For official ballot drop-off and early in-person voting locations in CA, click here. Further details are below.
East Bay COVID-19 updates
Last week Alameda County moved into the orange tier (“moderate” risk), and Contra Costa and Solano Counties remain in the red tier (“substantial” risk) in California’s Blueprint to Safer Reopening. Testing positivity rates have reached new lows (≤3%) in the Bay Area and across the state. These trends show stabilization and decreases after the summer surge. Fall surges in Europe, a third peak of cases other parts of the US, and increasing transmission rates remind us to remain vigilant with precautions.
Keep up the good work! Take good care of yourself and don’t let pandemic fatigue prevent yourself from keeping safe with masking, distancing, hand hygiene and avoiding crowds.
Contra Costa and Solano Counties are following state allowances for reopenings, including the allowance for school reopenings and indoor activities at reduced capacity. Alameda County is reopening at a slower pace and has allowed reopening of elementary schools that have COVID-19 health and safety reopening plans. School reopening plans vary by school district and individual schools.
A county must remain in a tier for a minimum of three weeks and meet all 3 targets for the next tier for at least two weeks before being able to advance to a less restrictive tier. Counties can only move one tier at a time.
Current estimated transmission rates are 0.99 in Alameda County, 0.96 in Contra Costa and 1.1 in Solano County, compared to 0.96 statewide. Our goal is to support community measures around masking, distancing, hygiene and testing to keep transmission rates less than 1.
Case trends by race/ethnicity in Alameda County show that there have been declines in all groups since August, with the most pronounced declines among Latinx people and some narrowing of disparities (see graph). Weeks marked by red rectangles in the horizontal axis indicate when reopenings were allowed. The rapid increase in cases in the summer reflect the major reopenings in late spring. With additional reopenings allowed in September and October, including school reopenings, case trends will be monitored closely in 4-6 week increments to determine whether it’s safe enough for additional activities to reopen. Click here for all current approved businesses and activities in Alameda County.
Upcoming reopenings in Alameda County starting October 26 include:
Indoor worship services at <25% capacity or <100 people
Indoor dining at <25% capacity or <100 people
Indoor retail expansion to 50% capacity
Shopping centers expansion to 50% capacity, limited food courts
Indoor movie theaters at <25% capacity or <100 people
California state has distributed rapid COVID-19 antigen test kits to county public health departments. Alameda County received 30,000 test kits and is prioritizing distribution to safety net emergency departments, urgent care clinics, community health centers, jails, long-term care facilities and other congregate settings who can perform CLIA-waived tests. Alameda County facilities can request testing kits here. Alameda County antigen testing guidance can be downloaded here. FDA Bianax NOW test kit procedures can be downloaded here.
New guidance on private gatherings was released by the California Department of Public Health, allowing outdoor private gatherings of up to three separate households provided masks and physical distancing protocols are met. This includes gatherings at public parks. The fewer people and households involved and the shorter the time period, the less risk of COVID transmission. Indoor gatherings with people outside of an immediate household are still strongly discouraged.
The CDC director has warned that small household gatherings are contributing to increased spread, possibly as these have moved indoors due to colder weather in many parts of the country.
California Department of Public Health submitted its first draft of a COVID-19 vaccination plan to the CDC on October 16. Many supply chain, distribution, storage, immunization tracking and deployment systems still need to be worked out with health care providers and other stakeholders. A vaccine is not expected to be authorized until later November-December, and sufficient quantities for a release to the general public is not expected until mid-2021. Click here to download the draft CA COVID-19 vaccine plan.
Let’s fight flu together! And prevent a COVID-flu twindemic this winter. All health care workers are required by Public Health to get a flu vaccine unless there is a clear exemption. For people with Medi-Cal in Alameda County: Walgreens pharmacies confirmed that they will accept Alameda Alliance Med-Cal to cover the flu vaccine without copays or cost; people can walk in or use the Walgreens online scheduler. Local CVS pharmacies confirmed that Blue Cross Anthem Medi-Cal members ages 19-64 can walk in or use the CVS online scheduler to get flu vaccines without cost.
