December 9, 2020
Eden Health District COVID-19 Bulletin
"Immunity isn't just around the corner — it's going to take many months to roll out vaccines. We need to be extra careful right now so we don't avoidably lose lives until then."
Dr. Tom Frieden, former CDC Director, 12/8/20
San Francisco's GLIDE providing more holiday grocery bags than ever before
GLIDE's annual grocery bag giveaway is expanding to its largest event in its 42-year history as it pivots from on-site distribution to packing and delivering meals across San Francisco. The organization is packing 800 more bags this year than last, planning to distribute 5,300 grocery bags to people in need.

"Before we would do an onsite distribution of 2,000 bags and then deliver the other 2,500 bags at the same time, but in order to keep everyone safe we're taking it all on the road," said Lillian Mark, GLIDE deputy director of programs.

GLIDE staff members stepped up to pack the holiday grocery bags with volunteers told to stay home under the Bay Area's latest stay-at-home order.
The organization is going through 3,900 chickens, 1,400 turkeys, 5,300 pounds of vegetables, 5,300 dozen dinner rolls, 1,600 pounds of mac & cheese and other sides and fixings.

GLIDE is known for its outreach and feeding the hungry daily. The organization is now seeing more families in need of assistance.

"(It's) parents who have lost their jobs, especially in this kind of economic landscape, kids who are sheltered at home and not able to access the regular meals they may have access to at school," said Mark.

Source: ABC 7 News
By the Numbers
Bay Area: 174,784

California: 1,421,783

U.S.: 15,285,261
Alameda County

Cases: 33,736

Deaths: 525

Adjusted Cases per Day: 15.7

Test Positivity: 4.9%

Hospitalized Patients: 280

ICU Beds Available: 87
Bay Area: 2,047

California: 20,273

U.S.: 287,671
Contra Costa County

Cases: 28,391

Deaths: 270

Adjusted Cases per Day: 20.5

Test Positivity: 6.2%

Hospitalized Patients: 159

ICU Beds Available: 34
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 7-day average. Hospitalized patients refers to patients with confirmed and suspected Covid-19.
Bay Area News
SF Chronicle, December 8, 2020
In efforts to stem panic buying and hoarding, at least three of the five Bay Area counties mandating stay-at-home orders will increase the number of customers allowed inside grocery stores, matching the state’s latest update. Alameda, Contra Costa and Marin counties will allow up to 35% capacity in grocery stores, up from the 20% initially announced last week.

What's Open, What's Closed

County website, December 9, 2020
Recent county coronavirus case data in California is not static. Counties regularly adjust case data within a 7 day period as new cases are reported for dates earlier in the week. This is true for Alameda County. An additional factor is that Alameda County generally does not update its data until the late afternoon, whereas Contra Costa County updates its data at 11:30 a.m. daily.

For example, on the morning of Monday, December 7, Alameda County's Covid-19 dashboard showed 580 coronavirus cases for Friday, December 4. On the night of December 7, the dashboard updated the number of coronavirus cases on December 4 to 618. Today, the county dashboard shows 668 cases for December 4. That makes December 4, so far, the date with the highest number of coronavirus cases reported in Alameda County.

In the above graphic for Alameda County, the dotted line represents 500 cases. The last bar in the graphic is December 7, showing 136 cases. As of this morning, the county has not reported any case data for December 8 and 9. Later today, the first set of cases should be reported for December 8. It is also highly likely that the number of cases reported for December 7 will be significantly revised upward. The same may be true for cases reported for December 6.
SF Chronicle, December 9, 2020
The message from Bay Area officials was firm: Don’t gather or travel for Thanksgiving. They warned that coronavirus case rates, which had been rising since the beginning of November, would dramatically worsen and strain hospital resources if holiday gatherings yielded a rash of new infections.

And data indicates that the worst is coming true. In the nine Bay Area counties, the seven-day rolling average of new cases per 100,000 people has spiked sharply in the past week, reflecting new infections from the Thanksgiving holiday. On Tuesday it was 35, up from 23 on Dec. 2.

