
This page includes East Bay COVID viral levels, testing, vaccine, masking, prevention, treatment and other resources, updated monthly. Please click here to share feedback.
East Bay COVID updates
March 2023
There are still free COVID vaccines, tests and treatment in the East Bay, available to everyone regardless of immigration and insurance status.
California’s COVID state of emergency ended on February 28, 2023. The end of the state emergency has led to the end of additional pandemic-era CalFresh benefits and the closure of some Covid testing and treatment sites. It may also impact hospitals’ ability to address staffing and space shortages as well as some COVID-related paid medical leave policies.
The end of the federal emergency on May 11, 2023 will have a greater impact on all of us, including:
- The end of continuous Medi-Cal coverage; people will have to manually prove eligibility again.
- The end of national requirements for insurance to cover COVID-related costs. A CA law (CA Senate Bill 1473) extends this requirement for 6 more months to November 11, 2023, so insurance coverage of home test kits and Covid-related health care costs in California will extend till then.
- The end of requirements for insurance to cover all telehealth services; coverage will vary by state.
- The loss of federal purchases of COVID vaccines and treatment for people without insurance.
Click to read more about: the end of the California state emergency and the end of the federal emergency.
Virus levels:

As of March 16, 2023:
- EBMUD wastewater data shows COVID viral concentration rose and fell sharply in February, staying at high transmission levels into mid-March. This likely reflects an East Bay XBB/1.5 variant wave. The immune-evading XBB variants are now widely circulating in the Bay Area, with XBB1.5 increasing rapidly in proportion. Predictions are for East Bay COVID levels to level off in late March to April.
- COVID hospitalizations leveled off in the East Bay and are predicted to increase slightly into April.
- Immunity lasts 4-6 months, and bivalent boosters add significant additional protection against hospitalization and symptomatic and severe infection, so get your updated bivalent booster if you haven’t yet.
To reduce the risk of respiratory illnesses during a time of substantial or high transmission risk, we recommend to:
- Stay home and do a home test when sick.
- Gather outdoors instead of indoors when possible.
- When indoors in public and for gatherings: wear high-quality masks, open windows/doors and maximize ventilation and test before gathering to prevent transmissions.
Click here to read our Wastewater FAQs and 💩 Feces Facts.
Variants:
- XBB and XBB1.5 variants are widely circulating in the Bay Area: The Unidos en Salud variant data from their SF Mission District community testing site as of February 22, 2023 shows that there’s a growing proportion of the XBB and XBB1.5 variants. XBB1.5 (nicknamed “Kraken” after a mythical sea monster) has a mutation that virologists believe allows the virus to bind to the ACE2 receptor more tightly, making it more immune evasive and transmissible, with a greater risk for reinfection. Evusheld for prevention and bebtelovimab for treatment are no longer effective against these variants. Boosters, paxlovid, remdesivir and molnupiravir treatment are still effective against severe disease from XBB1.5 and the newer variants.
- California variant data also shows that the XBB1.5 variant has been rapidly increasing in proportion since the beginning of January and was projected to be about 85% of the variant proportion by March 15, 2023.
- Boosters increase protection against new variants: Recent data show us how immunity against Omicron wanes after 4-6 months and boosters are crucial to protect us against these new variants. Vaccine boosters are effective in reducing the risk of long Covid, severe disease and death, especially for people over 50 and those at higher risk.
- Stay healthy by getting the updated booster, wearing N95/KN95/KF94 masks and using rapid tests before gathering and when you have symptoms.
Vaccines:
- New data finds that the bivalent booster protects against symptomatic and severe disease from the newest variants, including XBB1.5.
- Real-world data published in January show that the bivalent booster provided 48% additional protection against symptomatic XBB/1.5 infection compared to no bivalent booster.
- CDC hospital data through December shows that people who got the bivalent booster had a 13x lower risk of dying from COVID-19 compared to those who didn’t get vaccinated and 2.4x lower risk of dying compared to vaccinated people who didn’t get the bivalent booster.
- Updated bivalent boosters against the omicron variants are now available for children 6 months and over who’ve received their last dose or were last infected 2 or more months ago. The FDA authorized the updated bivalent boosters for children ages 6 months to 4 years on December 8, 2022 with these eligibility criteria:
- Moderna booster for ages 6 months to 4 years: all children that had the primary series (2 shots) is eligible for the bivalent booster.
- Pfizer boosters for ages 6 months to 4 years:
- If your child completed primary series (3 shots), they are not eligible.
- If your child did not complete the primary series (i.e., had 1 or 2 shots only), they are eligible for the bivalent booster.
- Get a free updated bivalent booster at local pharmacies, your medical provider, MyTurn.ca.gov, Vaccines.gov, or county sites.
- When should I get the booster? If it’s been…
- <2-3 months since infection/vaccination: Wait and plan to get the booster 3-6 months out.
- 3-6 months since infection/vaccination: Get the booster soon. If you have an event or trip, get it 2-4 weeks before to optimize protection.
- 6+ months since infection/vaccination: Get the booster ASAP.
- When should I get the booster? If it’s been…
Prevention:
- Evusheld for COVID prevention is no longer authorized due to XBB and BQ resistance. The Evusheld monoclonal antibodies are no longer effective against >90% of the circulating variants, so its authorization was revoked by the FDA.
- Masks: ACPHD and CDPH have aligned masking guidance with the CDC community levels.
- Starting April 3 in California, masks will be recommended but not required in indoor high-risk settings, including health care, long-term care, correctional facilities; homeless, emergency and warming and cooling centers.
- Masks will remain recommended in public indoor and transit settings when community levels are high (or medium for vulnerable people).
- Masks are also recommended when exposed to or infected with COVID-19.
- If your goal is to prevent infection and long Covid for yourself and/or people you live with, we recommend following the wastewater framework above or the CDC transmission levels.
Test-and-treat:
- Get your free COVID home tests while you can! Insurance companies will no longer be required to fully cover COVID-related costs, including the 8 COVID home tests per insured person per month after November 11, 2023 (a 6 month extension from the federal end thanks to CA Senate Bill 1473).
- For everyone: if you haven’t yet requested the 4 free COVID home tests since December 19, you can still click here to request them or call 1-800-232-0233.
- Contra Costa residents can get 4 additional free at-home COVID test kits per household by filling out this online form or by calling 833-829-2626.
- For people with Medi-Cal, Medicare or private insurance: click here for instructions on how to get free tests through your insurance.
- Are expired COVID home tests still useful? If you still get a clear “control” line, the test is likely to still be effective.
- Free COVID clinical consults for CA clinicians: California health care providers can now call (866) 268-4322 (COVID-CA) to receive free and confidential consultation on COVID-19 testing and treatment from the UCSF National Clinician Consultation Center.
- COVID test-and-treat: Paxlovid is still free and widely available! Community members at risk can get treatment at the same location and on the same day that you test positive and regardless of insurance or immigration status. Please encourage anyone who tests positive to contact their provider or a free test-and-treat center ASAP, as they may be able to get treatment.
- Paxlovid, remdesivir and molnupiravir remain effective against the newer variants.
- Paxlovid was also found to reduce the risk of long COVID by 26% in a large VA study.
- The monoclonal antibody COVID treatment bebtelovimab is not effective against XBB or BQ.1 variants and the FDA has withdrawn its authorization.
- Viral rebound is common for both treated and untreated people with COVID-19. There is no evidence of resistance to Paxlovid. Treatment still helps reduce viral load and severity. Just make sure to re-isolate.
Latest COVID resources
Click here for more East Bay COVID guidance and resources on how to protect ourselves and our communities.