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Dear East Bay Getting to Zero community,
    
Please see the weekly update on the
EBGTZ website and highlights below. Click here to download the PDF version. 
 

You are invited to join us on Thursday, April 29, 11:00 am – 12:30 pm to strengthen HIV service collaborations! This East Bay linkage and retention network workshop will focus on strengthening our online resources and contacts to streamline warm hand-offs, rapid linkages and access to a holistic array of services. Please click here for more info and to register.
 
On February 25, we held an online discussion on the current state of COVID-19 in Alameda County, the vaccine and roll-out, and strategies to protect our community from the virus and misinformation. 
Please click here for the slides and video recording. 
 
In HIV-related news, the
Ready, Set, PrEP program is providing a new mail-order prescription option.  PrEP medication may be delivered to a person’s home or health care provider in participating states.

The Lancet published a special issue on HIV in the US, including a call to action, coverage of inequities and HIV in key communities. Click here to download the articles
 
 

East Bay COVID-19 updates
 
COVID-19 daily case and hospitalization rates in the East Bay have fallen by 60-80% over the past month. Death rates in the Bay Area have declined but remain higher than in 2020. As counties start to loosen restrictions, we are at a critical and yet hopeful point in the pandemic. We can prevent another surge if we keep up masking, distancing and getting people vaccinated.
 
Alameda, Contra Costa and Solano counties remain in the
highest-risk purple tier this week with slightly more than 7 cases per 100k residents, while neighboring San Francisco and Santa Clara counties moved into the red tier. Estimated transmission rates in the Bay Area have been below 1 (0.66 to 0.76), so cases are decreasing and officials are hopeful we can advance to the red tier in the next week or two. Alameda County’s new vaccination dashboard shows that nearly 23% of residents ages 16 and over have received at least one vaccine dose as of March 3. 
 

The California variants (B1427/9) have been found to be dominant in the Bay Area, more infectious (by ~35%) and associated with increased ICU and death rates in two UCSF studies reported on February 22, one by the Unidos en Salud group and one by Dr. Charles Chiu’s sequencing lab. The B1351 (South African) variant was reported on February 10 in Alameda and Santa Clara Counties, and so far 2 cases with travel history have been identified in Alameda County. The P.1 (Brazilian) variant has not yet been found in California, but new data from Manaus estimates that the variant is 1.4-2.2 times more transmissible and can reinfect people who’ve had COVID before. Alameda County will soon send out a health alert with instructions on how to report variants, vaccine breakthroughs and repeat infections.     
 
Please continue to
wear masks, keep distance and help everyone get vaccinated as soon as we can, especially with more infectious variants identified in the Bay Area. Please see below for more prevention tips.
 
Promising new vaccine outcomes data from nursing homes in Alameda County show major reductions in outbreaks and a 74% decrease in deaths after vaccine roll-out started at the end of December. Dr. Ronn Berrol, Summit ED Director, also reports a significant reduction in hospitalizations, especially among older people, and an 80% reduction in ICU cases. 

Titapu Mataafa, MA at LifeLong East Oakland, holding a celebratory wreath/crown of empty Moderna vaccine vials, made by Dr. Laura Miller, CMO of Community Health Center Network.
 

It’s been a busy week for COVID vaccines! Johnson & Johnson’s one-dose vaccine received authorization by the FDA on February 27, adding a third vaccine to our supplies that is simpler to administer and can be stored for up to 3 months in a regular fridge. Alameda County expects to get the first shipment next week and is considering prioritizing distribution to mobile sites, people experiencing homelessness and hospital discharges, situations in which follow up with a second dose has major logistical barriers. The vaccine was found to be 100% effective against hospitalization and death, 85% against severe disease and 66% effective overall 28 days after the single dose. Johnson & Johnson plans to deliver 20 million doses nationwide by the end of March.
 
The federal government has also negotiated increased doses from Pfizer and Moderna to have enough to vaccinate roughly half of eligible adults nationwide by the end of March, and enough doses to vaccinate all adults by the end of May. Having the doses produced is the first step in a complex process to getting vaccine into people’s arms.   
 
