East Bay Getting to Zero
SARS-CoV-2 scanning electron microscope image from NIAID

This page includes a guide to East Bay COVID info and resources, which are updated monthly with practice-changing developments. Please click here to share feedback.


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East Bay COVID updates

October 2022

This month’s virus levels:

East Bay’s EBMUD wastewater surveillance data shows that viral levels have plateaued at substantial levels. As of October 6, Alameda and Contra Costa Counties are in the substantial transmission risk level.

How do we use wastewater viral levels to understand risk and guide our activities?

  • The graph above shows how wastewater data correlates with CDC transmission risk levels.
  • The chart above shows prevention actions to consider taking for each level of risk.
  • When we are in the substantial risk level:
    • Gather outdoors instead of indoors when possible.
    • When indoors, we strongly recommend wearing masks and/or testing to prevent transmissions.

Wastewater FAQs: 💩 Feces Facts!

  • Why use wastewater data? Wastewater viral levels capture virus shed by a large population and can provide a more accurate picture of how much virus there is in the community and thus transmission risk. Case counts have become less accurate because fewer people are getting the PCR tests that reported as cases.  
  • Why not use CDC community levels or transmission levels to guide activities? Both CDC community and transmission levels use case counts, which substantially underestimates prevalence now that people are using rapid tests more often than PCR tests. The CDC community levels are designed to manage hospital burden rather than prevent infection and long Covid. Changes in CDC community levels tend to lag wastewater data by about 4 weeks, and CDC transmission levels lag wastewater by about 2 weeks. By the time the CDC community levels are high, viral transmissions would have been high for a month, and it’s much harder to prevent transmissions at that late point. Basically:
    • If your goal is to prevent hospitals from getting overwhelmed and you’re OK with a moderate to substantial risk of infection, then following the CDC community levels is sufficient.
    • If your goal is to prevent infections and long Covid, then follow the wastewater and/or transmission risk levels.
  • What are the dots and lines in the graph? The dots represent the viral concentration result for a specific date, and the line takes an average and connects it to create a trend line. When the dots for a given week are very far apart (for example, one dot in high risk and one dot in moderate risk), you could decide to follow the highest risk dot and be extra cautious … or you could look at the overall trend line and follow the average risk level. 
  • What communities are included in the EBMUD wastewater data? You can see the map on the CalSuWers dashboard, among with data from other (smaller) East Bay sewer sites. The EBMUD sewershed includes northwestern Alameda County (Oakland flatlands down to Hayward) and the southwestern part of Contra Costa County. Unfortunately, there is no unified East Bay graph.   

Variants in the East Bay:

  • The BA.5 Omicron subvariant still accounted for a vast majority of the variants sequenced in the East Bay as of mid-September (>90% of East Bay wastewater sequencing).
  • Omicron BA.4.6 cases have started to rise nationwide while BA.5 cases are falling as of mid-September 2022. This pattern is especially pronounced in the Northeast US but is also seen in California and other western states. BA.4.6 doesn’t appear to escape immunity over BA.5. 
  • Omicron BQ.1.1 and BA.2.75.2 are second-generation Omicron subvariants which are doubling every 1-2 weeks and currently mostly in parts of Africa, Asia, and increasingly in Europe. These variants may also appear in the East Bay sometime this fall. BA.2.75.2 has three mutations and BQ.1.1 has five additional spike protein mutations that may help them bind to human cells more tightly. There are signs that BQ.1.1 and BA.2.75.2 can escape prior immunity. 

Vaccine updates:

  • Updated bivalent boosters with protection against BA.5 Omicron are available and recommended for people ages 12+ who’ve completed their primary series, received their last booster dose or were infected 2+ months ago. Get a free updated 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.

Prevention updates:

  • CDPH issued new masking guidance on September 20 to align with the CDC community levels.
    • Masks remain required in California health care settings and long-term care facilities.
    • The new CDPH guidance also says, “Despite what level your community may be in, masks that offer the best fit and filtration (e.g., N95s, KN95s, KF94s), are highly recommended, and remain a critical component of our multi-layered approach for protection against COVID-19 infection.”
    • The goal of the CDC community levels is to manage hospital burden.
    • 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.
  • COVID pre-exposure prophylaxis with Evusheld for people in Alameda County with immunocompromising conditions (including PLWH with CD4<200) is available at Total Infusion with provider referral.

Testing and treatment updates:

  • COVID-19 test-and-treat: more access points are available now! 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 ASAP, as they may be able to get treatment. There’s plenty of medication supply now. If you don’t have a provider or can’t reach them, here are other free testing and treatment options:
    • California Test-to-Treat locations, through Optum Serve.
    • California free virtual COVID-19 visits and treatment access: phone line 833-686-5051 and website through Sesame Care. Appointments are available 24/7.
    • In Alameda County, you can also call the COVID-19 Community Support Team: 510-268-2101, Monday-Friday, 8:30 a.m. – 5 p.m for additional help.
    • Contra Costa County residents can call 1-877-661-6230 if you test positive to reach a nurse and get a free same-day telehealth consult and prescription if medically appropriate.
    • It’s best to call within 48 hours of the positive test results or symptom onset.

East Bay COVID guidance: how to protect our communities and get tests, vaccines, masks, treatment

How do we protect ourselves and our communities in the absence of mask and vaccination requirements?

  1. Get vaccinated and boosted. Click here for where to get free vaccines.
  2. Wear high-quality masks (N95, KN95, KF94s) in indoor public spaces and transit. Click here to find free N95 masks at a pharmacy near you.
  3. Have a supply of rapid home COVID tests ready to use. Click here for more details on how to get home tests free through health insurance.
  4. Make a plan for treatment in case you get infected.
  5. Ventilate and distance: Open windows/doors and stay in well-ventilated areas. Avoid the busiest times on public transport and other indoor spaces.
  6. Have back-up plans for gatherings and travel if cases increase.
  7. Check the amount of virus in your community using the early detection wastewater surveillance dashboards: US | CA counties.

The MyCOVIDRisk.app COVID-19 risk calculator from Brown University can help you determine the risk of getting COVID-19 infection in different settings and gives you options to lower your risk.

More East Bay guidance and resources:



Latest local requirements


Latest national COVID updates

Deeper dives into pandemic epidemiology, policies and science

  • Epidemiology: Your Local Epidemiologist online newsletter with Dr. Katelyn Jetelina, epidemiologist, for her translation of public health science for a broader community.
  • Policy and practices: In the Bubble podcast with Andy Slavitt, for discussions on pandemic policy and developments with national scientists and policy leaders.
  • Medical science: Dr. Eric Topol’s twitter feed with up-to-the-minute reports on new medical and scientific studies on COVID vaccines and treatments. 

Archives: Our weekly updates from the first two years of the pandemic (March 2020 to March 2022) have switched to periodic, practice-changing updates to the pages linked above. You can find PDFs of our previous updates here


COVID risk reduction graphics

Click to download: graphic in English | graphic in Spanish | PDF in English and Spanish

Table summarizing the top 7 COVID harm reduction strategies.

Latest COVID Resources

View All COVID Resources