Dr. Mark Ghaly, secretary of California Health and Human Services, said Monday that cases from Thanksgiving gatherings and travel are showing up now, and “we’ll be seeing it for many days to come.” John Swartzberg, an infectious disease expert for UC Berkeley, also said that Thanksgiving cases likely began showing up around Dec. 6 or 7, and he expects them to continue rising for the next five or six days.

SF Gate, December 9, 2020
As of Tuesday, there were only 50 remaining intensive care unit beds available in the county. These beds are critical in caring for the sickest Covid patients. "That's 50 beds for a county of 2 million people to care not just for Covid but to care for everyone who needs critical care in a hospital," Dr. Ahmad Kamala, director of health care preparedness in Santa Clara County, said. "Many of our hospitals continue to have five or fewer ICU beds."

SF Chronicle, December 8, 2020
UCSF expects to receive 975 doses in the first round of vaccine allocation, and is preparing to vaccinate health care workers and first responders at its Parnassus and Mission Bay campuses, UCSF spokeswoman Kristen Bole said in an email. The doses will go to 975 people as their first of two doses; the Pfizer vaccine is administered in two injections, 21 days apart.
Health News
STAT, December 8, 2020
Scientists at the Food and Drug Administration endorsed the efficacy and safety of the Covid-19 vaccine from Pfizer and BioNTech in detailed documents released Tuesday, setting the stage for an emergency authorization as early as this week.

The documents are a prelude to a Thursday, Dec. 10 meeting of outside experts, which is likely the final step before the FDA grants an emergency use authorization, or EUA.

The FDA reviewers state that the two-dose vaccine was “highly effective” in preventing symptomatic Covid-19, and that the data “suggest a favorable safety profile, with no specific safety concerns identified that would preclude issuance of an EUA.” The data also suggest that the two-dose vaccine may begin preventing some Covid-19 cases after the first dose.

The documents also provides new information about the side effects of the vaccine (most patients have sore arms and headaches). And it sets up topics for discussion about the vaccine’s efficacy, including what potential rare side effects regulators and the manufacturers should watch for, and how well the vaccine protects against severe Covid-19.

Injection site reactions occurred in 84.1% of recipients, fatigue in 62.9%, headache in 55.1%, chills in 31.9%, and fever in 14.2%. Severe reactions occurred in 2.8% of volunteers over the age of 55 and in 4.6% of those under 55; younger patients often have stronger reactions because they have stronger immune systems.

Washington Post, December 9, 2020
After two health-care workers reacted adversely to injections of the new Pfizer-BioNTech vaccine, British regulators on Wednesday ordered hospitals not to inject people who have a history of “significant” allergic reactions. The new warnings come just a day after Britain launched the first mass immunization campaign in the West, with the aim of vaccinating the whole country against the coronavirus.

STAT, December 8, 2020
The Covid-19 vaccine being developed by the University of Oxford and AstraZeneca appears to have moderate efficacy in preventing symptomatic illness, and may significantly reduce hospitalization from the disease, data from four clinical trials of the vaccine reveal.

The highly anticipated publication of the data, released Tuesday in The Lancet, also point to some signals that deserve further exploration — the possibility of protection after a single dose and the suggestion that at least one dosing regimen may have led to a decrease the number of asymptomatic infections.

Bloomberg, December 8, 2020
The U.S. government’s plan to vaccinate most Americans by next summer rests heavily on two Covid-19 shots that U.S. regulators won’t get a chance to rule on until early in 2021. AstraZeneca Plc and Johnson & Johnson together would provide 150 million to 200 million shots in the first quarter, said Moncef Slaoui, chief scientific officer of Operation Warp Speed. This could immunize 110 million to 150 million people, if the doses are evenly split between J&J’s single-dose vaccine and Astra’s two-dose regimen.

