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

November 2023

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

Virus levels:

As of October 31, 2023:

  • East Bay EBMUD wastewater data shows COVID viral levels at moderate to substantial transmission risk levels at the end of October. As of October 26 (the latest East Bay WastewaterSCAN data), RSV levels were medium and rising, and influenza levels were low and rising.
    • Vaccines, tests and treatments work with the current variants in the Bay Area: EG.5, HK.3 and XBB.1.5, which are all descendants of the original XBB Omicron strain.
    •  Predictions are for East Bay COVID levels and hospitalizations to be stable through November, then increase going into December.   

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


  • The EG.5 (“Eris”) variant continues to have the highest proportion in the Bay Area. As of October 25, EG.5 was estimated to be about 16% of the variants sequenced, followed by HK.3 and XBB.
  • The highly mutated BA.2.86 (“Pirola”) subvariant has mutated into the JN.1 subvariant in France and the UK, where it is rapidly spreading. If JN.1 spreads as quickly in the US, it may gain dominance here by December. Vaccination and infection with an XBB strain (such as from the updated fall vaccine or an infection in the past few months) is expected to provide some protection against these newer strains. 
  • Symptoms and severity appear to be similar across these Omicron subvariants.
  • Rapid tests still work. Omicron variants tend to replicate in the throat earlier than the nose, so consider getting throat samples, then nose samples on the same swab.
  • Boosters and antiviral treatment are still effective against severe disease from the newer variants.
  • Read more about East Bay variants here.


  • Updated Covid vaccines are available in the East Bay and protect against the currently circulating variants, which are descended from the XBB strain, well-matched in the updated vaccine targeting XBB.1.5. Get a booster now to protect yourself and the community during the winter wave, especially if it’s been 6+ months since your last vaccine or infection.   
    • The 2023-2024 updated Covid vaccines targeting XBB1.5 have been approved and recommended by the FDA and CDC for everyone ages 6 months and up.
    • Updated vaccine data shows that it provides a significant increase in antibody response to the currently circulating variants, including EG.5, FL.1.5 and XBB1.16. New data also shows that vaccinations reduce the risk of long Covid symptoms in adults and children.   
    • If you have insurance, check with your primary care clinic or pharmacy for the updated vaccine. They are most likely to provide the vaccine with the fewest insurance issues. Unlike before, insurance coverage will be checked before Covid vaccines are given at pharmacies. Coverage at specific pharmacies depends on their insurance contracts.
    • If you don’t have insurance or your insurance doesn’t cover the complete Covid vaccine cost: CVS and Walgreens are required by the national Bridge Program to cover Covid vaccines at no cost to you. You can also go to designated public/county vaccine sites – click here for details. 
    • When to get the booster: you are eligible if your last vaccine dose was 2+ months ago. Generally, most people can wait 3 months after their last infection. To have protection for the anticipated winter wave, get it by early November.
    • The Novavax COVID-19 vaccine is now available at your local Walgreeens, CVS, and Costco pharmacies. The Novavax COVID-19 Vaccine, Adjuvanted, a monovalent vaccine, has been updated to include the Omicron variant lineage XBB.1.5 (2023-2024 formula). Please see this FDA Fact Sheet for more information. To schedule a vaccination appointment, please visit the website of your pharmacy of choice. Kaiser locations will offer the Novavax only to persons who were previously unable to receive the Pfizer or Moderna vaccines.

  • Covid mRNA vaccine researchers win the 2023 Nobel Prize! Katalin Karikó and Drew Weissman were awarded the 2023 Nobel Prize in Physiology or Medicine on October 2 for their discoveries and development of the Covid mRNA vaccines.

  • The CDC has updated their vaccine guidelines:
    • Everyone ages 6+ should get at least one updated vaccine dose (Pfizer or Moderna) to be considered up to date.
    • People ages 65+ may get a 2nd updated booster dose at least 4 months after the first one.
    • People who are moderately or severely immunocompromised may get additional updated doses at least 2 months after the previous one.
  • Get an updated vaccine at local pharmacies, your medical provider, MyTurn.ca.gov, Vaccines.gov, or county sites.


  • California isolation and quarantine guidelines were updated in August 2023:
    • If you test positive for Covid, isolate for at least 5 days and wear a mask for 10 days.
      • Click for the California COVID-19 Personalized Testing and Isolation Calculator.
      • Talk to your provider about getting treatment or get a free virtual Covid visit here (1 (888) 897-1244).
      • Wear a mask around others for 10 full days after start of symptoms. If you had no symptoms, wear a mask for 10 full days after your positive test. You may remove your mask sooner than Day 10 if you have two negative tests in a row, at least one day apart.
      • You may leave isolation after 5 days if symptoms are gone or improving and have had no fevers for 24 hours without the use of fever-reducing medications.
    • Click here to download the Alameda County isolation PDF. Click here to read more isolation details from Alameda County.
    • If you were exposed and have no symptoms, test immediately and 3-5 days after your last exposure. Wear a mask for 10 days, even at home around others.
  • Ventilation: The CDC released new indoor building ventilation standards in May 2023. They recommend aiming for at least 5 air exchanges per hour and using MERV-13 or better filters to reduce transmission of respiratory infections.
  • Masks: New mask requirement for workers in high risk health settings, November 1, 2023 through April 30, 2024: Staff and other workers in specified health facilities (General Acute Care Hospitals, Long Term Acute Care Hospitals, Psychiatric Hospitals, Skilled Nursing Facilities, Dialysis Centers, and Infusion Centers) in Alameda County and Contra Costa County are required to wear high-quality, well-fitting masks in patient care areas. Sonoma and San Mateo counties will have the same requirement. San Francisco already has a year-round masking requirement for health care workers. Other individual facilities may still choose to make masks required.
  • Want to test how well your mask fits? If you can’t get a professional mask fit-test, aerosol scientist Linsey Marr says you can informally test your mask by cupping “your hands around the edges and hold it down while you’re breathing through it and see if there’s any difference when you do that and press it to your face versus when you don’t. If you notice a difference, that means it’s not well sealed to your face and you should try a different type of mask.”


