December 21, 2020
Eden Health District COVID-19 Bulletin
“While California is in some of the darkest days of our Covid-19 surge, with too many families grieving lost loved ones, there is light as more vaccines are approved for distribution. With the Moderna vaccine in circulation, we have another tool to fight this deadly disease.”
Governor Gavin Newsom, 12/20/20
By the Numbers
CONFIRMED CASES
Bay Area: 221,156

California: 1,867,722

U.S.: 17,905,466
Alameda County

Cases: 44,004

Deaths: 587

Adjusted Cases per Day: 19.8

Test Positivity: 8.7%

Hospitalized Patients: 414

ICU Beds Available: 90
REPORTED DEATHS
Bay Area: 2,268

California: 22,676

U.S.: 318,300
Contra Costa County

Cases: 35,322

Deaths: 298

Adjusted Cases per Day: 31.3

Test Positivity: 10.9%

Hospitalized Patients: 250

ICU Beds Available: 37
Sources: Johns Hopkins UniversitySF Chronicle, and dashboards for California and Alameda and Contra Costa Counties
Adjusted cases per day is per 100,000 residents. Test positivity is based on a 14-day average. Hospitalized patients refers to patients with confirmed and suspected Covid-19.
Bay Area News
Mercury News, December 21, 2020
Alameda County recorded its highest-ever number of new coronavirus cases on the same day that San Francisco health officials reported that the city had surpassed 20,000 cases of the deadly virus, a grim milestone for a region beset with a health crisis unlike any other. On Saturday, Alameda County health officials recorded 1,767 new cases of the virus, the most since the start of the pandemic.

The county’s closest recent figure was on Dec. 8 when 1,111 infections were reported. On Saturday, Alameda County stood at 42,029 total cases of the virus and 585 deaths. Eleven deaths were reported Saturday.
Commencing today and continuing through Wednesday, December 23rd, Davis Street Family Resource Center in San Leandro is distributing food to families in need throughout the Eden Area. This year is the nonprofit organization's 48th Annual Holiday Basket Program.

With significant support from the community, including by the men and women of the Alameda County Fire Department, California Highway Patrol, San Leandro Police Department, and multiple local service organizations, Davis Street’s Holiday Basket Program will provide over 1,000 families in need with a holiday feast, including a turkey, fresh produce and all the fixings, and gift cards and toys for the children.

"Many of our families are struggling this year, and we are so grateful to our donors for giving us the opportunity to give them hope this holiday. If you haven't donated, there's still time to support to help brighten the holidays for our less fortunate neighbors.," stated Davis Street CEO Rose Padilla Johnson.

Visit Davis Street's Instagram page for current photos and video clips on the distribution of the baskets and gifts to community members.

KABC News TV, December 19, 2020
Alameda County received more than 13,000 doses of Pfizer's COVID-19 vaccine on Saturday. Among the first to get vaccinated were 911 first responders. "There are three different groups that are being vaccinated first in Alameda County. That's our Alameda county 911 paramedics, those firefighters that have a paramedic or an EMT license or certificate and we also have all of our chiefs," explained Joanna Leal, Alameda County Fire Department public information officer."

[We are] really excited to be one of the few counties in California that is extending this first dose of vaccine to our 911 first responders," said Colleen Chawla, Alameda County Health Care Services Agency's Director.

KABC News TV, December 20, 2020
Many stores are strictly enforcing the state-mandated coronavirus guidelines and we saw that Sunday night in the East Bay. Victoria's Secret, Ecco and Lush all had lines as retailers enforce COVID-19 restrictions at the Broadway Plaza in Walnut Creek. "This year you have to wait in line," says shopper Vick Svetcoff.

State Covid-19 website, December 21, 2020
  • Bay Area: 12.4%
  • Greater Sacramento Region: 11.6%
  • Northern California: 24.2%
  • San Joaquin Valley: 0.0%
  • Southern California: 0.0%
Health News
Washington Post, December 20, 2020
The front lines of America’s workforce should be next to get the coronavirus vaccine, along with adults ages 75 and older, a federal advisory panel said Sunday. The recommendations, which came two days after regulators authorized a second coronavirus vaccine, will guide state authorities in deciding who should have priority to receive limited doses of shots made by Pfizer-BioNTech and Moderna.

