Alameda County Health Care Services Agency Update

Public Health – Emergency Medical Services – Behavioral Health – Environmental Health

Homeless Care & Coordination – HealthPAC – Center for Healthy Schools & Communities

Week of September 21, 2020

Alameda County Health Care Services Agency Update

This week Alameda County advanced to the Red Tier in California’s Blueprint for a Safer Economy. This progress reflects continued downward trends in COVID-19 cases and test positivity rates in Alameda County. To avoid dramatic increases in disease transmission that would force re-closures, we are continuing to take a measured approach to reopening and there are no changes to our local Health Officer Orders at this time. We will monitor data to ensure that the favorable trends are stable, and will issue a revised reopening plan soon.

We are preparing for flu season and encouraging flu shots broadly this fall. Our flu team is finalizing guidance and scheduling large scale flu clinics in the community. The flu team is also working with our health care partners and the Board of Supervisors to ensure a robust countywide strategy.

We are also planning our future COVID operations, shifting our agency from emergency to sustained pandemic response. Our current focus is on two simultaneous planning processes: stabilization in the next three months and strategic response planning over the next three years. Our four critical COVID response areas are: testing, case investigation and contact tracing, special population outbreaks, and data. The group is also identifying the triggers and milestones for standing down or activating elements of our Department Operations Center and incident command structure to address COVID activity in the future. We will continue sharing information about COVID Futures as plans develop.

Finally, we are pleased to announce the launch of the new Age-Friendly website developed in partnership with the Social Services Agency and Information Technology Department. The website provides a user-friendly, centralized location for older adults to access services and information to stay informed and connected for an independent and full life. Requested by the Board of Supervisors, the site serves as an important tool as Alameda County seeks to become an Age-Friendly County which is a project of the World Health Organization.

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.

Public Health Department Website

Alameda County Dashboard

School and Waivers

Bringing students back for in-person learning is a top priority for the next phase of reopening.

We continue to review school waiver applications. Applications are reviewed by County staff on a rolling basis and sent to the State for approval. All Alameda County schools and school districts are urged to prioritize preparing for school reopening following guidance developed by Public Health and the County Office of Education. Schools are encouraged to use state and locally permitted school-based small cohorts to provide targeted, specialized services for students with special needs and English learners, access to internet and devices for distance learning, and in-person support for at-risk and high need students.

Trends in Cases and Hospitalizations

Case and hospitalization rates continue to trend downward noting 3.5 new COVID-19 cases per day per 100,000 residents and:

91 confirmed COVID-19 hospitalized patients including 35 ICU patients on September 22.
20,839 cumulative cases and 395 deaths on September 23.

The LEMMA COVID-19 prediction model using hospital data through September 21 estimates the median Alameda County transmission rate (Rt) to be 0.61. This means each person with COVID-19, on average, transmits the virus to 0.61 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 eight models and estimates our transmission rate to be 0.87 compared to 0.89 statewide.

For help with enforcement or report violations of workplace safety orders in Alameda County, please email: [email protected]

Testing

We conducted over 4,000 tests per day in the past week, which is above our goal of 3,100 per day. The percentage of people testing positive is 2.5%, using CDPH data through September 12. While this is within our positivity rate goal of less than 8%, it varies greatly by zip code and race/ethnicity.

Testing locations and appointment links are posted and searchable in the 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.

Upcoming events and new sites:

· The Sanando Juntos Fruitvale testing event will be held on September 26 and 27 in the La Clínica de la Raza parking lot at 35th and E. 12 St in Oakland for people in the 94601 zip code.

· Glad Tidings Church in Hayward is testing Wednesday through Saturday, 11 am-4 pm. Hours may change.

· Global Communication Education and Art (GCEA) launched a pop-up site at Kidus Michael Ethiopian Orthodox Church, 678 26th St, Oakland. The site will operate once a week on Wednesdays for three weeks, beginning Wednesday, September 23.