The U.S. has an agreement for 100 million doses of the Pfizer two-dose vaccine regimen, enough for 50 million people. Both shots are needed to provide full immunity. Pfizer had offered an additional 100 million doses to the U.S., which declined.

NY Times, December 7, 2020
After it signed its federal contract in late July, Pfizer went on to seal deals with other governments, including the European Union, which last month finalized an agreement to acquire 200 million doses from Pfizer.
US and California Data: Full Range
Covid Tracking Project, 12/8/20 (bold lines are 7-day averages)
United States
California News
East Bay Times, December 9, 2020
More Californians were added to the state’s death toll from COVID-19 on Tuesday than all but one other day of the pandemic, while new cases of the virus continued to come in larger numbers than ever before.

On Tuesday, California reported 34,775 new infections and 212 fatalities from COVID-19. The case count Tuesday edged out the the total Monday, which shattered the previous daily record; the daily death toll exceeded every other day in the past nine-plus months except July 31, at the height of the summertime surge. However, there are no indications that California’s current surge has reached its peak. Cases, hospitalizations and deaths are still on the rise, and capacity in intensive care units continued to dwindle.

The Bay Area is trending similarly to the state: Cases are up 64% from a week ago; hospitalizations have increased about 27%; and the daily death toll has about doubled. On a per-capita basis, however, infections and fatalities in the Bay Area were still coming at rates about half that of all of California. At 24.5%, the region has the second-highest remaining ICU capacity in the state.

CalMatters, December 9, 2020
As hospitals throughout California are filling up, dozens of counties are facing staff shortages that prevent them from expanding their ICUs to meet the surge.

Nearly two dozen counties had fewer than 10 available ICU beds on Tuesday, and four had all of their ICU beds full, according to state data
When comparing available ICU beds to population, Imperial, Kings, San Benito, Madera, Fresno and Yolo counties are in the worst shape. All of them have zero or less than one ICU bed open per 100,000 residents. 
Another 13 counties have less than three open beds per 100,000 residents: San Bernardino, Riverside, Santa Cruz, Sonoma, San Joaquin, Kern, Lake, Humboldt, Nevada, El Dorado, Solano, Merced and Stanislaus.

LA Times, December 9, 2020
As states plan for vaccine distribution, an all-too-important question has arisen: How many people will take it? That question might prove especially pivotal for groups that have seen the highest casualty rates from Covid-19.
“I’m concerned more about vaccines for different demographic groups that normally are reluctant to get vaccinated, like the minority communities,” Fauci said during a Facebook livestream last week.

In California, the plight of Latino residents looms especially large. They make up about 40% of the state’s population, but represent 58% of its Covid cases and 48% of its deaths from the virus. They also account for a disproportionate number of “essential workers,” who are more exposed to the coronavirus, which has swept through fields, meatpacking plants and construction sites.

LA Times, December 8, 2020
In L.A. County, Latino residents are now becoming infected with the virus at more than double the rate of white residents, according to data. The increase is a reversal in progress the county saw in the late summer and early fall as the disparity among racial and ethnic groups lessened and the overall spread of the virus flattened. In August, county officials expressed optimism as Covid-19 infection rates and deaths in the Latino and Black communities tumbled. Now they are sounding new alarms.

Latino communities are at higher risk for the illness for several reasons. They tend to be essential workers who must go to retail stores, manufacturing plants and other sites rather than working from home. That puts them at a great risk of contracting the virus. Some Latino neighborhoods are more densely populated, making the virus easier to spread. Latino and Black residents have disproportionately higher rates of hospitalization for Covid-19 than white residents.

East Bay Times, December 9, 2020
To the relief of parents, California quietly reversed the outdoor playground ban Wednesday in its regional stay-home order, which is now in effect for the state’s southern half and many Bay Area counties to control spread of the coronavirus. The stay-home order announced last Thursday listed outdoor playgrounds as off limits in affected regions. It also bans outdoor dining at restaurants, but encourages other outdoor activity like hiking or going to the beach.