More than 2.8 million doses of the Pfizer vaccine have been distributed, and 556,208 of those shots were given as of 2 p.m. Sunday, according to the CDC. The groups designated Sunday include about 49 million people, some of whom could begin getting shots early in the new year. The priorities represent a compromise between the desire to shield people most likely to catch and transmit the virus, because they cannot socially distance or work from home, and the effort to protect people who are most prone to serious complications and death.

Notes:

1) Frontline workers are defined as first responders, teachers and other education workers including day care workers, food and agriculture workers, correctional facility staff, postal workers, public transit workers, and people who work in manufacturing and in grocery stores.

2) The advisory panel also voted to recommend that the third stage of the national vaccination program should focus on adults 65 to 74, people 16 to 64 years old with high-risk medical conditions, and essential workers not included in the second phase of vaccination.

3) 50 million Americans are expected to receive the first dose of the Pfizer or Moderna vaccine by the end of January.

Sources: STAT, December 20, 2020, and USA Today, December 21, 2020.

CBS News, December 21, 2020
Initial shipments of the second COVID-19 vaccine authorized in the U.S. left a distribution center Sunday, a desperately needed boost as the nation works to bring the coronavirus pandemic under control. The trucks left the factory in the Memphis area with the vaccine developed by Moderna Inc. and the National Institutes of Health.

NY Times, December 20, 2020
Just as vaccines begin to offer hope for a path out of the pandemic, officials in Britain this past weekend sounded an urgent alarm about what they called a highly contagious new variant of the coronavirus circulating in England. Scientists are worried about these variants but not surprised by them. Researchers have recorded thousands of tiny modifications in the genetic material of the coronavirus as it has hopscotched across the world.


Washington Post, December 21, 2020
Officials at the National Institutes of Health are rushing to devise a study to find out why, in a few rare cases, people have had severe allergic reactions to the Pfizer vaccine. The goal is to identify the component of the vaccine most likely to be responsible for these potentially life-threatening incidents, known as anaphylaxis. Government officials and medical experts say these rare reactions should not deter the general public from taking the vaccine, although the standard guidance is that people who get the shot should linger at the clinic or doctor’s office for 15 minutes, and 30 minutes if they have a history of severe allergic reactions. Anaphylaxis can be quickly reversed with epinephrine and other medicines.

Wall Street Journal, December 20, 2020
Doctors are treating a new flood of critically ill coronavirus patients with treatments from before the pandemic. Doctors hold off longer before placing patients on ventilators. Patients get less powerful sedatives, with doctors checking more frequently to see if they can halt the drugs entirely and dialing back how much air ventilators push into patients’ lungs with each breath.
Special Feature: Understanding the New Vaccines
"This will go down in history as one of science and medical research's greatest achievements. Perhaps the most impressive."

Dr. Eric Topol on development of the new mRNA Covid-19 vaccines
Messenger RNA (mRNA) may not be as famous as its cousin, DNA, but it’s having a moment in the spotlight. This crucial intermediary in the protein-making process is now being harnessed by scientists to to try to protect us from disease — including Covid-19, as explained in a short video from STAT, a leading online medial news source. Never before have mRNA vaccines — such as the two-dose Pfizer/BioNTech and Moderna vaccines that have now received emergency use authorization from the FDA — been approved for use in any disease.

How do mRNA vaccines differ from traditional vaccines, and why we should have confidence in their safety and efficiency are questions Dr. Anthony Komaroff, editor in chief of Harvard Health Letter, answers on the Harvard Health Blog, updated December 18, 2020.
Dr. Komaroff writes: "Compared to traditional vaccines, mRNA vaccines can actually generate a stronger type of immunity: they stimulate the immune system to make antibodies and immune system killer cells — a double strike at the virus."

"30 years of painstaking research allowed several groups of scientists — including a group at Pfizer working with a German company called BioNTech, and a young company in Massachusetts called Moderna — to bring mRNA vaccine technology to the threshold of actually working," Dr. Komaroff explains.
"The companies had built platforms that, theoretically, could be used to create a vaccine for any infectious disease simply by inserting the right mRNA sequence for that disease," Dr. Komaroff adds.

The authors explained:

"There are about a dozen experimental vaccines in late-stage clinical trials globally, but the ones being tested by Pfizer and Moderna are the only two that rely on messenger RNA. For decades, scientists have dreamed about the seemingly endless possibilities of custom-made messenger RNA, or mRNA.

