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Dear East Bay Getting to Zero community,
    
Please see the complete weekly update on the
EBGTZ website and highlights below. Click here to download the PDF version. 
 
East Bay strategic planning process: Our
next meeting on writing the strategic plan will be held on Friday, October 23, 10-11:30 am. Please join us. Your voice is important. You can register for the meeting here.
 
2020 Election: This year every registered California voter will get a ballot in the mail. Expect to receive your ballot soon. Important things to note:
1)
Click here to check your registration status or register to vote.
2) You can vote as soon as you receive your ballot.
3) Fill the ballot out using blue or black ink, and put it in the return envelope.
4) Sign your name on the back and seal the envelope.
5) Drop off your completed, signed ballot at one of the official drop box locations (Alameda County
locations, and Contra Costa County locations). This is recommended as the safest option. Or put it in the mailbox. No stamps are necessary. If needed, you can also bring your ballot to a polling place on Election Day. 

East Bay COVID-19 updates 
 
This week a new statewide COVID-19 equity metric went into effect. Alameda, Contra Costa and Solano counties remain in the red tier (“substantial” risk level) in California’s Blueprint to Safer Reopening with stable case rates. These trends show encouraging decreases after summer surges.
 
The state Blueprint tiers have been determined by new case and test positivity rates. The equity metric adds the requirement that test positivity rates in the lowest quartile of the
Healthy Places Index census tracts do not significantly lag behind the overall county test positivity rate.
 
The
California Healthy Places Index (HPI) is a composite measure of socioeconomic opportunity applied to census tracts that includes 25 indicators across economic, social, education, transportation, housing, environmental and neighborhood factors that determine life expectancy. While the state's lowest quartile HPI census tracts are home to 24% of Californians, they account for 40% of COVID-19 cases. The equity metric targets must be met to move into less restrictive tiers but will not be considered as a factor in whether a county needs to move to a more restrictive tier. 

All 3 counties are currently meeting the health equity red tier goal of ≤8% test positivity in the lowest quartile HPI census tract. Alameda County has a test positivity rate of 3.9% in the lowest quartile HPI census tract, compared to overall county positivity rates of 2%. Contra Costa County’s testing positivity rate is 6.8% in the lowest quartile HPI census tract. Solano County’s testing positivity rate is 2.9% in the lowest quartile HPI census tract.
Contra Costa and Solano Counties are following state allowances for reopenings. Alameda County announced that as of October 13, elementary schools that complete a COVID-19 health and safety reopening plan are permitted to open. School reopening plans vary by school district and individual schools.   
 

Current estimated transmission rates are 0.88 in Alameda County, 0.94 in Contra Costa and 1.04 in Solano County, compared to 0.96 statewide. Our goal is to keep transmission rates less than 1 so that cases decrease. Our collective efforts to wear masks and maintain physical distance are crucial for limiting illness and death.
Alameda County:
  • 4.0 new cases of COVID-19 per day per 100,000 residents (down from 4.8 last week for the unadjusted new case rate).
  • 2.0% test positivity rate countywide (down from 2.3%).
  • 3.9% test positivity in the lowest quartile HPI census tract.
  • 21,845 cumulative cases and 440 deaths.
  • 78 hospitalized patients (highest was 213 on 7/28), including 26 ICU patients (highest was 73 on 8/20) with confirmed COVID-19.
  • 0.88 transmission rate on the updated Cal-CAT model (down from 0.89). 
Contra Costa County: Solano County:
Alameda County test positivity trends by Healthy Places Index (HPI) quartiles also show encouraging progress, with the gap between the lowest and highest HPI quartiles narrowing from August to September. 
New HIV and COVID-19 studies
 

Rapid ART with integrase inhibitors leads to a drop in secondary HIV transmissions among MSM: A large modeling study in PLoS One found that initiating HIV treatment with an integrase inhibitor–based regimen immediately after a person is diagnosed led to an 88% reduction in onward HIV transmission risk over the next eight weeks among men who have sex with men (MSM), when compared to starting treatment 28 days after diagnosis. That’s a moderately higher rate reduction than the researchers found for efavirenz-based therapy (76%) and considerably higher rate than for boosted darunavir–based therapy (58%).

A special UCSF COVID-19 Medical Grand Rounds was recorded on October 6: President Trump’s Covid-19 Diagnosis: Implications for Transmission, Treatment, and Prognosis and can be viewed anytime here

The first large-scale COVID-19 population study in a lower-resource country was recently published with data from India. Notably, this study showed that kids can get and transmit COVID-19. More than 5,300 school-aged children in the study had infected 2,508 contacts but were more likely to spread the virus to other children of a similar age. Researchers could not assess the children’s ability to transmit relative to adults.
A new CDC MMWR adolescent case study showed that a 13-year-old with nasal congestion was the index case for a large family outbreak. This finding fits with the data that adolescents can serve as a source of outbreaks, even when their symptoms are mild.
COVID-19 and altered mental status: A new study of 509 hospitalized COVID-19 patients in the Chicago area showed that nearly a third of patients experienced some type of altered mental function, ranging from confusion to delirium to unresponsiveness. These patients stayed three times as long in the hospital as patients without altered mental status.
 

