Please see the weekly update on the EBGTZ website and highlights below. Click here to download the PDF version.
This week we celebrated MLK Day and the inauguration of a new administration at the White House. This new era brings the possibility of progress and change. We hope our new leaders are continually guided by love and justice.
“If we merged mercy with might, and might with right, then love becomes our legacy, and change our children's birthright.” - Amanda Gorman, Youth Poet Laureate & 2021 Presidential Inaugural Poet (left picture above)
Right picture above: Artwork by Nikkolas Smith (Nikkolas.com)
East Bay COVID-19 updates
COVID-19 daily case rates have slowly decreased in the past week and hospitalization rates remain at high levels in the Bay Area. The US has surpassed 400,000 deaths. Estimated transmission rates in the Bay Area continue to hover around 1 and Bay Area ICU capacity is 7.4% as of January 19, higher than last week and a hopeful sign.
Mask and distancing requirements in all federal buildings, federal lands and by federal employees and contractors. He is also challenging all people in the US to wear a mask for the next 100 days as he pushes to get out 100 million vaccine shots in 100 days.
Rejoining the World Health Organization (WHO), with Dr. Anthony Fauci leading the US delegation and scheduled to present the US plan on supporting the pandemic response and global health.
With more infectious variants of the SARS-CoV-2 virus circulating, this continues to be the most important time to wear masks, stay home or outdoors, avoid gatherings and get vaccinated as soon as we can! The better we do now, the sooner we can get back together later this year.
People needing medical care for any condition are still encouraged to seek care as our clinics and hospitals remain open with strict safety protocols to take care of all people.
Vaccinations are rolling out for health care workers, nursing home residents and elders! There are glimmers of hope as we get more vaccines out and into the arms of people in our communities despite the confusion and fragmentation of our health care system. With the new Biden-Harris administration pushing for increased production and a more coordinated distribution effort, we hope to turn the tide of this devastating pandemic.
Community Spotlight on the COVID-19 Vaccine
Shirley Mychelle Gainey - Case Manager at CAL-PEP
Shirley, pictured above with her son Theo (L) and getting the COVID-19 vaccine (R) received her vaccine last week and here is what she said about why she chose to do it: "The reason I got vaccinated is that I miss hugging my baby boy. I haven't hugged him tight since Mother's day. When it comes to HIV or STI's, he is well informed and asks questions. (Thank you CAL-PEP and APEB) I want him to be just as informed about COVID-19. My landlord is 83 years old. I don't want to place him in harm's way. I miss going to campus. I am so over virtual everything! I understand that the masks will be with us through the next 100 days. At Least. If you and I and 100 people we know also get the vaccine, maybe the 100 days will seem more like 80."
Dr. Sami Lubega of EBGTZ
Dr. Lubega pictured above getting the vaccine from Dr. Maggie Edmonds, Deputy CMO at LifeLong. Here’s what she said about why she got the vaccine: “I got the vaccine because I trust it to help me protect my patients, family, and community. For me, getting the vaccine is an important step in the movement to fight COVID-19 and to bring healing and togetherness into our lives again!”
Dr. Sophy Wong of EBGTZ
Dr. Wong pictured above getting the vaccine from DL Poole, PA and COO at LifeLong. Here’s what Dr. Wong said about the importance of the vaccine: “Getting the vaccine is a pivotal moment in the pandemic for me. It feels like we’re finally starting to dig our way out of this crisis. I’m grateful to get such a highly effective vaccine to protect not only my own health but the health of loved ones and our communities. I look forward to working with everyone to get more vaccines out to more people more quickly!”
Providers are encouraged to talk with patients and clients about vaccinations to combat misinformation and address concerns. Local clinics report that people are declining vaccines due to misinformation that vaccines cause sterility and/or COVID and fear of feeling sick, like after the flu shot. Communities of color continue to turn to their trusted health providers for counsel, and providers are changing minds about vaccinations. The ICD-10 code Z71.89 (other specified counseling) may be used for vaccine counseling done in medical provider visits. We are currently researching whether this code alone is sufficient for medical visit billing purposes.