The best vaccine is the one that you can get the soonest. All three authorized vaccines are highly protective, especially against severe disease, and 100% effective in clinical trials against hospitalization and death. Don’t throw away your shot because you’re picky!  

Vaccinations are available now for people over 65, nursing home residents and people over 65, and workers in health care, education/child care, emergency services and food/agriculture. In Alameda County, vaccinations are also underway at shelters, and at least 36% of
Project Roomkey residents have been vaccinated. 
 

Last week the FEMA mobile vaccine unit (see photo) partnered with Native American Health Center, Resilient Fruitvale (La Familia, including Homies and La Clínica) to provide outreach, education and easier-access vaccinations to people living in the Fruitvale neighborhood of Oakland. The partnership has provided 250-500 vaccine doses each day and hopes to extend and continue this service.
Other new vaccine access points that have opened up in the last month include:
the Alameda County Fairgrounds mass vaccination site,  the Oakland Coliseum mass vaccination site, CVS pharmacies and Rite Aid pharmacies. Please see additional details below. 
 
Real-world vaccine data shows high efficacy and safety:
A real-world study of 1.2 million people in Israel confirms high efficacy for mRNA vaccines 92% overall for any infection, 94% for symptomatic infection, and suggests a 90% reduction in asymptomatic infection for people vaccinated with the Pfizer mRNA vaccine. Two new studies from Britain showed that a single dose of the Pfizer vaccine produced very high levels of antibodies, humoral and T-cell immune responses in people who previously had COVID-19, supporting a policy to prioritize first and second doses for people with no previous infection to maximize vaccine coverage and impact. 
 
First dose effectiveness studies: The first dose of the Oxford-AstraZeneca vaccine was found to be 73% effective in preventing COVID-19 among people at least 70 years old in England 35 days after the dose, researchers wrote in a
pre-print paper posted online on March 1. This is good news for the world, since the AstraZeneca vaccine is affordable and easy to make, store and deploy. Earlier clinical trials for the vaccine did not enroll as many older people, so this data adds important effectiveness outcomes among those 70 years old and over.
 
The same study (by
Lopez Bernal et al) showed that a single dose of the Pfizer vaccine was 61% effective overall, 80% effective at preventing hospitalization, and 85% effective in preventing death for people age 70 and over after 4 weeks. This data also reassures us that these vaccines are effective against the UK variant.
 
New large population vaccine safety data from the CDC on February 19 found that the Pfizer and Moderna vaccines were safe and side effects were rare. Nearly 14 million vaccinations were tracked and found that of the adverse events reported (injection site pain, headaches, fatigue, muscle aches), 91 percent of those cases were not serious.
 
Alameda Health Consortium has
posted new downloadable flyers on COVID Vaccine Myths and Facts and FAQs in English, Español, 中文, and Arabic. Click here to download. 
 
CA state legislature passed the
Golden State Stimulus plan on February 23. The package will provide direct relief payments for working Californians earning less than $30,000. For Californians left out of federal stimulus programs, $600 one-time tax refunds to Californians with income of $75,000 or less who were excluded from federal stimulus payments because they file taxes with an Individual Taxpayer Identification Number (ITIN), rather than a Social Security Number (SSN). To receive the $600 Golden State Stimulus payment for CalEITC filers, as well as the $600 for ITIN filers, eligible Californians must complete their 2020 tax returns.    
 
The California Legislature and Governor Newsom passed a
school reopening plan (Senate Bill 86) on March 1, including $2 billion in incentives and prioritizing vaccinations for teachers to encourage reopenings during the remaining school year as well as $4.6 billion for summer school and additional mental health and tutoring services. 
 
Providers are encouraged to talk with patients and clients about vaccinations to combat misinformation and address concerns. 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 may be used for vaccine counseling done in medical provider visits. Dr. Sunny Lai from Highland’s HIV clinic compiled Guidance for talking with patients about vaccines and FAQs for PLWH (click to download the PDF).
 