The CDC acknowledges that COVID-19 can be spread by airborne transmission. The CDC website now states that “There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than 6 feet away. These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising.”
 

A new CDC study investigates COVID-19 transmission during a 5-hour flight in Australia, where 11 patients with confirmed SARS-CoV-2 infection likely transmitted virus to another 11 passengers. Among secondary cases, 8 passengers were seated within 2 rows of infectious passengers, 2 possibly flight-associated cases were seated 3 rows away, and 1 flight-associated case was seated 6 rows away. Mask use was low overall during the flight, and only 2 of the secondary cases said they wore masks for only part of the flight.



Our summary of COVID-19 harm reduction strategies is continuously updated with these and other new studies. 
 
Free COVID-19 testing sites:
Click here for Alameda County, Contra Costa County and Solano County testing sites.
 
Other updates and opportunities:

Resources for clients:
  • Election 2020: Oakland Rising’s Voter Guide is out. Check it out here.
  • Generic Truvada: Teva Pharmaceuticals (makers of generic Truvada) now has a copay card available here. It pays up to $600 a month, but is only for people with insurance (and won't work with Medicare, which bans copay cards). The Gilead copay card and free drug programs are still available, as is the federal Ready Set PrEP program. Teva has an exclusive agreement with Gilead to sell the generic for six months. Any generic manufacturer will be allowed to sell their generic starting in April of 2021, when we will likely see prices fall.
  • Black TRANS (Training Resisting Advancing Never Settling) University is a new 12-week stipend-supported program created by Black trans people for Black trans people at the Oakland LGBTQ Center in collaboration with Tranz of Anarchii Inc. Learn more here.
Resources for agencies/advocates:
  • CDC’s Capacity Building Branch has released a Toolkit for Providing HIV Prevention Services to Transgender Women of Color. It is a technical assistance guide that community-based organizations and similar organizations can use to support their HIV prevention services for transgender women of color. Learn more about it here.
  • Newsletter: California Department of Public Health - Office of AIDS’ October 2020 newsletter OAVoice is here.
Funding opportunities:
  • The CDC’s Notice of Funding Opportunity is still open. Applications are due on November 20th. Learn more about the opportunity here.
Job Opportunities:
  • La Clinica de la Raza is looking to hire a Street Outreach Worker. The individual in this position will conduct rapid HIV testing and provide referrals. Learn more about the opportunity here.
  • IRC Oakland is looking for a Financial Coach to join its Economic Empowerment team. IRC Oakland's Economic Empowerment programming connects individuals to employment and asset-building opportunities to lead them down the path of self-sufficiency. Learn more about the opportunity here.
Trainings, webinars & virtual events:
  • Training video on Alameda County Housing services: In this recording, Colleen Budenholzer covers the housing Coordinated Entry system, a streamlined system designed to efficiently match people experiencing homelessness to available housing, shelter, and services. Participants will learn about points of entry and services for clients, housing problem solving, and the documents needed for housing services.
  • PTBI Collaboratory: California Preterm Birth Initiative will be holding a special Collaboratory “Communities as the Compass: When communities are the North Star” on October 23rd from 1-2:30pm. Learn how health research initiatives centered community wisdom to evolve their missions, leadership teams and research strategies to focus anti-racism and drive positive, sustainable change for the organization and most importantly the communities they serve. More information can be found here.
  • Positive Change II - Dismantling Racism in the HIV Workplace is a virtual conference to be held on Thursday, October 29 and Friday, October 30. The purpose is to both inform the HIV workforce and to reflect and strategize on the roles that leaders, communities and our organizations play in perpetuating structural racism and white supremacy. Speakers include Drs. Camara Phyllis Jones, Tonia Poteat, Sheldon Fields and Russell Brewer. Register for the event here.
You are always welcome to go to the EBGTZ website for detailed updates (usually posted Wednesday evenings). Please follow and share our Instagram, Facebook and Twitter accounts. 
 
Please note that these HIV+COVID-19 updates are now on a bi-weekly schedule of 1st and 3rd Wednesdays. COVID data updates will still be posted to the
EBGTZ website on Wednesdays in the late afternoon during non-holiday weeks and new studies will be continuously added to our summary of COVID-19 harm reduction strategies. You can sign up for Alameda County weekly COVID-19 newsletters by emailing Jamie.Yee@acgov.org.
 
Thank you for all that you do for our communities!
Sophy and Yamini
 
***
Sophy S. Wong, MD, Director
Yamini Oseguera-Bhatnagar, Program Manager

East Bay Getting to Zero
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