More vaccine updates
California has administered nearly 1.4 million vaccine doses as of January 17th out of the 3.2 million doses distributed of the Pfizer and Moderna mRNA vaccines, including 357,437 in the Bay Area region, primarily to health care workers, first responders and nursing home residents (Phase 1a) and have started vaccinating people over the age of 65 (Phase 1b), though
Contra Costa County has been administering vaccines for health care workers, first responders and nursing home residents (Phase 1a) since December 15 and started vaccinating people 65 and over (Phase 1b’s first group).
Alameda County administered its first Phase 1a vaccines on December 18 and has received 85,350 doses as of January 14. There are an estimated 145,000 people in Phase 1a in Alameda County. Reports from health care and nursing home vaccinations so far describe mixed acceptance rates and no unusual vaccine reactions.
Alameda County reports that they are “reviewing all Moderna vaccine distributed to the County to make sure administration of vaccine doses from the Lot in question (41L20A) is paused. The County Points of Dispensing have not received or administered vaccine from this Lot, but some local providers did receive doses from it.”
For the weeks of January 18 and 25, Alameda County is releasing limited vaccine appointments primarily to long-term care facility workers, home health workers, emergency service providers, school nurses, primary and specialty care clinic staff due to limited vaccine supplies. If you signed up for notifications as an Alameda County resident working in health care but were not on a health care provider list from one of these organizations, you probably did not receive an appointment notification for this reason.
Alameda County is asking health care workers who have Kaiser or receive care from a Sutter affiliate to ask their healthcare provider to vaccinate them. If you find that that this option is not available to you or your staff, please fill out this form for Health Care Providers to receive notifications when vaccine is available.
Health Care Providers(for fastest access: health care organizations should sign up here and submit lists of health care workers who need vaccination)
If you provide direct services to clients or patients in your usual job, you count as a health care worker in Alameda County's Phase 1a definition. Housing navigators, peer navigators, support group facilitators, etc. count as health care workers because they provide direct support services for patients.
People living with HIV and COVID-19 vaccines
Currently all people living with HIV (PLWH) are recommended to get the COVID-19 vaccine once eligible so long as they don’t have severe allergic reactions to components of the vaccines. For PLWH not otherwise eligible in Phase 1, all PLWH will be eligible in Phase 2. We don’t know yet when there will be enough vaccines for Phase 2 but it will hopefully be in the early spring.
The Moderna vaccine trial included 179 PLWH but data on this specific group has not been reported separately yet. There is currently no recommendation to check antibody levels for people living with HIV after completing vaccination. We don’t know yet if commercially available SARS-CoV2 antibody tests such as at Quest and LabCorp check for the spike antibodies generated by the vaccines, but providers and patients may consider checking for antibody response while we await more data.
Current estimated transmission rates (Re) are 0.99 in Alameda County, 0.99 in Contra Costa and 0.93 in Solano County, compared to 0.92 statewide. Our goal is to support the vaccine roll-out and community measures around masking, staying outdoors and avoiding gatherings to keep transmission rates less than 1.
The LEMMA hospitalization prediction for Alameda County using data through January 18 is that if Alameda County’s transmission rate stays the same (LEMMA’s current estimated Rt is 0.95, down from a high of 1.52 at the end of November), the median projection is for hospital and ICU rates to continue trending downward from our highest hospitalization levels in early January.
Latinx and Black/African American Californians continue to be disproportionately impacted by COVID-19 as shown here in the CDPH CA State COVID-19 dashboard.
In Alameda County, Latinx people are 4.3 times more likely to be diagnosed with COVID-19 and Black/African American people are 1.8 times more likely to die from COVID-19 compared to their white neighbors.
Other HIV and COVID-19 studies
A randomized trial of long-acting injectablecabotegravir and rilpivirine found that 8-week dosing had similar virologic suppression rates as 4-week dosing. Patients (unsurprisingly) preferred the longer dosing interval. Real-world studies and data are needed to help guide implementation.
The L452R variant of COVID-19 is increasingly identified in multiple counties across California sending samples for genomic sequencing. In mid-December the L452R variant was 3.8% of samples sequenced at UCSF and by early January, it was more than 25% of samples sequenced. We don’t have enough data yet to know if this variant is more infectious, but Santa Clara County has sequenced this variant from several large outbreaks where high proportions of exposed people became infected (including one at the Kaiser San Jose ER), so there is concern for greater infectiousness.