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.
Community Spotlight on the COVID-19 Vaccine
Moisés Cruz Jáuregui, EBGTZ and La Clinica:

Una vacuna significa tener la posibilidad de prevenir una enfermedad. El COVID19 ha lastimado mucho nuestra comunidad y a la vez nos ha enseñado lo fuertes que podemos ser juntos. Tuve la oportunidad de recibir la vacuna y me siento muy agradecido y afortunado por mi mismo y por la comunidad con la trabajo. Cuando tengan la oportunidad, aprovechenla y opten por protegerse y proteger a los que aman!”

 

Vincent Williams, Oakland LGBTQ Center:

The idea of getting a vaccination was very scary for me. Being a person of color. But seeing that I could take potential steps in protecting myself out weighed my skepticism.  I had some side effects from the first shot. But the second was a breeze. I am proud, and glad to say, ‘I got vaccinated!’”
 

More vaccine updates

Vaccine eligibility and access:

As of March 3,
Alameda and Contra Costa and Solano Counties have all opened eligibility to all people ages 65 and over as well as workers in health care, education/child care, emergency services, and food/agriculture. CA vaccine priority groups are defined here
 
Starting March 15, Californians with high-risk health conditions will become eligible: “healthcare providers may use their clinical judgement to vaccinate individuals age 16-64 who are deemed to be at the very highest risk for morbidity and mortality from COVID-19 as a direct result of one or more of the severe health conditions included in this 
provider bulletin.” Please see the graphic below. HIV, regardless of CD4 or immunocompromised status, is not one of the qualifying health conditions. 

Learn more about vaccine access
here

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 by age, work exposures and/or underlying conditions.

Learn more about PLWH and COVID-19 vaccines here

Trends in cases, transmission rates and disparities
 
Transmission rates (Re) continue to be less than 1, which means cases are decreasing. As of March 1, the transmission rates were 0.74 in Alameda County, 0.76 in Contra Costa and 0.66 in Solano County, and 0.67 statewide. Our goal is to support the vaccine roll-out, masking, distancing, staying outdoors and avoiding gatherings to keep transmission rates less than 1.

Alameda County vaccination rates by race/ethnicity on 3/3/21 show that Latinx, Black/African American and Asian residents continue to be less likely to have been vaccinated compared to white residents. Vaccination rates in higher income areas such as Piedmont are almost twice as high (40%) than the hardest-hit cities of Oakland (23%) and Hayward (21%). 

A vaccination site at Fremont High School in East Oakland found that allowing for drop-in and walk-up vaccinations increased vaccination rates among Black and Latinx residents. The County will be advocating for more walk-up vaccination opportunities located in the hardest-hit neighborhoods.

For more information on trends in cases, transmission rates and disparities, please click here.  

Harm reduction tips and resources
 
Promising real-world vaccination data is showing signs that vaccinated people have lower likelihood of transmitting the virus to others. The early data shows that vaccinated people are less likely to get asymptomatic infection (
90%) and lower viral loads when infected (4x decreases). In turn, lower viral loads and asymptomatic infection are linked to less viral spread. 
 
What does this mean in practice? (based on data above and Dr. Monica Gandhi’s expert opinion)
  • Vaccinated people with vaccinated people: get together without restrictions.
  • Vaccinated people around unvaccinated people and general public: keep on masks and distancing for now until we have more data (early data is promising that the risk of transmission from a vaccinated person is very low). 
  • Unvaccinated people around unvaccinated people: keep all usual restrictions with masks, distancing, staying outdoors, avoiding crowds.
The CDC released a new study of COVID-19 outbreaks in gyms and urges mask wearing for people going to gyms, and to keep the masks on when they exercise as well as remain 6 feet or more apart from others.


Our summary of COVID-19 harm reduction strategies is continuously updated with new studies. 
 
Free COVID-19 testing sites:
Click here for Alameda County, Contra Costa County and Solano County testing sites.
 

