rights for 6 months, then other producers will join the market and are expected to reduce prices further. Medi-Cal coverage should not change but private insurance and Medicare plans may alter coverage. If you or clients have problems getting PrEP fills, please contact your PrEP provider immediately. Here’s a useful SFDPH fact sheet on generic PrEP

2020 Election

November 3rd is right around the corner. Here are some important things to note about mail-in voting (learn more at the  California Secretary of State website):

  • All California active registered voters will receive a vote-by-mail ballot for the November 3, 2020 election. Your county elections office will begin mailing ballots by October 5, 2020.
  • Voters who can vote-by-mail will help reduce the numbers of people at voting locations and support distancing.
  • Ballots returned by mail must be postmarked by November 3, 2020. Ballots returned at a secure ballot drop box or a voting location must be deposited by 8:00 p.m. on November 3, 2020.
  • In-person voting locations will offer voter registration, replacement ballots, accessible voting machines, and language assistance to those who need it.

EBGTZ updates

East Bay Getting to Zero has developed two tools for the community:

  • A set of 3 short videos on masking for COVID-19 prevention: 1) Why masks are helpful; 2) What to look for in masks; 3) How to wear & care for masks. Please share these with your teams, your networks and via your social media channels.
  • HIV & COVID-19 prevention palm cards in collaboration with Jesse Brooks, Terri Lynn Haggins and Moises Jauregui. They are available for any of our network agencies to download print here. If you would like EBGTZ to print some for your clients/patients, please reach out to Yamini (yamini@ebgtz.org).

We’ve added various great HIV prevention resources from our partner agencies to our website including: Interim STD Treatment Recommendations During Covid-19 For Symptomatic Patients, Self-Swab Collection Instructions – English/Spanish, How To Take: PrEP 2-1-1 For Anal Sex, Which PrEP Medication Is Best For Me?, PrEP & Youth Fact Sheet, PrEP Navigator Manual in English & Spanish, Sex In The Time Of Covid-19 in English & Spanish.

Bay Area updates

Bay Area hospitals have reported their first cases of the flu. Please make plans to get a flu shot and support loved ones and clients to get theirs if you haven’t done so already. Check your local pharmacies and/or health care providers for availability and schedules. California health organizations are collaborating on a statewide “Fight the Flu” campaign, which will post schedules for free flu vaccine clinics. 

A Spare the Air alert is extended for the Bay Area in response to the Glass Fire in Napa County. To check your local air quality rating, please visit AirNow or PurpleAir.  

Recent earthquakes in the South Bay Area remind us to be prepared. The CDPH Emergency Preparedness Office (EPO) posts guidance for public health emergencies including earthquakes. Visit earthquake preparedness for more information.

Statewide legislative updates

Governor Gavin Newson recently signed the following legislation relevant to our work and communities:

  • A package of mental health-related bills that puts California at the forefront of efforts by states to address a mental health crisis that has been worsening for years and is being amplified by the coronavirus pandemic. SB 855 expands the ability of Californians who buy insurance or get it from their employers to obtain treatment for a wide array of mental health and substance use disorders. SB 803 requires the state to establish statewide requirements for certifying peer support specialists –people with personal experience with the mental health system who are trained to support and assist others who are going through mental health challenges. AB 1976, amends the bill known as Laura’s Law, making it permanent and requiring all counties to implement the program, unless they formally opt out of doing so. AB 1766 would require the state Department of Social Services to annually report the number of board-and-care homes that serve low-income Californians living with a severe mental illness, track their closures, and notify county behavioral health departments within three days of receiving notice that an operator plans to close a home. AB 2265 allows counties to use funds from the Mental Health Services Act to treat and assess people believed to be suffering from co-occurring mental health and substance use disorders.
  • Legislation strengthening protections for LGBTQ+ Californians, including: SB 932, which ensures comprehensive data collection to understand how COVID-19 is impacting the LGBTQ+ community; AB 2218 which establishes the Transgender Wellness and Equity Fund; SB 132 requires CDCR to house transgender, gender-nonconforming and intersex people with a focus on health and safety and SB 1255 ends the practice of insurance companies discriminating against HIV-positive individuals
  • Landmark Legislation to Advance Racial Justice including AB 3121 to establish a first-in-the-nation task force to study and make recommendations on reparations for slavery; AB 2542 will prohibit the use of race, ethnicity or national origin to seek or obtain convictions or impose sentences. The Governor also signed AB 3070 which aims to eliminate discrimination in jury selection

East Bay COVID-19 updates 

This week Contra Costa joined Alameda and Solano counties in the red tier (2nd risk level) in California’s Blueprint to Safer Reopening. The tiers are determined by new case and test positivity rates. A statewide health equity metric is pending. While there is progress with East Bay COVID-19 cases and test positivity mostly trending downward, transmission rates have begun to increase, so we must remain vigilant and support masking and distancing.

