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.

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East Bay COVID updates

December 2022

Virus levels:

COVID, RSV and Influenza trends as of December 6:

  • COVID EBMUD wastewater levels show a very rapid rise in community viral levels and COVID hospitalizations in Alameda and Contra Costa Counties more than doubled from November to December. The new immune-evading BQ.1/BQ.1.1/XBB variants are now widely circulating in the Bay Area. California predictions are that levels will continue to rise through December. Immunity only lasts 4-6 months, and the bivalent booster adds significant protection against symptomatic and severe infection, so get your updated bivalent booster if you haven’t yet.
  • RSV has remained at very high levels into December, way above last year’s highest levels. This represents a very early RSV season, and indoor holiday gatherings may keep RSV levels high.
  • Influenza has risen to very high levels, with influenza-like illnesses at their highest rate in the past 6 years, 2 months earlier than our usual peak in late January. There was a rapid rise in Alameda and Contra Costa County influenza hospitalizations into December. Influenza levels in the Bay Area are expected to rise further through December and January. 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.

To reduce the risk of COVID, RSV and flu during a time of 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.


  • New variants are widely 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 BQ.1/BQ.1.1 and XBB variants with immune-evading properties. Western US regional variant data also shows that new variants have overtaken BA.5 and are now over 80% of circulating strains.
    • 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 BQ.1/BQ.1.1 resistance.
  • Boosters increase protection against new variants: Recent data show us how boosters are crucial to protect us from waning immunity and 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.


  • 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 recommended: While BQ.1.1 and some of the newer variants are resistant to Evusheld, 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.


  • 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 now 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. 

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

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