Our Health Care for the Homeless (HCH) and Public Health teams, along with partners including Roots Community Health Center, LifeLong Medical Care, Hayward/Fremont Fire and others have conducted 1,277 COVID tests in homeless shelters and encampments. To date, there are 40 positive results from 60 different testing events and an overall positivity rate of 3.1%. HCH and Public Health have coordinated 304 tests to date at Project Roomkey hotel sites, with 29 positive results and a positivity rate of 9.5%.

Case and Contact Investigation, Isolation and Quarantine

Alameda County currently has 45 outbreak investigators and 150 trained case investigators/contact tracers including 28 at community-based organizations. Between September 16 through 18, 56% of cases were reached within 24 hours of receiving contact information and 61% of cases were reached within 48 hours. Each contact tracing team is associated with resource navigators to assist in finding additional resources in the community. Resource supports may include lodging for people who need to isolate themselves successfully, financial assistance, food, housing rights and necessary household items.

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.

Project Roomkey continues to provide isolation/quarantine housing for people living in crowded conditions or is experiencing homelessness.

The Alameda County Responsibility to Community Health (ARCH) Program provides financial assistance to self-isolating County residents in high-risk communities who test positive for COVID-19. Please see the FAQand press release for more information.

Hospital Capacity and Surge Planning

Our hospital utilization data as of September 22:

4% of the patients in hospital beds were confirmed COVID-19 positive.
12% of ICU patients were COVID-19 positive.
38% of the staffed inpatient hospital beds and 39% of the ICU beds were available and within our goal of above 20%.
76% 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 Latino communities continue to experience the highest case rates, and Black/African American communities continue to experience the highest death rates. Latinx people have 6.4 times the case rate and 1.5 the death rate compared to White people. Black/African American people have 2.1 times the case rate and 2.1 times the death rate compared to White people. Native American people have 1.9 times the case rate and Pacific Islander people have 2.2 times the case rate compared to White people.

The highest case and positivity rates in Alameda County continue to occur in the Fruitvale and Coliseum zip codes in East Oakland, and the 880 corridor.

Among the six Alameda County community testing sites that provided raw demographic data in August (see graph), people who self-identify as Latinx have the highest positivity rate at 14.6% compared to a 6.9% overall positivity rate and a 1.7% positivity rate among Whites.

Pacific Islander communities in the US face disproportionate COVID-19 infections, hospitalizations, and deaths in addition to Black, Latinx, and Native American communities. Many Pacific Islanders immigrated under the Compact of Free Association (COFA), which allows residents from Micronesia, the Marshall Islands, and Palau to live in the US but not have citizenship or legal permanent residency, which makes it more challenging to access social services. Pacific Islanders in the US are disproportionately employed in low-wage frontline occupations at high risk for outbreaks such as meat or poultry plants, and are disproportionately impacted by diabetes, a risk factor for worse outcomes from COVID-19.

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.

Community COVID-19 testing sites and events utilize geographic and racial/ethnic disparity data to provide testing and outreach services to the communities disproportionately impacted by the pandemic and social determinants of health.

Eliminating Homelessness

Alameda County set ambitious targets for 2026 – to ensure the availability of diverse and affordable housing for all residents with the goal of eliminating homelessness. These 10x goals are part of the County’s Vision 2026. Our Agency is actively involved in this particular goal, as noted by the following highlights and work underway:

We opened a Safe Parking site in March 2019 to serve homeless residents who are living temporarily in their vehicles while they seek permanent housing. The site offers meal delivery, laundry facilities, Wi-Fi access and a permanent mailing address which is critical when applying for permanent housing. We have served more than 60 people and transitioned 32 into permanent housing to date.
The Tiny Homes project, approved by Board of Supervisors on August 4, will provide 34 units with individual bathrooms and cooking areas. The project is expected to be completed by January 2021.
Our Home Together Plan is a collaborative effort with homeless service and housing providers, County agencies, and regional organizations. The plan, adopted by the Board of Supervisors on August 4, makes recommendations for addressing homelessness in Alameda County through new investments and system improvements. The plan is available online for review.