Counties in the red tier are permitted to open schools for in-person learning after two weeks in the red tier. Contra Costa and Solano Counties are following state allowances for reopenings. Alameda County is now allowing indoor barbershops, hair and nail services with modifications to operate, will issue new orders this week, and will reopen more cautiously, prioritizing consideration of in-person elementary school reopenings.

A joint Bay Area statement on Halloween and Día de Los Muertos offers guidance to avoid high risk activities such as trick or treating and parties and tips on celebrating safely by keeping it small and keeping it at home.

Current estimated transmission rates are 0.97 in Alameda County, 0.93 in Contra Costa and 0.91 in Solano County, compared to 0.93 statewide. Transmission rates increased in September but remained less than 1 since mid-August. That means on average each person with COVID-19 transmits the virus to fewer than one other person. Our goal is to keep transmission rates less than 1.

Alameda County:

  • 4.1 new cases of COVID-19 per day per 100,000 residents (up from 3.5 last week).
  • 2.3% testing positivity rate (down from 2.5%).
  • 21,383 cumulative cases and 412 deaths.
  • 78 hospitalized patients (highest was 213 on 7/28), including 26 ICU patients (highest was 73 on 8/20) with confirmed COVID-19.
  • 0.97 transmission rate on the ensemble Cal-CAT model, including data from the LEMMA hospital data model (up from 0.92). 

Contra Costa County:

  • 6.3 new cases of COVID-19 per day per 100,000 residents (down from 6.5).
  • 3.7% positivity rate (down from 4%).
  • 0.93 transmission rate (down from 0.98). 

Solano County:

  • 6.0 new cases of COVID-19 per day per 100,000 residents (down from 6.5).
  • 3.2% positivity rate (down from 3.4%).
  • 0.91 transmission rate (up from 0.90).

Erik Solorio, Head RN at La Clínica, spoke with KCBS Radio about the new statewide health equity metric, the Sanando Juntos Fruitvale testing event, and bringing COVID numbers down in the hardest hit zip codes, including the Fruitvale District in Oakland.

Check out videos in Spanish and in Maya languages from the San Francisco Latino Task Force.

New HIV and COVID-19 studies

A new study analyzing PrEP trends from 2014 to 2018 showed that more than 1 million prescriptions for preexposure prophylaxis (PrEP) were filled at a cost of $2.08 billion dollars, yet the number of persons receiving PrEP is less than 20% of those estimated to need it. This is far short of the US Ending the HIV Epidemic goal to increase PrEP coverage to 50% of the eligible population. The cost of PrEP remains a significant barrier, and whether the availability of generic TDF/FTC will increase PrEP uptake remains to be seen. 

A national SARS-CoV2 seroprevalence study in The Lancet found that as of July 2020, less than 10% of the US population is estimated to have immunity, with <5% in the western US region up to 25% in Northeastern US region. In this national sample, Black patients had the highest seropositivity, followed by Latinx patients, and White patients had the lowest. It is estimated that about 70% of the population needs to be immune (either by surviving infection or vaccination) in order to reach herd immunity, the point at which COVID-19 won’t widely spread. 

The age distribution of COVID-19 incidence has shifted nationally from older adults early in the pandemic to younger adults ages 20-29 from June to August 2020, shown in a recent study published by the CDC. A related CDC study of US summer surges show that increases in cases among older adults (ages 60+) followed increases among younger adults (ages 20-39) by 4-15 days.

Data from the American Academy of Pediatrics shows that cases, hospitalizations and deaths have increased at a faster rate in children and adolescents over the summer than among the general public, comprising 5% of infections in late May and increasing to 10.5% as of September 24. A CDC analysis published Monday shows that COVID-19 in the US has been twice as common in adolescents ages 12-17 than in younger children ages 5-11. Underlying conditions were more common among school-aged children with severe outcomes related to COVID-19.

These findings underscore the importance of providing access, education and support for masking and distancing among adolescents and younger adults to help reduce infections and subsequent transmission to people at higher risk for severe illness. 