Sacramento Bee, December 9, 2020
Since November, a coalition of Sacramento-based nonprofits and community advocacy groups have been distributing $4 million worth of direct payments to families impacted by the coronavirus pandemic. Funded by federal CARES Act money supplied by the county, residents selected for the financial assistance program receive a one-time stipend between $1,000 and $3,000 — a first-of-its-kind direct payment program in Sacramento County, starting just as Covid-19 cases and hospitalizations across the region are reaching unprecedented heights.

NY Times, December 9, 2020
Until late last month, outdoor dining — no masks required — was the closest thing to pre-pandemic normal for the 10 million residents of Los Angeles County. But amid a record-busting surge in hospitalizations and cases of the coronavirus, the county’s health department recently said outdoor dining must come to a complete halt for the first time since May.

This time, angry at the order and worried it would be the death knell for many of the 30,000 eateries sprawled across the vast county’s patchwork of 88 independent jurisdictions, several cash-strapped municipalities have pushed back and banded together — with votes to form their own health departments. While largely symbolic because there is no process for local jurisdictions to easily create their own health departments, city councils across the county have in recent days passed resolutions to do exactly that — or to annex and join a city that already has its own.

LA Times, December 8, 2020
A state law protecting tenants from evictions in California expires in 2 months, but lawmakers are seeking an extension until the end of next year, citing continuing economic hardships from a new stay-at-home order that’s meant to curb the spread of the coronavirus.

The current law bars evictions as long as renters pay at least 25% of their rent and attest to financial hardship, but it expires on Jan. 31, 2021. Legislation introduced Monday would extend the protections for 11 months, until Dec. 31 of next year.
US News
NY Times, December 9, 2020
More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the Covid-19 epidemic.

Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services.

Many areas are even worse off: One in 10 Americans — across a large swath of the Midwest, South and Southwest — lives in an area where intensive care beds are either completely full, or fewer than 5 percent of beds are available. At these levels, experts say maintaining existing standards of care for the sickest patients may be difficult or impossible.

Wall Street Journal, December 9, 2020
The federal government has fallen well short of its goal to shore up an emergency stockpile of respirator masks and some other personal protective equipment for health workers amid the current surge in Covid-19 cases.

The Trump administration said in May it was aiming to increase its emergency supply of N95 respirator masks to 300 million in the coming 90 days. It never met the goal; by mid-November, the U.S. Strategic National Stockpile and the FEMA held 142 million N95 masks, which filter out at least 95% of small particles and fit snugly to the face.

The U.S. also has yet to develop a centralized database to distribute medical gear to all health providers. The HHS hasn’t adopted key recommendations to ease supply shortages made in September by the U.S. GAO. A federal crisis response program hasn’t reached its staffing goals for health responders.

Associated Press, December 9, 2020
A survey from The Associated Press-NORC Center for Public Affairs Research shows about a quarter of U.S. adults aren’t sure if they want to get vaccinated against the coronavirus. Roughly another quarter say they won’t.

Many on the fence have safety concerns and want to watch how the initial rollout fares — skepticism that could hinder the campaign against the scourge that has killed nearly 290,000 Americans. Experts estimate at least 70% of the U.S. population needs to be vaccinated to achieve herd immunity, or the point at which enough people are protected that the virus can be held in check.

Washington Post, December 8, 2020
President-elect Joe Biden on Tuesday laid out a three-point plan to begin defeating the coronavirus pandemic during his first 100 days in office, saying he will sign an executive order the day he is sworn in to require Americans to wear masks on buses and trains crossing state lines, as well as in federal buildings.

Biden also pledged to distribute “at least 100 million Covid vaccine shots” during that time, singling out educators, who he said should get shots “as soon as possible” after they are given first to health workers and people who live and work in long-term-care facilities under current plans. He did not specify whether he meant 100 million doses or vaccinating that many people; the two vaccines nearing approval both require two doses.