  • Free Covid tests are still available:
    • Free PCR tests are available at the Community Church in Oakland on Tuesdays, Wednesdays and Thursdays 10:00am to 3:00pm at 1527 34th St Oakland, CA 94608. Register here, visit the Community Church website or call 510 594-2207 for more information. 
    • Free Covid-19 tests are back on COVIDtests.gov. Each US household can request another round of 4 free rapid tests through USPS.
    • People with health insurance in California can still get 8 free rapid tests per member per month. Some insurance plans (such as Kaiser) will continue to cover in-network rapid test kits after November 11, 2023, the data when CA law no longer requires them to.
    • Umoja Health Community Hub offers free rapid antigen tests at their North Oakland site at 750 Aileen Street, Oakland 94609, Monday-Tuesday-Wednesday, 10 am to 2 pm, 1-888-763-0007. They offer N95s and other masks, hand sanitizer, rapid antigen tests and printed resources at this location.
    • 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.
  • If you have symptoms, mask up and repeat antigen testing or get a PCR test. Recent data shows that viral loads don’t peak until around Day 4 of symptoms with the Omicron variants. This means that antigen tests miss some infections in the first few days of symptoms. We have accumulated more immunity and are now more likely to have symptoms early in an infection. Another study also suggests that antigen levels might be lower than RNA levels with Omicron infections. Omicron viral levels rise in the throat before the nose, so consider swabbing the throat before swabbing the nose. Repeat antigen testing has also been shown to increase accuracy in picking up infections. Current guidance is to repeat antigen testing 48 hours after the first negative test before excluding Covid infection. PCR tests still pick up early Omicron infections.    
  • Are expired COVID home tests still useful? If you still get a clear “control” line, the test is likely to still be effective.
  • 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.
  • 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.
  • What are current COVID treatment options?
    • Paxlovid, remdesivir and molnupiravir remain effective against the newer variants.
    • 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. 
    • Paxlovid expiration dates have been extended to 24 months by the FDA. Check updated expiration dates here.
  • How can we prevent long COVID? Aside from wearing masks and preventing infection, the latest data suggests that you can reduce the risk of long COVID if you get infected with:
    • Vaccination with at least 2 doses was associated with a 43% reduction of long COVID in a large systematic review of 41 studies.
    • Paxlovid treatment was found to reduce the risk of long COVID by 26% in a large VA study
    • Metformin (a safe and inexpensive medication usually used for diabetes) taken for 2 weeks during acute COVID infection was found to reduce healthcare utilization for severe COVID and the development of long COVID symptoms by 42% in a randomized control trial.
    • Ensitrelvir (a protease inhibitor like Paxlovid) taken once a day for 5 days was compared to placebo in a randomized control trial in people at lower risk (mostly ages 12-69, vaccinated, no medical risk factors for severe disease), and was found to reduce long Covid symptoms by 26-45%, shorten symptoms by a day and reduce time to first negative test. This study was also presented at CROI 2023. Ensitrelvir is already approved for COVID treatment in Japan.
    • A “healthy lifestyle” (BMI 18-25, never smoking, exercise, moderate alcohol intake, high quality diet, sleeping 7-9 hours per day) was found in the Nurses’ Health Study II cohort (all women, 97% white) to be associated with a lower risk of long COVID. Participants with 5-6 healthy lifestyle factors had 49% lower risk of long COVID.

The end of COVID emergencies:

Free Covid vaccines, testing and treatment will still be covered by insurance and available at pharmacies and community partners for uninsured people after the federal public health emergency ends on May 11 under CA law, the national PREP Act and new Bridge Access Program.   

  • In April 2023, the Department of Health and Human Services (DHHS) announced that some of the PREP Act protections for Covid vaccines and treatment distributed by the US through pharmacies and community partners will continue, including pharmacist-administered free vaccines and treatments and the national Covid test-to-treat program. The CA Covid test-to-treat program through Sesame care is also still available.
  •  DHHS also announced that they will partner with pharmacies to provide Covid vaccines and treatments such as Paxlovid free-of-charge to people without insurance coverage in the Bridge Access Program to be launched this fall.
  • People with insurance coverage in California will be protected from out-of-pocket charges for Covid testing, vaccines and treatment from any licensed provider until November 11, 2023. After that, California insurance companies will still be required to cover these costs in-network without out-of-pocket charges. Click for more info about the end of the public health emergency for California residents.

California’s COVID state of emergency ended on February 28, 2023. The end of the state emergency has led to the end of extra 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. Click for more info about the end of the public health emergency for California residents.

The end of the federal emergency on May 11, 2023 will result in:

  • The end of continuous Medi-Cal coverage. Medi-Cal recipients will have to manually renew and 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.

Click to read more about: the end of the California state emergency and the end of the federal emergency.

Latest COVID resources

Click here for more East Bay COVID guidance and resources on how to protect ourselves and our communities.