The US National Academies of Sciences, Engineering and Medicine has proposed a five-phase plan to fairly allocate a coronavirus vaccine to US residents, including guidance for addressing equity and socio-economic factors for disproportionately impacted racial and ethnic groups. The World Health Organization (WHO) also released preliminary guidance for global vaccine allocation, identifying groups that should be prioritized.

People wearing eyeglasses had 5.4x less COVID-19: In this study of 276 patients hospitalized in Suizhou, China, the proportion of daily wearers of eyeglasses with COVID-19 was lower than that of the local population (5.8% vs 31.5%).

Several new HIV prevention/treatment, STD prevention, hepatitis B/C vaccine/treatment research studies are enrolling participants. More info is on our webpage of current research studies including studies at UCSF for outpatient treatment of recent COVID-19 infection and vaccines for people at higher risk for serious illness.   

Our summary of COVID harm reduction strategies is constantly updated with new studies. 

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

To stay safe during wildfire season and the pandemic, we all need to:

  • Stay in cooler locations away from smoke,
  • Wear non-medical N95s when unable to stay indoors during times of unhealthy air quality,
  • Wear face coverings when in public and within 30 feet of others,
  • Maintain at least six feet distance from others,
  • Sanitize or wash hands frequently, and
  • Stay home when sick.

Other updates and opportunities:

  • The California End the Epidemic coalition has released two resources in the past week: their Racial Justice statement and their 2020 Voter guide.
  • The Praxis Project published a compelling blog about Black Organizing Project’s work to remove police presence from Oakland Unified School District. Read more here.
  • Advocacy/Service opportunities:
    • Familia TQLM, Transgender Law Center, Santa Fe Dreamers Project, and others have been working on a collaborative border project to link LGBTQ asylum seekers with resources and legal, humanitarian and post-detention support. The project is looking to recruit sponsors for 100-200 LGBTQI+ migrants in Mexico, who are waiting to cross the border. If you’re interested in learning what sponsorship is, please sign up here.
    • California Latinas for Reproductive Justice, the Disability Rights Education and Defense Fund, the California Coalition for Women Prisoners, are requesting inclusion of the funds required to establish the Forced Sterilization Compensation Program — a Program that would provide reparations to survivors of California-sponsored forced sterilizations — in the January Budget Revise. You can learn more here and sign-on by Thursday 10/1.
  • Funding opportunities:
    • The Centers for Disease Control and Prevention (CDC) has announced the availability of fiscal year 2021 funds for community-based organizations to develop and implement high-impact HIV prevention programs. The Notice of Funding Opportunity focuses on addressing the national HIV epidemic by reducing new infections, increasing access to care, and promoting health equity. Learn more about the opportunity here.
  • Job Opportunities:
    • Castlemont Farm and Gardens is looking for a Farm Education and Space Manager. As part of the Sustainable Urban Design Academy and Community Health Equity Academy, Castlemont High School has created a 1-acre+ education and production farm and gardens. This is an opportunity to simultaneously develop pathway projects that authentically serve the community and achieve pathway goals of college, career and community preparation. Learn more about the opportunity here.
    • The City of Berkeley is currently accepting applications for  two Health Services Program Specialists within the Health, Housing and Community Services (HHCS) department to support their Public Health Division – COVID-Response and High School Health Center. Learn more about the opportunity here.
    • California Rural Legal Assistance, Inc. (CRLA) is building a network of skilled interpreters across California. They are offering a 42-hour introduction to community legal interpreting and language justice which is open to aspiring and experienced interpreters of all levels. Training graduates will receive a certificate of successful completion and will be considered for paid interpreting work with CRLA. Applications are here: English & Spanish.
  • Webinars & virtual events:
    • September 30: WORLD is hosting their “Being Positive in the Midst of COVID-19” Town Hall from 5:30-7:30pm. Join the Zoom event with this link.
    • NASTAD and The AIDS Institute are hosting their first ever Hepatitis Virtual Collaborative. Learn more and register here.
    • In Honor of “National Latinx AIDS Awareness Day, the Prevention through Active Community Engagement Program (PACE) Region 9 would like to invite you to join an interactive Spanish discussion on Ending the HIV Epidemic on Tuesday, October 13 at 11:00 AM – 12:30 PM (PST) (2:00 PM – 3:30 PM EST). Registration is not required, you can join via this link.

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.

Please follow and share our Instagram, Facebook and Twitter accounts.  


Alameda County detailed updates:

Trends in Cases and Hospitalizations

New case rates increased in the past two weeks, which may in part represent increased testing and case detection after a period of poor air quality. Hospitalization rates have slowly trended down after peaks in August. These trends will be watched carefully to determine reopening timelines. Our goal is for cases to be flat or decreasing. Test positivity rates decreased below 5% in September. 

