Public Health – Emergency Medical Services – Behavioral Health – Environmental Health Homeless Care & Coordination – HealthPAC – Center for Healthy Schools & Communities
Week of August 24, 2020
Alameda County Health Care Services Agency Update
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Last Friday, Alameda County issued modifications to our Shelter in Place Order to allow limited lower-risk outdoor activities as permitted by the State. Alameda County remains on the California State Data Monitoring List for a continued case rate trend of more than 100 cases per 100,000 people over the past 14 days. A summary of activities allowed as of this Friday, August 28th, including outdoor pools and outdoor personal services at hair salons, barbershops, and nail salons is available on our website. Whenever and wherever there are smoke and air quality concerns, we ask that you take precautions as indicated for the Air Quality Indicator range in your area.
This week the Alameda County Social Services Agency, in partnership with our Health Care Services Agency, launched an economic resiliency program to address the pandemic. The Alameda County Responsibility to Community Health (ARCH) Program is curbing the spread of COVID-19 by providing financial assistance to self-isolating County residents in high-risk communities who have tested positive. ARCH will distribute approximately $10M in economic assistance to an estimated 7,500 County residents who have tested COVID-19 positive and need support due to economic instability. The pilot program funding and development was unanimously approved by the Alameda County Board of Supervisors during their August 4 meeting. See the Frequently Asked Questions for more information.
Each week we provide a digest of evolving information about COVID-19 along with emerging trends and relevant news. We hope you find this summary useful and we appreciate your readership.
Heat and Air Quality
Portions of Alameda County continue experiencing unhealthy air quality due to wildfire smoke. To check your local air quality, visit AirNow and enter your zip code and visit COVID-19 Considerations for Extreme Heat and Unhealthy Air Quality.
When possible, stay inside with windows and doors closed until smoke levels subside and if temperatures allow. AC or car vents should be set to recirculate. Cloth and surgical masks used to protect against COVID-19 provide very little protection against smoke and are not a replacement for staying inside. Our Health Care for the Homeless team recently distributed more than 4,000 non-medical N95 masks to unsheltered people across the County who are unable to get inside to safer air.
The Alameda County Office of Emergency Services (OES) issues AC Alertsand all residents are encouraged to subscribe. OES also publishes lists for cooling centers and clean air facilities. CAL FIRE maintains an online evacuation map and posts updates to the @calfireSCU Twitter feed.
 To stay safe during wildfire season and the pandemic, please:
  • Stay in cooler locations away from smoke,
  • Wear non-medical N95s when unable to stay indoors during times of unhealthy air quality,
  • Wear face coverings when in public and within 30 feet of others,
  • Maintain at least six feet distance from others,
  • Sanitize or wash hands frequently,
  • Stay home when sick, and
  • Help spread the Mask On Alameda County message in your community.
All indicators remain at the same status levels this week compared to last week. COVID-19 cases have stabilized since mid-July, and hospitalizations and ICU rates have more recently stabilized. Available hospital capacity is 37% of inpatient beds and 29% of ICU beds available which is within our goal to remain above 20%. We are exceeding the goal for more than 3,100 tests per day.
Testing
We conducted about 3,500 tests per day in the past week. The percentage of people testing positive is 5.3% which is within our goal of less than 8% but varies by zip code and race/ethnicity.
We continue to expand testing availability through sites and events:
Updated testing locations and appointment links are posted on the COVID-19 testing webpage and searchable in the interactive map of COVID-19 services. 11 community testing sites offer free tests for any community member with symptoms, all essential workers and those at higher medical risk regardless of symptoms.
Updated COVID-19 testing guidance was issued for Alameda County and prioritizes:
  • Tier 1: people with COVID-19 symptoms who are hospitalized and in skilled nursing facilities and those in outbreak investigations.
  • Tier 2: all other people with symptoms, close contacts of cases, and higher risk essential workers and those in congregate facilities who are asymptomatic.
We will not be changing our testing strategy.
Testing sites should:
  • distribute isolation orders and contact tracing information for all people getting tested,
  • remind people to stay home until they get test results and to pick up calls from the health department, and
  • submit full names, addresses, dates of birth and phone numbers and demographics (including race, ethnicity, sexual orientation, and gender identity) for all positive cases, including positive antigen results, using the COVID-19 Confidential Mortality Report (CMR).
 Trends in Cases and Hospitalizations
Case rates have stabilized after a peak in mid-July. Hospitalization rates have stabilized this week as well. Our goal is for cases to be flat or decreasing.
An analysis of the higher hospital and ICU rates shows that they are likely due to community spread during the mid-July surge and cases from long-term care facilities.
Our goal is to keep the transmission rate to less than 1 by ensuring preventive measures are implemented and sustained in our communities and work places. This includes face coverings and maintaining distance in all settings including gatherings with family and friends in parks, yards and homes.
For help with enforcement or report violations of workplace safety orders in Alameda County, please email: COVID19compliance@acgov.org
Case and Contact Investigation, Isolation and Quarantine
Alameda County currently has 135 trained case investigators and contact tracers with a goal to reach 300 in the fall. Case and contact data show:
  • An increasing percentage of cases ages 30 and younger: 37% in August compared to 16% in March.
  • More close contacts from work settings: 17% in August compared to 1% in March.
  • Cases at Santa Rita Jail peaked in April and are decreasing.
  • Cases from skilled nursing facilities peaked in April and June and are now decreasing.
We’ve issued an emergency RFQ to receive proposals from community based organizations and clinical partners interested in supporting our case investigation and contact tracing efforts. Responses will be due on a rolling basis and evaluated every two to three weeks.
Project Roomkey continues to provide isolation and quarantine housing for people living in crowded conditions or experiencing homelessness. We opened the Livermore Safer Ground hotel this week and partnered with the cities of Livermore and Fremont to move unsheltered people out of evacuation zones impacted by wildfires.
Hospital Capacity and Surge Planning
Our hospital capacity indicators as of August 24:
  • 7.5% of the patients in Alameda County hospital beds confirmed COVID-19 positive.
  • 22% of ICU patients were COVID-19 positive and within goal of 50% or less.
  • 37% of staffed inpatient beds and 29% of the ICU beds were available and within goal above 20%.
  • 67% of mechanical ventilators were available.
If your facility needs COVID-related supplies or staffing please visit the Emergency Medical Services website to request PPE, request staffing and request testing supplies.
Disparities and Equity
Updated race and ethnicity data show Latinx people face the highest case rates and Blacks/African Americans face the highest death rates. Latinx people currently have 6.6 times the case rate and 1.7 the death rate compared to Whites. Blacks/African Americans have 2.2 times the case rate and 2.8 times the death rate compared to Whites.
Native Americans and Pacific Islanders have more than 2 times the case rate compared to Whites.  The highest case and positivity rates in Alameda County continue to occur in the Fruitvale and Coliseum zip codes in East Oakland.