Researchers understood its role as a recipe book for the body’s trillions of cells, but their efforts to expand the menu have come in fits and starts. The concept: By making precise tweaks to synthetic mRNA and injecting people with it, any cell in the body could be transformed into an on-demand drug factory. But turning scientific promise into medical reality has been more difficult than many assumed. Although relatively easy and quick to produce compared to traditional vaccine-making, no mRNA vaccine or drug has ever won approval."
"Before messenger RNA was a multibillion-dollar idea, it was a scientific backwater. And for the Hungarian-born scientist behind a key mRNA discovery, it was a career dead-end. Katalin Karikó (in photo above) spent the 1990s collecting rejections. Her work, attempting to harness the power of mRNA to fight disease, was too far-fetched for government grants, corporate funding, and even support from her own colleagues.

It all made sense on paper. In the natural world, the body relies on millions of tiny proteins to keep itself alive and healthy, and it uses mRNA to tell cells which proteins to make. If you could design your own mRNA, you could, in theory, hijack that process and create any protein you might desire — antibodies to vaccinate against infection, enzymes to reverse a rare disease, or growth agents to mend damaged heart tissue."
US and California Data: Last 90 Days
Covid Tracking Project, 12/20/20 (bold lines are 7-day averages)
United States
California
Video: A ‘constant battle’ against Covid-19 at California hospital
At St. Mary Medical Center, a hospital in the desert town of Apple Valley in San Bernardino County, the ICU has burst its capacity, the Washington Post reports. Patients undergo triage in a parking lot tent and the hospital’s lobbies and hallways have become makeshift Covid wards.

In Apple Valley the only capacity is overcapacity — sometimes by double and even triple the number of beds. Officially, there are 213 beds in the hospital and about 20 ICU spaces. But those numbers are meaningless now as patients are treated in hallways, lobbies and other improvised wards.
"Every day we're running at 200, 250% capacity. That includes the emergency department, the ICU, all of the inpatient units," Randy Loveless, the interim director of St. Mary's emergency department, told the Post. "We have well over double the number of patients that we were built to house."
California News
LA Times, December 21, 2020
It has been 2 weeks since a second stay-at-home order was issued, and no such flattening has yet occurred across most of California. This may be because restrictions are looser than those in the spring, and because many Californians are so fatigued by public health orders — or militantly resistant to them — that they are mixing with people from outside their households.

But experts say the most pertinent explanation has to do with the amount of the coronavirus in the community. The latest orders came after the virus was already raging out of control, in part because of Thanksgiving travel — a difference experts say will make the current surge much harder to corral.
When new daily case counts reach more than 20 per 100,000 people, “it becomes really difficult to control the infections,” said Aragón, who has helped lead San Francisco’s pandemic response as the county’s health officer. California’s daily case rates are soaring way beyond that number. Los Angeles County’s daily case rate last week was 153.6 per 100,000 residents, Aragón said. The state’s count was 82.2 per 100,000 residents, compared with a national average of 64.6.

Associated Press, December 21, 2020
Medical staffing is stretched increasingly thin as California hospitals scramble to find beds for patients amid an explosion of coronavirus cases that threatens to overwhelm the state’s emergency care system. As of Sunday, more than 16,840 people were hospitalized with confirmed Covid-19 infections — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach 75,000 by mid-January.

More than 3,610 Covid-19 patients were in intensive care units. All of Southern California and the 12-county San Joaquin Valley to the north have exhausted their regular ICU capacity, and some hospitals have begun using “surge” space. Overall, the state’s ICU capacity was just 2.1% on Sunday.

SF Chronicle, December 20, 2020
The $900 billion coronavirus aid package that congressional leaders agreed to Sunday includes no dedicated money for state or local governments, undercutting hopes that California and many of its cities would be able to close growing budget gaps without major cuts.

LA Times, December 20, 2020
Gov. Newsom is in quarantine again for 10 days after being exposed to a staff member who tested positive for the coronavirus, a representative said in a statement Sunday night. Newsom tested negative but entered quarantine as a precaution, in accordance with state public health guidelines. Other staffers in the governor’s office who were exposed to the infected individual also tested negative. They will begin 10-day quarantines, the representative said.