Our estimated transmission rate as of September 30 is 0.97, up from 0.92 last week and compared to 0.93 statewide, using the California COVID Assessment Tool (Cal-CAT), an ensemble of eight models, including the LEMMA hospital data model. This means each person with COVID-19 on average transmits the virus to 0.97 other people. The transmission rate has been increasing since mid-September. If we renew efforts to keep the transmission rate less than 1, new cases will decrease.

Data from the Chan Zuckerberg Biohub show that as of September 4, our death rate was 1.8%, which was among the lowest death rates compared to the other major US cities in the table shown. 

Please help us get the message out to communities with the Mask On, Alameda County campaign. Face coverings are mandatory statewide for everyone over the age of 2.  

For help with enforcement or report violations of workplace safety orders in Alameda County, please email: COVID19compliance@acgov.org

Disparities and Equity

Updated race and ethnicity data in Alameda County show that Latinx people continue to face the highest case rates and Blacks/African American people continue to face the highest death rates. Currently Latinx people have 6.3 times the case rate and 1.5 the death rate compared to White people. Blacks/African American people have 2.1 times the case rate and 2.2 times the death rate compared to White people. Native American people have 1.8 times and Pacific Islander people have 2.2 times the case rate compared to Whites. These disparity rates are similar this week compared to last week.

The highest case and positivity rates in Alameda County continue to be in the Fruitvale and Coliseum zip codes in East Oakland and the 880-highway corridor.

These persistent disparities underscore the urgent need to address racial and socioeconomic inequities in economic stability, workplace safety, education and access to precautions, rapid access to testing, safe isolation housing, quarantine, medical care, and income replacement.

Testing

We have conducted over 4,500 tests per day in the past week, which is above our goal of 3,100 per day. The percentage of people testing positive is 2.3%, using CDPH data through September 19. This is within our positivity rate goal of less than 5%, but continues to vary greatly by zip code and race/ethnicity.

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). Eleven community testing sites offer free tests using county testing guidance for any community member with symptoms, all essential workers and those at higher medical risk regardless of symptoms.

Updated Alameda County guidance on COVID-19 laboratory testing was released on September 24.

Testing sites provide critical support with disease containment by:

  • distributing isolation orders and contact tracing information for all people getting tested,  
  • reminding people to stay home until they get test results and to pick up calls from the health department, and
  • submitting full names, addresses, dates of birth and phone numbers and demographics (including race, ethnicity, sexual orientation, and gender identity) for all positive cases, including positive antigen results, using the COVID-19 Confidential Mortality Report (CMR).

Case and Contact Investigations, Isolation and Quarantine

Alameda County currently has 37 outbreak investigators and 168 trained case investigators/contact tracers, including 29 at community-based organizations. Last week 46% cases were reached within 24 hours of receiving contact information, 52% cases were reached within 48 hours and 68% were reached within the week.

Project Roomkey has 1,234 hotel rooms and trailer slots and continues to provide isolation/quarantine housing for people living in crowded conditions or are experiencing homelessness.

Rolling applications for the COVID-19 case investigation and contact tracing services funding opportunity are due every first and third Friday of the month. For more information, go to: Request for Qualification (RFQ) No. HCSA-900420.

The Alameda County Responsibility to Community Health (ARCH) Program provides financial assistance to self-isolating County residents in high-risk communities who have tested positive for COVID-19. For more information, please see the FAQ and press release.

Hospital Capacity and Surge Planning

As of September 29, our hospital capacity indicators are:

  • 3% of the patients in hospital beds across Alameda County were confirmed COVID-19 positive (highest was 10.8% on 7/22), 8% of ICU patients were COVID-19 positive (highest was 24% on 8/20). These percentages have been decreasing since the end of August and within our goal of 50% of less.
  • 38% of the inpatient hospital beds and 40% of the ICU beds were available, which is within our goal of above 20%. 73% of the mechanical ventilators were available.

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

Opportunities to help:

  • California Health Corps – Use this link to register for the California Health Corps which is a State program for trained medical and healthcare workers to sign up and provide availability to assist in the COVID-19 response. 
  • Medical Surge Volunteer Sign Up – Use this link to register as a volunteer with the County of Alameda to assist with the COVID-19 response. Medically and non-medically trained volunteers will be needed. Click here for more information. 

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 webpage. 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
  • Solano County free testing sites
  • 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.
  • 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.