Week of September 14, 2020
 
Alameda County Health Care Services Agency Update
Last Friday, we modified our Vehicle Based Gathering Order to authorize live performances, extend the vehicle limit to 400, and permit the sale of concessions. We are working with representatives from the arts community, production companies and venue spaces to further refine guidance for live performances. Hosts of all live performances over with more than vehicles are required to submit aLive Performance Plan to [email protected].
Last Friday also marked the deadline for schools across the county to share with us their plans for in-person learning. We received more than 130 responses to our in-person learning readiness questionnaire, with more than 80 schools expressing interest in waivers. We are partnering with the Alameda County Office of Education to review responses and determine next steps.
This week Alameda County reached a significant milestone by having temporarily housed 1,200 homeless residents through Project Roomkey. Please help promote our Landlord Liaison program and help find permanent housing for people exiting Project Roomkey. If you or someone you know has a housing unit for rent, please call 510-777-2100 or email [email protected].
As wildfires continue across the State, please download our Wildfire Smoke and Your Health FAQs. The Alameda County Office of Emergency Services (OES) coordinates a list of extreme heat cooling centers. We remind our community to check on air quality status before going outdoors, stay hydrated and check in on vulnerable neighbors.
Each week we provide a digest of new information pulled from presentations to the Board of Supervisors and other key stakeholders. We hope you find this summary useful and we appreciate your readership and your support.
 
Alameda County Current Ranking
While Alameda County remains in the Purple Tier, we met criteria for the Red Tier last week. Our case rate has dropped to below 6 new cases per day per 100,000 residents andour testing positivity rate is less than 5%.
 
We must meet Red Tier requirements for two consecutive weeks to move into that tier per California’s Blueprint to Safer Economy. A county must remain in a tier for a minimum of three weeks before moving to a less restrictive tier and can only move one tier at a time. Data is reviewed weekly and tiers are updated on Tuesdays.
 
Next week’s calculations will reflect the effect of Labor Day weekend and we’ve seen in the past that holiday weekends can lead to upticks in COVID-19 transmissions. Even if we do go into the Red Tier, we will want to ensure stability in disease trends before adjusting any reopening plans.
 
Schools and Waivers
 
Counties in the Purple Tier are not permitted to open for in-person learning but may accept for waivers to allow in-person elementary school learning to serve students with the highest needs. Approximately 80 waivers have been submitted to the Alameda County Office of Education and are making their way through the Public Health Department for review before being sent to the State. For in-person attendance, schools and districts will need to develop reopening plans that address disinfection, cohorting, health screenings, contact tracing, testing of all staff. Districts are encouraged to utilize the State’s guidance for Small Cohorts/Groups of Children and Youth.
 
School may look a little different this year, but we can all stay healthy and keep learning. Join Sesame Street’s Elmo in getting ready for school because we are all in this together.
 
Check out the Alameda County Public Health Department and the Alameda County Office of Education joint school reopening plan. More details will be shared in the coming weeks.
 
Flu Vaccines Help the Community Avoid a Twindemic
 
In preparation for the upcoming flu season, Alameda County is working with our clinical and community partners to ensure broad access and to implement the planning infrastructure for COVID vaccine. We will be receiving 36,000 flu vaccine doses in September and October from the State to distribute to existing partner clinics. 41,000 additional flu vaccine doses are available from the State upon request from the County in November and December.
We are also partnering with the Board of Supervisors to host community flu clinics throughout the county. Please be sure to get your flu vaccine this year and support vaccine access for all staff and members of your organization.
Trends in Cases and Hospitalizations
 
Case rates continue to slowly trend downward. Hospitalization rates continue to slowly trend down though remaining at higher levels than hospitalizations in June. Our goal is for cases to be flat or decreasing.
·     On September 15, there were 5.6 new cases of COVID-19 per day per 100,000 residents and a test positivity rate of 3.4% using CDPH data adjusted through September 5.
·     On September 15, there were 20,097 cumulative cases and 356 deaths.
·     On September 14, there were 118 hospitalized patients (highest was 213 on 7/28), including 33 ICU patients with confirmed COVID-19.
 
Case rates remain highest among ages 18-50, and hospitalizations in these age groups increased in August while death rates remain highest among those over the age of 50. 
 