Sacramento Bee, December 21, 2020
The high number of coronavirus infections and deaths among California’s Latino communities is underscoring the state’s shortage of culturally competent, Spanish-speaking doctors. Medical experts fear the scarcity of Latino or Spanish-speaking doctors could lead to worse health outcomes for the state’s Hispanic communities, who, so far, represent more than 700,000 Covid-19 cases and 10,000 virus-related deaths in California.

Dr. David E. Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at UCLA, said the reason Latinos are seeing higher infection and death rates than other groups is, in part, due to the fact that they are over-represented in jobs where socially distancing or limiting their exposure to the public is not possible. In California, Latino workers are over-represented in meat-packing, construction, food service and agricultural industries, he said. Yet, researchers say physicians who speak Spanish are “the most under-represented in the physician workforce in California,” according to the LPPI study. There are about 62 Spanish-speaking physicians for every 100,000 Spanish speakers in the state, the study shows.

Mercury News, December 21, 2020
The federal government will continue paying into California’s Project Roomkey until the pandemic ends, Gov. Newsom said Friday, eliminating some uncertainty around the program and potentially buying more time for unhoused residents sheltering in hotels throughout the state.

Under Project Roomkey, FEMA had agreed to reimburse California counties for 75% of the costs associated with putting homeless residents up in hotel rooms — but the counties had to reapply for the funding every month. As the pandemic dragged on, some Bay Area officials worried the reimbursements would end, and they’d be left footing the bill for the rooms. They began winding down their Roomkey programs, and attempting to move people from the hotels into long-term housing.

Fresno Bee, December 19, 2020
Coronavirus infections inside prisons have exploded in recent weeks with one of the worst surges taking place in California, where more than 40,000 inmates and staff across the state’s 35 prisons have tested positive for the virus. In the past two weeks alone, the state has raked in about 8,200 new cases, a staggering number that has public health experts worried the outbreaks could threaten the wider community and further strain the hospital system.

CalMatters, December 19, 2020
Just around 80 of the state’s over 800,000 farmworkers have quarantined or isolated in hotel rooms for agricultural workers since the program was announced. In interviews with nearly 20 farmworkers, advocates and administrators, as well as a review of internal county emails obtained through record requests, reporters found a potent cocktail of fear, testing barriers and miscalculations have hobbled the statewide hotel isolation and quarantine program even as the virus spreads faster in California’s vast farmworker population than in the general public. In that time, over 16,500 California farmworkers have fallen ill from Covid-19, according to estimates by Purdue University.
US News
Mercury News, December 21, 2020
Leaders in the House and Senate reached an agreement late Sunday on a $900 billion pandemic relief bill that includes enhanced unemployment benefits and direct cash payments:

·     The package would send direct stimulus payments of $600 to individuals, half the amount provided in the first round of checks that went out in the spring. As with the first round, the payments will only be sent to people below a certain income level, though it wasn’t clear Sunday where that would be set.
·     The jobless would receive a $300 weekly federal enhancement in benefits for 11 weeks, from the end of December through mid-March under the deal.
·     The bill would reopen the Paycheck Protection Program so that some of the hardest-hit small businesses can apply for a second loan.
·     The bill would provide $82 billion in aid for K-12 schools and colleges. 
·     The bill would extend until January 31 the eviction protection set to expire at the end of the year. It also would provide $25 billion in rental assistance for individuals who lost their source of income during the pandemic.
·     The deal would raise SNAP benefits by 15% for six months but would not expand eligibility.
·     The agreement would provide $20 billion for the purchase of vaccines so they can be available at no charge for those who need it, as well as another $8 billion for vaccine distribution. It also would give states $20 billion to assist with testing.

USA Today, December 21, 2020
Even though Congress struck a Covid-19 stimulus deal late Sunday to extend badly needed financial relief to millions of jobless Americans, some could see their unemployment benefits lapse since it may take weeks for aid to reach them due to outdated state systems, experts say.

The lag could affect 12 million Americans who were set to lose their jobless aid the day after Christmas if Congress didn’t pass new legislation. For those whose benefits were going to expire on Dec. 26, their regular benefits and extra $300 supplement could face delays for at least three weeks, or a maximum of six to eight weeks in some states. 

Reuters, December 21, 2020
The U.S. government and two of the nation’s largest pharmacy chains kick off a nationwide campaign to vaccinate nursing home residents against Covid-19 on Monday, a week after the first vaccines authorized in the country began being administered to healthcare workers.