New HIV and COVID-19 guidelines and studies
IAS-USA released new HIV prevention and treatment guidelineson October 14: Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2020 Recommendations of the International Antiviral Society–USA Panel. In addition to reiterating the importance of removing structural barriers to rapid ART and PrEP, highlights include an initial double-dose of TDF/FTC PrEP for MSM, a 2-drug dolutegravir-lamivudine initial regimen for some PLWH, and recommendations for the long-acting cabotegravir injectable for PrEP and HIV treatment, which is pending FDA approval.
“Innovations in HIV care delivery during the COVID-19 pandemic: Policies to strengthen the Ending the Epidemic Initiative – A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association” (Armstrong, et. al.) reports that the pandemic has severely reduced in-person visits. At one large Boston health center, nearly 75% fewer people initiated PrEP between January and April 2020. The pandemic has also “accelerated growth of alternative options, bolstered by additional funding support,” including services that are more patient-centered, accessible, collaborative and less bureaucratic, including telehealth, longer and early refills and remote access to Ryan White recertification and services, which should be integrated into sustained policy changes.
“Advancing Digital Health Equity: A Policy Paper of the Infectious Diseases Society of America and the HIV Medicine Association” (Wood, et. al.) reports on the “digital divide” in telemedicine, including disparities in video and phone access. People identified as female, low income (<$50k/year), age above 60, Black or non-English speaking have been found to be less likely to complete video visits instead of phone visits during the pandemic. Non-English proficiency was associated with 50% less video or phone visits. The authors identify and support people around 4 digital health access points: technology, technical literacy, broadband connectivity and personal privacy (e.g. location, use of headphones).
Disparities among Latinx people in Oakland:Fruitvale Unidos en Salud COVID study led by a coalition including La Clínica and Unity Council tested 1,099 people with PCR and antibody tests and found 39 with a positive PCR test, a 3.5% positivity rate. 97% of the people who tested positive were Latinx even though they were only 62% of those tested. 10% of people were antibody positive, including 12% of Latinx people and 27% among Mayan residents.
“It is not new that we are the underserved and one of the most vulnerable groups in the area, and now with COVID-19 we are facing an even greater crisis especially with access to health services, housing, food and financial support,” said Rosendo Aguilar, a Fruitvale resident and Mam speaker.
A new CDC study estimated 198,081 excess deaths attributed to COVID-19 from late January to early October 2020 in addition to the 215,025 diagnosed COVID-19 deaths. This represents 2/3 of all the 299,028 excess deaths. The largest percentage increases were seen among adults aged 25–44 years and among Latinx people.
Disparities among Filipino American nurses: A recent report by the National Nurses United union found that Filipino Americans in California make up 20% of the nurse work force but make up 70% of COVID-19 deaths among nurses. Filipino American nurses are concentrated in in-patient, critical care roles, many work second jobs in long term care facilities, and often live in large, intergenerational households.
Face masks were not found impair oxygen levels in patients with COPD: This study assessed whether masks cause added impairments in oxygen and carbon dioxide exchange among people with COPD. They found no change in the carbon dioxide concentration at rest or after a 6-minute walk test. Oxygen levels did not decline at rest, and after a 6-minute walk test with masks, oxygen levels declined only at the level expected for the severity of the person’s COPD.
COVID-19 transmission in child care programs: A study of 57,335 US child care providers reported 427 COVID-19 cases April-May 2020. Community prevalence, race, travel and social gatherings (family gatherings, restaurants) were predictive of infection, but exposure to a childcare center was not. Masking was low: only 35% staff, 12% children >2 masked. Being a home-based provider was associated with COVID-19 but not due to exposure in the childcare setting. However, case reports of outbreaks in day care settings like this one in Poland with a 27% cluster positivity rate remind us to ensure preventive measures are in place.