East Bay Opportunities: Funding, Jobs & Events
 
Jobs, Internships, Scholarships and more:

  • Alameda County Public Health Department is looking for a Director for Communicable Diseases job announcement: Deadline for applications is March 4, 2021. Click here for more info.
  • Transform Health is a nationally certified women and minority-led health policy consulting firm based in California. They are hiring for a Senior Policy Analyst. This is a new position building off of their existing project needs and expanding a current role.
  • La Clinica is looking for a Street Outreach Worker/HIV Linkage Coordinator as well as for many other positions. Browse opportunities here.
  • Prevention Institute has partnered with Healthline to offer this year’s Stronger Scholarship. The scholarship will award three Black, Indigenous, Latinx, and Pacific Islander youth leaders $7,000 scholarships. Leaders must be undergraduate students working to improve community conditions and reduce health inequities in their communities. Learn about and apply for the Stronger Scholarship here.
  • Oakland-based Human Impact Partners is accepting applications for a full-time summer Communications and Advocacy Intern. This will be a remote role supporting their communications, advocacy campaigns, and digital content strategy. View the job description including details on how to apply here.
  • The DreamSF Fellowship is a paid leadership and professional development program for immigrants in the Bay Area. This program is welcome to everyone who meets the minimum qualifications. You can apply regardless of your immigration status. Applications are due April 14th, 2021. Learn more and apply here.
 
Resources, trainings and web events:
  • Oakland LGBTQ Center is sponsoring a Mental Health First Aid virtual training. This is an interactive training equipping the general public to help persons with mental health challenges connect to care. First Aiders will complete a 2-hour, self-paced online class, and then participate in a 6.5-hour Instructor-led virtual training. Space is limited. Registration ends March 18, 2021. You can register by contacting: Tai’Rance “Omega”: He/Him/King at (510) 781-2922.
  • The Santa Clara County Getting to Zero Initiative, in partnership with Gilead Sciences, is proud to bring a 3-part Cultural Humility Program that seeks to address barriers to accessing HIV treatment and preventative care.  The program will provide an overview to healthcare providers, administration, and staff to create an inclusive, supportive healthcare environment for individuals facing structural and socioeconomic barriers to HIV care. To register, visit the following links:
  • Join Alameda County Care Connect for the following upcoming trainings:
    • Matter of Trust: Strategies to Address Medical Mistrust. Wednesday, March 10 and Thursday March 11, 9:00 - 12:30 PM. Register Here.
    • The Empathy Effect: Skills for Countering Bias to Improve Health Outcomes (Part 2). Friday, March 5th,10:00-12:00pm. Click here to register.
    • Cultural Humility- An Approach to Promote Health Equity. Tuesday, March 9th, 10:00-12:00pm. Click here to register
    • Working with People who Use Drugs- Trauma and Substance Use. Thursday, March 11th, 2021, 10:00-12:00pm. Click here to register.
  • The Community Health Worker (CHW) institute is a two-day virtual training (April 9th & 12th, 2021) which will occur prior to the National Latinx Conference on HIV/HCV/SUD. Applicants strongly encouraged to apply are: People living with HIV and allies who are interested in or already serving their communities as a CHW/peer/navigator/linkage to care coordinator. Learn more about the opportunity here.
  • Working While Receiving Disability Benefits workshop by the Positive Resource Center in San Francisco focuses on how working affects eligibility and how to avoid pitfalls of SSI & SSDI Benefits. Learn the implications of returning to work when receiving SSI & SSDI and how to appropriately report earnings when returning to work. Thursday, March 25th, 10-12pm. Register for the session here.
  • On February 22, HHS released an enhanced version of the America’s HIV Epidemic Analysis Dashboard (AHEAD).You can now filter by specific EHE HIV indicators and national demographic information, compare multiple jurisdictions on the same chart, and download data in multiple formats. This release also includes updated linkage to care and diagnosis data, as well as HIV indicator data for all 50 states.
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
 
***
Sophy S. Wong, MD, Director
Yamini Oseguera-Bhatnagar, Program Manager
Sami Lubega, MD, Prevention Director

East Bay Getting to Zero

 
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