The program is the latest effort to control a pandemic that has killed more than 300,000 people in the country and is straining the capacity of healthcare systems in some states. Many states have put healthcare workers and nursing home residents first in line for vaccinations, in keeping with recommendations from the U.S. Centers for Disease Control and Prevention. Older people in nursing homes have accounted for a disproportionate number of deaths in the pandemic.

NPR, December 20, 2020
On both Friday and Saturday, about 1.07 million travelers passed through TSA checkpoints, the agency reported. That's down nearly 60% from last year, but still much higher than the typical checkpoint statistics since the pandemic began.

The TSA had expected passenger volume to increase during the end-of-year holiday travel season. In addition to the typical pandemic advice — keep six feet apart from others and wear a face mask — the agency advised arriving early to allow extra time to go through security. "Covid-19 has affected staffing and operations across the airport environment, so extra time will keep your stress level low," the agency said in a blog post Friday.

USA Today, December 20, 2020
An ABC News/Ipsos poll released Monday found more than eight in 10 Americans would receive the COVID-19 vaccine, but 44% said they would wait before getting it. While it's understandable to be hesitant of a new vaccine, physicians such as Dr. Caesar Djavaherian say, patients don't need to wait.

“Historically with a vaccine, the terrible (serious adverse events) that we’re always worried about actually present themselves in a matter of weeks,” Djavaherian, an ER doctor who leads the pandemic response at Carbon Health, a national primary and urgent care provider. “We’re not seeing that type of spike ... in the weeks we see people taking the Pfizer or Moderna vaccine.”

Mercury News, December 21, 2020
Stop AAPI Hate, a coalition of Asian American advocacy groups, issued a report in August stating that it had received more than 2,500 reports of hate and discrimination across the country since the group was founded in March, around the time the outbreak began to seriously worsen in the U.S. The group said it received data from 47 states, with 46% of the incidents taking place in California, followed by 14% in New York.

In addition, Asian American small businesses have been among the hardest hit by the economic downturn during the pandemic. While there was a 22% decline in all small business-owner activity nationwide from February to April, Asian American business-owner activity dropped by 26%, according to a study by the National Bureau of Economic Research. Many businesses that survived have been subject to stigmatization, Clarence Kwan, creator of the anti-racist cooking zine “Chinese Protest Recipes,” said. “Restaurants have been vandalized. As if the pandemic wasn’t hard enough, there’s this added threat to Asian businesses of this lingering hate.”

Associated Press, December 20, 2020
Early and aggressive local measures coupled with a strictly enforced statewide travel quarantine kept Kauai’s 72,000 residents mostly healthy — the island had only 61 known coronavirus cases from March through September. But on Oct. 15, the state launched a pre-travel testing program to reignite Hawaii’s decimated tourism economy. Kauai then went from having no active infections at all in the first part of October to at least 84 new cases in the ensuing seven weeks.
CA Education News
LA Times, December 20, 2020
San Francisco public schools won’t reopen for in-person learning in January because of a breakdown in negotiations between the school district and teachers unions over coronavirus safety, the San Francisco Unified School District said. The biggest barrier, the district said, is a demand by labor groups that no staff or students return for in-person learning until the state puts San Francisco in the orange tier, reserved for places with moderate transmission of the coronavirus.

CalMatters, December 18, 2020
School reopenings will likely take center stage in 2021 as one of California’s biggest political battles. It’s a battle all the more noteworthy because it pits two groups that are often allies — unions and Democratic lawmakers — against each other. The state’s two largest teachers’ unions publicly opposed a bill introduced by eight Democratic lawmakers that could force schools to reopen in March. The unions’ decision to come out against the bill in December, several weeks before legislators return to Sacramento, was unusual — and an indication of their intent to halt it in its tracks.

CalMatters, December 18, 2020
Dr. Anthony Fauci said he anticipates that Covid-19 vaccines will begin to become widely available to the general public in March and April, and that immunization combined with aggressive testing of students would bode well for an in-person school year.
“If we do that efficiently, and the doses of vaccine come in… by the time we get to April, May, June, July, August, we can get the overwhelming majority of the people in this country vaccinated so that by the time we get to the 2021-2022 term, I think we could be in good shape,” Fauci said. 
US Education News
Bloomberg, December 21, 2020
A December study by consultant McKinsey & Co. found that students of color in U.S. schools had fallen behind in math by three to five months because of the pandemic; white students trailed by only one to three months. A quarter of kids do not have access to any kind of web-enabled device or broadband at home. Other disadvantaged groups are floundering, too.

