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

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

January 2023

There are still free COVID vaccines, tests and treatment in the East Bay, available to everyone regardless of immigration and insurance status.

Virus levels:

COVID, RSV and Influenza trends as of January 19:

  • EBMUD wastewater data shows COVID viral levels peaked in mid-December and has been decreasing for a few weeks. COVID hospitalizations in Alameda and Contra Costa Counties peaked in early January and have decreased in the past 2 weeks. The new immune-evading BQ and XBB variants are now widely circulating in the Bay Area, with XBB1.5 increasing in proportion. California predictions are that levels will decrease into February. Immunity lasts 4-6 months, and bivalent boosters add significant protection against hospitalization and symptomatic and severe infection, so get your updated bivalent booster if you haven’t yet.
  • RSV peaked in early December and has decreased since then.
  • Influenza is still at high levels though started to decrease in January. Influenza-like illnesses have been at their highest rate in the past 6 years. Hospitalizations in Alameda and Contra Costa County have started to decrease slightly in January after a rapid rise in December. Influenza levels in the Bay Area are expected to decrease into February. This year’s flu vaccine is a good match for circulating flu strains, so get your flu shot if you haven’t gotten it this year.
Covid risk reduction graphic to mask, ventilate, test and avoid crowds when wastewater levels are over 40% of peak.

To reduce the risk of respiratory illnesses during a time of substantial or high transmission risk, we recommend to:

  • Stay home when sick.
  • Gather outdoors instead of indoors when possible.
  • When indoors, open windows/doors and maximize ventilation, wear masks and test before gathering to prevent transmissions.

Click here to read our Wastewater FAQs and 💩 Feces Facts.


  • XBB and BQ subvariants are circulating in the Bay Area: The Unidos en Salud variant data from their SF Mission District community testing site shows that there’s a growing proportion of the XBB and BQ variants with immune-evading properties. Western US regional variant data also shows that BQ subvariants are 67% and XBB subvariants are 22% of the viruses sequenced the week ending January 14, with XBB1.5 increasing in proportion.
    • This means a greater risk for reinfections.
    • Boosters, paxlovid, remdesivir and molnupiravir treatment are still effective against the newer variants.
    • Bebtelovimab treatment is no longer recommended due to XBB and BQ resistance.
  • 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 during this winter by getting the updated booster, the flu shot, wearing N95/KN95/KF94 masks and using rapid tests before gathering and when you have symptoms.


  • 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.

  • Real-world data from US studies published in December show that the bivalent booster provided:
  • 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.


  • Masks: ACPHD and CDPH have aligned masking guidance with the CDC community levels.
    • Masks remain required in California in certain settings: in health care settings, long-term care facilities, correctional facilities, shelters and indoor transit hubs. They are also required 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.
  • Evusheld PrEP is still available but less effective: XBB, BQ.1.1 and some of the newer variants are resistant to Evusheld, but it may still offer some protection against some of the circulating variants, and is currently the only option for people who don’t have adequate immune protection from vaccines or have contraindications to vaccines.


  • Each US household can click here or call 1-800-232-0233 to request another set of 4 free COVID home tests. This round of free tests started December 19, 2022.
  • 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.
  • Are expired COVID home tests still useful? If you still get a clear “control” line, the test is likely to still be effective.
  • Contra Costa residents can still get free at-home COVID test kits from Contra Costa Health (CCH) through a new mail-order program. People can order up to 4 free at-home test kits per household by filling out this online form or by calling 833-829-2626. There are two tests in each kit. CCH will mail the kits directly to people’s homes within approximately 5-7 business days. You must be a Contra Costa County resident to be eligible.
  • 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 BQ.1/BQ.1.1, 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.