The LEMMA COVID-19 prediction model using hospital data through September 13 estimates the median Alameda County transmission rate (Rt) to be 0.65, down from 0.69 last week, and a peak of 1.24 in late June. This means each person with COVID-19, on average, transmits the virus to 0.65 other people. If we keep the transmission rate less than 1, new cases will decrease. The California COVID Assessment Tool (Cal-CAT) uses an ensemble of 8 models and estimates our transmission rate to be 0.91, the same as last week, and compared to 0.87 in California overall. To keep the transmission rate less than 1 and reduce the risk of transmissions, please slow the spread.
 
For help with enforcement or report violations of workplace safety orders in Alameda County, please email: [email protected]

 
Testing
 
We have conducted over 3,500 tests per day in the past week, which is above our goal of 3,100 per day. The percentage of people testing positive is 3.4%, using CDPH data through September 5. This is within our positivity rate goal of less than 8%, but varies by zip code and race/ethnicity. 
 
CDPH guidance updates:
·     Guidance on the use of antigen tests to diagnosis COVID-19 (September 12)
 
 
Updated testing locations and appointment links are posted on the COVID-19 testing webpage and searchable in this interactive map of COVID-19 services. 11 community testing sites offer free tests using county testing guidance for any community member with symptoms, all essential workers, and those at higher medical risk regardless of symptoms.
 
Umoja in Health Partners is providing pop-up COVID-19 testing on Friday, 9/18 at BOSS, 9006 MacArthur Blvd, and Saturday, 9/19 at the Center of Hope Community Church, 8400 MacArthur Blvd. If you would like to volunteer, please click here to sign up.
 
The Sanando Juntos Fruitvale testing event has been rescheduled to September 26 and 27th for people in the 94601 zip code.
Case and Contact Investigation, Isolation and Quarantine
 
Alameda County currently has 42 outbreak investigators, 125 trained case investigators and contact tracers at the County, and 29 at community-based organizations, with a goal to reach 300. Between September 9 through 15, 45% of cases were reached within 24 hours of receiving contact information and 72% of cases were reached within a week after multiple attempts. Each contact tracing team is associated with resource navigators to assist with finding additional resources in the community. The resource supports may include lodging for people who need to isolate themselves successfully, financial assistance, food, housing rights, and necessary household items. 
 
Project Roomkey continues to provide isolation/quarantine housing for people living in crowded conditions or is experiencing homelessness. There are now 1,234 hotel rooms and trailer slots open, with 936 or 76% occupied. This exceeds our goal of having 1,203 rooms or trailers, representing 15% of the 2019 point-in-time count of people experiencing homelessness in Alameda County.  
 
We anticipate the first round of awards from our case investigations and contact tracing RFPs to be announced next week. Rolling applications for the COVID-19 case investigation and contact tracing services funding opportunity are due every first and third Friday of the month. For more information, go to Request for Qualification (RFQ) No. HCSA-900420.
 
The Alameda County Responsibility to Community Health (ARCH) Program provides financial assistance to self-isolating County residents in high-risk communities who have tested positive for COVID-19. For more information, please see the FAQ and press release.
Hospital Capacity and Surge Planning
As of September 14, our hospital capacity indicators are:
·     5% of the patients in hospital beds across Alameda County were confirmed COVID-19 positive, 11% of ICU patients were COVID-19 positive. These percentages have been decreasing since the end of August and within our goal of 50% of less.
·     39% of the staffed inpatient hospital beds and 38% of the ICU beds were available, which is within our goal of above 20%.
·     77% of the mechanical ventilators were available. 
If your facility needs COVID-related supplies or staffing please visit the Emergency Medical Services websiteto request PPE, request staffing and request testing supplies.
Disparities and Equity
 
 
Updated race and ethnicity data in Alameda County show that Latinx people continue to face the highest case rates and Black/African American residents continue to face the highest death rates. Currently Latinx people have 6.4 times the case rate and 1.6 the death rate compared to White people. Black/African American people have 2.2 times the case rate and 2.3 times the death rate compared to White people. Native American people have 1.9 times and Pacific Islander people have 2.3 times the case rate compared to White people. These disparity rates are similar this week (within 0.4) compared to last week.
The highest case and positivity rates in Alameda County continue to be in the Fruitvale and Coliseum zip codes in East Oakland and the 880-highway corridor. However, as illustrated in the case, and testing rate maps, the highest rates of testing are not occurring in the zip codes with the highest case rates. Community-led grassroots testing efforts in the most highly impacted neighborhoods aim to increase testing for those who need it most. 
 
These persistent disparities underscore the urgent need to address racial and socioeconomic inequities in economic stability, workplace safety, education and access to precautions, rapid access to testing, safe isolation housing, quarantine, medical care, and income replacement.