NY Times, December 18, 2020
New York City on Friday announced major changes to how thousands of students are assigned to middle schools, replacing a merit-based system that critics say exacerbated segregation with a lottery that is expected to create more diversity at the most sought-after schools.

The move was driven by the pandemic, because tests typically used for admissions were not administered last spring. Selective high schools in D.C., Boston and San Francisco have also jettisoned admissions tests for the coming academic year, citing the crisis. Although these districts could reinstitute old systems after the pandemic abates, advocates have been pressing for these changes for years, and many expect them to outlive the pandemic.

NPR, December 21, 2020
Higher education was struggling to keep up with the skyrocketing demand for nurses even before the Covid-19 crisis. Now it's falling further behind.
Health protocols are limiting in-person instruction. Nursing teachers are quitting in large numbers, while others are nearing retirement. Hospitals are stretched too thin to provide required hands-on clinical training. And budgets are so constrained that student nurses are forced to buy their own personal protection equipment, or PPE.
Coronavirus survivor writes book to clear up misconceptions about the illness
Photographer Deion Campbell knows all too well what the Covid-19 can do - and he has dedicated himself to telling his story to all who will listen. He spent wo weeks in March on a ventilator, plus another 40 days in rehabilitation from the virus that took his breath and nearly his life before causing nerve damage to his arm and issues with his feet.

Earlier this year, things seemed to be going well for the Virginia resident. His burgeoning love of photography, nurtured during high school, seemed to be blowing up on his Instagram account, which swelled past 10,000 followers. Celebrities were taking note. The couple returned from a trip to Atlanta. He had a podcast and a brand.

Eight months after being hospitalized, Campbell and wife Tyisha Campbell reflected how the virus crept into their lives, shrouded them with uncertainty and what they did to survive the ordeal, which Campbell captured in his new book called “Ventilator.”

“It’s like an old wound. It hurts,” Tyisha Campbell said. “Just trying to move forward one day at a time.” Campbell decided to write a book about his experience for a couple of reasons. One, for those who are afraid to talk about it or even admit they had it. But mainly he started writing last summer after reading comments on social media in May that really irked him.
“I didn’t nearly die from a fake virus,” Campbell said. “That’s what seems to be the trend in society today. Everything’s a joke, until it hits home.”

Tyisha Campbell said after two days in the hospital, doctors intubated her husband. She needed to hear nightly from the doctors to sleep. When he woke up from being on the ventilator, he didn’t realize it was two weeks later.

Campbell spent nearly 6 weeks in rehab, relearning how to walk and use his right arm, which had suffered a lot nerve damage. Since coming home, the couple juggles multiple appointments with physical therapists and other specialists.

For now, photography work is on hold because it’s difficult to lift a camera, but Campbell says he has his podcast to keep him busy. “My arm is progressing,” he said. “Talking to my neurologists, they say it takes about six months at a time just to grow one inch of a nerve back. So, that’s just kind of a timeline representation of how long the recovery process actually is.”

Source: Daily Press
International News
CNN, December 21, 2020
British Prime Minister Boris Johnson will chair an emergency meeting with ministers Monday after the announcement of a new coronavirus variant prompted a chaotic border shutdown.

Alarm over the new variant, which was first identified in England, has resulted in British travelers being cut off from much of Europe and other parts of the world as countries imposed restrictions on travel from the UK. Worse, the move has sparked fears that European exporters would be reluctant to send goods to the UK, for fear of not being able to return. The timing of the restrictions, just days before Christmas and the end of the Brexit transition period, raised concerns about food and medicine shortages in the UK at a critical time.

Bloomberg, December 21, 2020
Unprecedented virus control measures including curfews and shutdowns of non-essential businesses may be considered in Hong Kong, according to a government health adviser, as the city continues to see a high number of locally-transmitted cases and the holiday season looms.

Limiting the number of people per household allowed to shop for groceries, shuttering all businesses deemed non-essential and shortening mall operating hours are among the curbs that may have to be imposed to prevent another Covid-19 wave, David Hui, a respiratory disease expert at the Chinese University of Hong Kong who advises the government on the virus response, told TVB on Sunday, according to various local media reports.