Since genomic sequencing is not done systematically in the US or in California, we don’t know how widespread the L452R variant is. These findings emphasize the importance of masking, distancing, avoiding gatherings, hand hygiene and vaccinations to prevent spread.
A pre-print lab study (not done in humans) found that that the Pfizer and BioNTech vaccine is effective against the N501Y mutation present in the UK and South African variants. The N501Y mutation is seen in experiments to allow the virus to bind to cells more tightly. However, there are other mutations, including the worrisome E484K mutation in the South African variant, that are still being investigated.
Public Health England released a new study of the B.1.1.7 UK variant in which researchers estimated that the variant is 30-50% more transmissible than the original strain. Another pre-print study from Imperial College London estimates that the UK variant is 40-70% more transmissible than the original virus, even while high levels of distancing measures were in place.
A recent study of memory T and B cell responses to COVID-19 after infection suggests that long-term immune memory occurs after either natural infection or vaccination for SARS-CoV-2.
Two new studies on the use of convalescent plasma (a randomized trial in Argentina and a second registry study in the US) demonstrate that high-doses of convalescent plasma may offer benefit to elderly and high-risk patients admitted to the hospital with COVID-19 within 72 hours of symptom onset.
A new study of COVID-19 transmissions during air travel used seat maps and genetic analysis to determine that one passenger initiated a chain of infection that spread to 7 people despite pre-flight testing. Two of the people infected acknowledged that they did not wear masks during the entire flight, and the airline did not require mask-wearing in the lobby before boarding.
A new study on transmissions from people without symptoms using meta-analysis data found that 59% of all transmission came from asymptomatic transmission, including 35% from presymptomatic individuals and 24% from individuals who never develop symptoms. These findings again emphasize how masking, distancing, avoiding gatherings are critical for slowing the spread of COVID-19 until we achieve widespread vaccinations.
Kaiser Health News is documenting the more than 2,900 health care workers who have died of COVID-19 in their “Lost on the Frontline” project, including the outsized toll on health workers of color.
ARTogether is an Oakland-based non-profit organization that provides art programs that foster compassionate communities where refugees and immigrants can flourish. They are looking for a Program Manager to oversee projects that support refugee and immigrant artists. To learn more or apply, email leva@artogether.org
BARHII is seeking a Communications Officer and an Administrative Specialist to join their team. Learn more about the organization and positions here.
Funding opportunities:
The California Department of Public Health (CDPH) Office of Health Equity (OHE) will be administering $5M from the Centers for Disease and Control Epidemiology and Laboratory Capacity Grant to approximately 16-30 community based organizations led by and serving communities facing inequities in COVID-19 impacts and infection. The COVID-19 Health Equity Pilot Projects RFA is now live and available here.
The AIDS Institute’s Women Informing Now (WIN) Micro-Grant Funding Opportunity, made possible through grant funding provided to The AIDS Institute (TAI) by ViiV Healthcare, is a micro-grant that supports grassroots community organizations and leaders conducting innovative approaches that break down isolation and stigma for women of color living with HIV across the gender spectrum living with HIV, include those living in “resource deserts” and/or rural areas. Learn more about the opportunities here.
Resources for the community:
San Diego county has put together a series of videos geared towards Black community members to provide accurate information about COVID-19 and the vaccines to prevent it. Watch them here.
Oakland LGBTQ Center’s new Glenn Burke Wellness Clinic is open. Learn more and schedule and appointment here.
Positive Women’s Network Policy Fellowship is a year–long program structured to increase participant’s ability to engage effectively in federal, state and local policy and advocacy. Applications are due by February 12, 2021. Register here to join an informational webinar on Thursday 1/21. More information and application can be found here.
Other resources:
CDPH Office of AIDS’s monthly newsletter for January is available here.
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, Yamini and Sami
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Sophy S. Wong, MD, Director
Yamini Oseguera-Bhatnagar, Program Manager
Sami Lubega, MD, Prevention Director East Bay Getting to Zero