A new study shows that viable SARS-CoV2 viruses last 9 hours on human skin, 5x longer than influenza A viruses. Both are inactivated within 15 seconds by 80% ethanol, a common alcohol ingredient in hand sanitizers, highlighting the importance of hand hygiene.
A COVID-19 outbreak at a spin studio/gym in Canada has resulted thus far in 44 patrons infected and 17 additional cases of household contacts of patrons. While the studio in Hamilton, Ontario and public health rules require masks while off the spin bikes, it does not require patrons to wear masks while on the bikes, which are spaced 6 feet apart. Gyms are at higher risk for transmission because people take off their masks while exercising, breathing at a higher rate and more deeply, and often talking loudly.
A CDC study on the impact of community COVID-19 prevention strategies in Arizona shows that cases rose by 151% in June after stay-at-home orders were lifted and decreased by 75% in July after prevention measures were implemented. These strategies included mask mandates, guidance around physical distancing, reducing the number and size of large gatherings, pausing operation of businesses where maintaining distance is challenging, such as bars, gyms, theaters, water parks, and reducing indoor dining capacity.
A new study from Carnegie Mellon University showed the highest self-reported mask usage in California and the Northeast, where more than 90 percent of people reported wearing masks either most or all of the time while in public when surveyed between September 8 and October 7. Increasing masking rates also correlated with lower official COVID-19 case rates. In the maps below, you can see how the states with the highest percentage of people wearing masks (in darker green) also had the lowest rates of knowing someone sick from COVID-19 (in lighter orange).
USCHA: The United States Conference on HIV/AIDS concluded today. The closing plenary on Ending the HIV Epidemic and keynote by Dr. Fauci (1 hour in) is posted on YouTube here. If you registered, you can still access conference sessions here. If you were unable to register, NMAC will reopen free registration on Nov 3rd for people who need access to the platform. The information will be online for 12 months. All you need is your email to access.
Job Opportunities:
EBGTZ is looking for two consultants to work with us on community messaging: a communications consultant and a graphic designer. For more info, please contact Yamini at yamini@ebgtz.org.
AHF is looking for a part-time HIV Testing Counselor (up to 20 hours/week) at their Oakland Wellness Center. Applicants must be available to work on Monday and Thursday afternoon/early evening. Interested applicants may send their resumes to: christopher.mejia@ahf.org
Alameda County Healthcare for the Homeless is looking for a medical director. Learn more about the opportunity here.
WORLD is hiring for a full-time delivery driver who will be in charge of assembling and dropping off COVID care kits to households. Learn more here.
Trucha at La Clinica is hiring for the following positions: Street Outreach Worker, PrEP Navigator, HIV Linkage Coordinator. Learn more by emailing them at trucha@laclinica.org
Services/opportunities for clients/participants:
AIDS Medi-Cal Waiver provides community/home based services as an alternative to nursing facility care or hospitalization. To make a referral, or obtain more information please contact dpowell@pcahi.org.
Youth opportunities:
Youth UpRising’s DPN’s employment program is hiring youth ages 14-21 who live in Alameda County. Learn more by contacting Tsehayu at tbantidagne@youthuprising.org.
Webinars/Virtual events:
PAETC and other partners are hosting the Getting to Zero webinar series.The next session is on October 29, 2020 from 8 – 10:00 am titled Increasing Access to Underserved Communities. Register here.
Alameda County Care Connect has many educational opportunities coming up. Create an account to view their offerings by emailing CareConnectTrainings@chcnetwork.org. The next training session will take place on October 29th from 10-11am and is titled governmentally-Subsidized Housing Opportunities for Immigrants. Learn more and register here.
SFDPH has put together a course on suggested techniques to support de-escalation when working with clients during COVID-19.’De-escalation for Front-line Providers in COVID-19’ will take place Friday, October 23, 2-4:00 pm. Click here to register and learn more.
The EBGTZ website continues to have weekly updates on Wednesday evenings, and this newsletter will be sent out twice a month on 1st and 3rd Wednesdays. Please follow and share our Instagram, Facebook and Twitter accounts.
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