While he isn’t a lawmaker, Hui’s comments raise the prospect Hong Kong could be on the cusp of its toughest virus restrictions yet. Local authorities have sought to avoid stay-at-home orders and lockdowns since the pandemic began, citing economic considerations. Hong Kong’s dense housing situation, with thousands living in subdivided units without private bathrooms or that combine toilets, kitchens and sleeping spaces, has been another factor in the government’s decision-making.

NY Times, December 19, 2020
As winter sets in, cold weather, pollution and public apathy to the coronavirus are weighing heavily on Pakistan’s limited health care system.
Pakistan’s Covid-19 positivity rate has rocketed up to about 7.7 percent of tests administered in recent weeks from only 2 percent in October, prompting a plea from health experts and doctors in Karachi for the government to impose a strict nationwide lockdown. Prime Minister Imran Khan has closed schools but has ruled out a second lockdown, saying it would decimate the economy.

Still, cases are surging, and limited testing compared with other countries suggests the virus could be racing through the country at an even higher rate. Health experts cite ineffective government limits on personal contact and widespread doubts, often fueled by conspiracy theories, that Covid-19 poses a threat.

Wall Street Journal, December 20, 2020
Around 611 people are dying of Covid-19 in Italy on an average day, behind only Brazil and the U.S. This year Italy has recorded about 68,900 confirmed deaths from the virus, the highest total in Europe and fifth in the world after the U.S., Brazil, India and Mexico—which all have much bigger populations.

Once again, Italians are asking themselves: Why is Covid-19 killing more people here than almost anywhere else? The answer lies partly in demographics, public health experts say. Italy has one of the world’s oldest populations, second only to Japan. Nearly one in four Italians is over 65, an age group much more likely to succumb to the disease. Another factor: Multigenerational homes are especially common in Italy, potentially exposing older people to infection from their younger relatives.
Analysis/Opinion
Ed Silverman, STAT, December 21, 2020
Most Americans believe the Biden administration should mandate several steps — such as requiring people to wear masks in public and banning gatherings of 10 or more people — to thwart the Covid-19 pandemic, according to the latest survey from STAT and The Harris Poll. The poll found that 75% of the public supports the idea of mandating a mask and a similar number believe people should be required to get tested if they feel sick. At the same time, two-thirds of Americans think President-elect Biden should ban gatherings involving more than 10 people.

Dr. James Hablin, The Atlantic, December 21, 2020
When President Donald Trump was flown to Walter Reed National Military Medical Center for COVID-19 treatment, his doctors prescribed, in addition to a plethora of other experimental therapies, melatonin. In addition to melatonin’s well-known effects on sleep, it plays a part in calibrating the immune system. Essentially, it acts as a moderator to help keep our self-protective responses from going haywire—which happens to be the basic problem that can quickly turn a mild case of COVID-19 into a life-threatening scenario.

Eight clinical trials are currently ongoing, around the world, to see if these melatonin correlations bear out. Few other treatments are receiving so much research attention. If melatonin actually proves to help people, it would be the cheapest and most readily accessible medicine to counter COVID-19. Unlike experimental drugs such as remdesivir and antibody cocktails, melatonin is widely available in the United States as an over-the-counter dietary supplement. People could start taking it immediately.
 
German Lopez, Vox, December 21, 2020
It’s true that individuals have an important role in fighting Covid-19. Everyone should wear a mask, and, unfortunately, everyone should reconsider big family gatherings this holiday season. But relying on individual action to fight a deadly virus — an approach that the US has leveraged for problems ranging from the opioid crisis to global warming — simply hasn’t worked.

Much less attention has gone to addressing Covid-19 from a truly structural perspective. The coronavirus has revealed America’s pathetic public health infrastructure — there’s still no national testing-and-tracing program, and no state has an adequate contact tracing program, if they have such a program at all. Businesses and workers have been left to fend for themselves, as Congress failed to pass an economic relief bill before the last one started to expire. For all the talk about outdoor activities being safer during the coronavirus pandemic, there’s been next to no action in most of the country on getting people outside — at times, governments have even eliminated outdoor venues by closing parks or beaches.

