Public Health – Emergency Medical Services – Behavioral Health – Environmental Health Homeless Care & Coordination – HealthPAC – Center for Healthy Schools & Communities
Week of April 27, 2020
Alameda County Health Care Services Agency Update
Yesterday, The Bay Area Health Officers issued a new Order that eases some restrictions while leaving many of the current Order’s requirements intact. We understand that social distancing hasn’t been easy, but it is clear that our collective actions have slowed the increase of new cases, prevented our health systems from becoming overwhelmed, and saved lives. Thank you all for your ongoing support and efforts.
In this issue we share key updates including:
  • Key provisions of the new shelter-in-place order
  • Indicators to measure progress
  • Data demonstrating the benefits of social distancing and sheltering
  • Testing and contact tracing
  • Hospital capacity and planning
On Tuesday, the Board of Supervisors approved new contracts for hotels to meet our COVID-19 needs. Collectively, these spaces increase our capacity as part of Operation Safer Ground and serve people who are at high risk for COVID-19 complications.
This week, Alameda County joined a Bay Area research initiative with the Chan Zuckerberg Biohub, UCSF, and Stanford. We will be participating in two studies over the next nine months. The first is a long-term surveillance study to help us understand the rate of new infections, and the second will focus on health care workers, looking at whether and how long antibodies offer any protection against COVID-19. Press Release
The Agency provides COVID-19 regular updates to the Alameda County Board of Supervisors and you will find a link to this week’s presentation here.
Revised and Extended Shelter In Place Order
The seven Bay Area Public Health Officers who ordered a shelter in place in mid-March extended the orders through May 31. The new Order allows the following activities to resume as long as physical distancing and industry-specific requirements are followed*:
  • All construction projects that follow the Construction Project Safety Protocols included with the order.
  • All real estate transactions.
  • Childcare, camps and programs that provide care and educational or recreational activities for children of people who are allowed to work outside of their homes.
  • Outdoor businesses such as nurseries, landscaping, and agriculture that normally operated outdoors prior to the shelter in place orders.
  • Use of certain outdoor recreational facilities, such as skate parks and athletic fields.
  • All businesses operating in the County must update or create a Social Distancing Protocol to reflect new requirements specified in the order.
  • Playgrounds, picnic areas, gyms, and other shared spaces that don’t enable physical distancing must remain closed.
  • Bars and restaurants continue to be restricted to take-out service only, even if they have outdoor seating.
Everyone else should continue to stay and work at home as much as possible to help us make forward progress. If our community continues to comply with the orders, we can prevent big spikes in cases, which would ultimately hinder progress toward fully opening the economy.
Please visit the frequently asked questions in multiple languages for additional information about the order.
*Where there are differences between the local order and the State’s order, everyone must follow the stricter restrictions.
Indicators to Measure Progress
The Health Officers also released indicators to measure progress in containing the virus and assist with decisions on how to safely ease out of shelter-in-place restrictions. These Indicators are complementary to the high-level metrics being tracked by the California Department of Public Health and the Governor and include:
  • Whether the total number of cases in the community is flat or decreasing;
  • Whether the number of hospitalized patients with COVID-19 is flat or decreasing; (and proportion of hospital beds/capacity)
  • Whether there is an adequate supply of personal protective equipment for all health care workers;
  • Whether we are meeting the need for testing, especially for vulnerable populations or those in high-risk settings or occupations; and
  • Whether we have the capacity to investigate >90% COVID-19 cases and trace >90% of their contacts, and ensuring they are safely isolated and quarantined.
Physical Distancing and Sheltering
Daily reported COVID cases, and hospitalization rates are lower than originally predicted and have remained relatively flat on average over the past three weeks (see graphs). On April 30, there were 1,603 reported COVID positive cases and 60 deaths in Alameda County, representing 3.5 deaths per 100k people, compared to 5 deaths per 100k overall in California. The Bay Area comprises 2% of the US population and has less than 0.5% of US COVID deaths. To continue to flatten the curve, the sheltering-in-place order has been extended through May.
Cell phone mobility data from this week shows that we have reduced our distance traveled by 40-55% and reduced non-essential visits by 65-70%.
Remember to stay in place, maintain space, and cover your face. Universal face coverings are an important strategy for reducing asymptomatic spread and are required when going out for essential activities. You can use simple fabric (bandannas, scarves, t-shirts) you may already have at home.
Local COVID-19 food distribution sites, shelters, social service agencies, and testing sites can be found on this interactive map.
Testing supplies remain a limiting factor in our efforts to expand testing across the county. We are revising our goals to increase capacity to 3,100 tests per day, which is a five fold increase over current capacity. New COVID testing sites are being added, and we have 21 sites listed on theinteractive map (filter for COVID-19 testing) and available on a downloadable PDF.
Over 15,500 COVID tests have been reported in Alameda County to date, with 9% of all tests positive, with a high number of cases along the 880 corridor. The positivity rate trend will be closely monitored to support our work to reduce health disparities.
Among COVID positive cases with known racein Alameda County, Latinos have the highest rates of cases and African Americans have the highest rates of death. African Americans have disproportionate rates of cases and deaths in many places across the US and California.
Alameda County is using this data to inform efforts to address disparities and ensure that we are testing, tracing and providing health and social supports to help people isolate and quarantine as needed.
Hospital Capacity and Surge Planning
Our goal is to decrease or flatten COVID hospitalization rates over a two-week period, having at least 50% hospital capacity available for COVID cases and enough personal protective equipment (PPE) for 30 days or more.
Hospitalization rates have been relatively flat over the past three weeks. On April 27, there were 128 hospitalizations (the highest was 198 on 4/14) and 47 ICU patients (highest was 71 on 4/10) with confirmed or suspected COVID. 58% of the 313 ICU beds and 81% of the 553 on-site ventilators were available across Alameda County.
Hospitals have their contingency and crisis plans in place to be ready for a surge (a rapid increase in hospitalized cases). They continue to monitor and report on suspected and confirmed cases, bed availability, and PPE supplies.
Managing Emotional Health
Resources for Self Care and Support
It is important to remember our mental and emotional health and wellness as we continue to focus on personal hygiene, social distancing, and generally staying well while staying home. Social connections, or those normal social activities that were generally useful in managing stress, may not be available to us as a result of COVID-19 precautions. Yet we know that finding alternative and creative ways to reach out and be connected with other individuals helps to minimize distress and isolation.
Our Behavioral Health team developed information to help professionals, caregivers, and community members manage emotional health during uncertain times. Even if you do not need them now, take the time to identify potential resources for your health and wellness and those of your loved ones. If you have children at home, we also offer a short video to guide you in talking about their needs and emotions.
Remember, that there are community supports designed to help by phone or through telehealth options even during shelter in place orders. Take time for self care – for yourself and for those who matter most to you.