Today, America is among the worst performers at fighting Covid-19. Despite recent surges in Europe and Israel, the US remains within the top 20 percent for most coronavirus deaths per person among developed nations, with more than twice the death rate as the median developed country. If the US managed the same Covid-19 death rate as Canada, more than 190,000 Americans would likely be alive today.

Kaiser Health News, December 21, 2020
KHN’s in-depth examination of the year-long pandemic shows that many leading infectious disease specialists underestimated the fast-moving outbreak in its first weeks and months, assuming that the United States would again emerge largely unscathed. American hubris prevented the country from reacting as quickly and effectively as Asian nations, said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Had more experts realized what was coming, the nation could have been far better prepared.
We are proud to partner with the East Bay Community Foundation in publishing this bulletin. Through donations to its Covid-19 Response Fund, the EBCF provides grants to East Bay nonprofit organizations delivering essential services to those most impacted by the economic fallout from the pandemic.
East Bay Focus
by day as of 12/20/20
by day as of 12/20/20
Over the last seven days, Alameda County officials have reported 6,470 new coronavirus cases, which amounts to 394 cases per 100,000 residents.
Over the last seven days, Contra Costa County officials have reported 5,158 new coronavirus cases, which amounts to 455 cases per 100,000 residents.
Top 10 Locations of Cases in Alameda County, as of 12/20/20. Alameda County does not publish cases per 100,000 in the last 14 days by city.
Oakland: 14,320

Hayward: 6,545

Fremont: 3,576

Eden MAC: 2,786

San Leandro: 2,523

Livermore: 2,146

Union City: 1,839

Berkeley: 1,633

Castro Valley: 1,249

Newark: 1,244
Top 10 Locations of Cases in Contra Costa County plus (in parentheses) cases per 100,000 in last 14 days, as of 12/17/20
Richmond: 6,045 (1,041)

Antioch: 4,439 (750)

Concord: 4,173 (565)

Pittsburgh: 3,481 (904)

San Pablo: 2,909 (1,964)

Brentwood: 1,657 (628)

Bay Point: 1,449 (985)

Walnut Creek: 1,367 (421)

Oakley: 1,304 (791)

San Ramon: 1,046 (318)
East Bay Resources


In their December 17, 2020, podcast, Dr. Michael Osterholm and host Chris Dall discuss discuss Covid-19 vaccines becoming vaccinations, forthcoming research related to the safety of vaccinating pregnant women, continued surges throughout much of the US, and guidance for having safe holidays.
Mask On Eden Area
Working in collaboration with the Alameda County Public Health Department, the Cities of Hayward and San Leandro, and the Castro Valley and Eden Area Municipal Advisory Councils, the District has printed “Mask On” posters for each city and community in the Eden Health District area. The posters are free and intended for businesses, health clinics, schools, churches, public agencies and nonprofit organizations to display in their entrances.

“Wearing masks in public or any gatherings, including events with friends and extended families, is essential for slowing the spread of the virus,” stated Eden Health District Director Pam Russo. “While we are seeing signs of progress in California, Alameda County remains a Covid-19 'hot spot' in the Bay Area. Please wear a mask to protect yourself while protecting others.”
The public is welcome to download and print or share “Mask On” posters from the District’s website. Posters are available in English, Spanish and Chinese languages.

Posters may also be retrieved during business hours from the lobby of the Eden Health District office building located at 20400 Lake Chabot Road, Castro Valley. Posters for the City of Hayward are also available from the Hayward Chamber of Commerce located at 22561 Main Street, Hayward.
Eden Area Food Pantries
We have posted information on food pantries and food services in the cities of Hayward and San Leandro and unincorporated Alameda County including Castro Valley and San Lorenzo. You can access the information here on our website. Alameda County has also released an interactive map listing food distributions and other social services. 
Your feedback is welcome. Please share the Bulletin.
The Eden Health District Board of Directors are Mariellen Faria, Chair, Pam Russo, Vice Chair, Roxann Lewis, Treasurer, Gordon Galvan and Varsha Chauhan. The Chief Executive Officer is Mark Friedman.

The Eden Health District is committed to ensuring that policy makers and community members receive accurate and timely information to help make the best policy and personal choices to meet and overcome the challenges posed by the Covid-19 pandemic. We publish the Bulletin on Mondays, Wednesdays and Fridays, unless the day falls on a public holiday.

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We welcome your feedback on our bulletin. Please contact editor Stephen Cassidy.