The other goal of his 100-day plan, Biden said, is to enable “the majority of our schools” to reopen within that time and to remain open. He called on Congress to devote the funding needed to make it safe for students and teachers to return to classrooms.

The Guardian, December 9, 2020
Before the pandemic, younger people in America were already making substantially less money than older generations, even compared with when those older people were young. In 1989, baby boomers controlled 21% of the nation’s wealth; millennials controlled just 5% of the nation’s wealth in 2019.

Coronavirus has made life worse.
From spring 2019 to spring 2020, unemployment among adults ages 16 to 24 increased from 8.4% to 24.4%, compared with an increase of 2.8% to 11.3% for adults 25 and older. Young Black (29.6%), Hispanic (27.5%), and Asian American (29.7%) workers are experiencing even higher rates of unemployment. One-third of young Americans in the current labor market are classified as underemployed.

Reuters, December 9, 2020
Companies and industry groups lobbying to get their U.S. workers to the front of the line for Covid vaccination are running into a patchwork of state plans and confusion over who is essential, and who is not.
Inoculation against the disease caused by the novel coronavirus is key to safely reopening large parts of the economy and reducing the risks of illness at crowded meatpacking plants, factories and warehouses.

The Hill, December 9, 2020
The Pentagon will get just under 44,000 initial doses of a coronavirus vaccine as early as next week. In the first phase of the rollout, which the Pentagon has dubbed a “controlled pilot,” health care providers and support personnel, residents and staff of Defense Department long-term care facilities, other essential workers and high-risk beneficiaries will receive the vaccine.

USA Today, December 9, 2020
Idaho public health officials abruptly ended a meeting Tuesday after the Boise mayor and chief of police said intense protests outside the health department building — as well as outside some health officials' homes — were threatening public safety. The health board had been expected to vote on a four-county mask mandate in Idaho's most populated region.

CNN, December 8, 2020
Rebekah Jones, who was fired after accusing Gov. DeSantis' administration of minimizing the pandemic and skewing state data, attracted national attention after her house was raided by armed state police on Monday morning. State authorities are investigating whether she accessed a government messaging system without authorization to send a message urging her former colleagues to speak out about coronavirus deaths. Jones has denied sending the message, but she told CNN she fears the computers and phone that state police seized from her Tallahassee home could expose her sources in the government to retaliation.
CA Education News
CalMatters, December 8, 2020
A group of eight California lawmakers will advance a proposal in January that would require the state’s public schools to reopen and offer in-person instruction once they receive permission to do so from state and local public-health authorities.

The Democratic legislators co-authoring Assembly Bill 10, one of the first bills introduced this legislative session, say the proposal is essentially in response to the fact that many public schools across California that had the state’s permission to physically reopen campuses this fall remained in remote learning.

If passed by two-thirds of the Legislature and signed by Gov. Newsom, the proposal led by Assemblymember Phill Ting, a San Francisco Democrat, would require public schools to plan the transition toward in-person instruction within 2 weeks after their counties move out of the most severe purple tier in the state’s four-color tiered system governing school and business reopenings during the pandemic. The schools would have wiggle-room as to when and how they actually reopen, but the plan would have to be in place within 2 weeks. 

SF Chronicle, December 8, 2020
UC Berkeley recently released travel guidelines for students planning to return home for the holidays, but some feel the university is sending mixed messages by urging students to follow new stay-at-home guidelines that restrict travel while it closes most on-campus housing during winter break. A UC Berkeley spokeswoman said most students living in the residence halls have informed the university that they plan to leave campus during winter break. Students who decide to stay will be accommodated, she said. Some students may be moved into separate rooms or dorms to adhere with social distancing guidelines.

SF Chronicle, December 9, 2020
Currently, the majority of the Bay Area’s 1.2 million school-age children are still learning remotely, even though the vast majority of research shows schools in the U.S. and abroad are not hotbeds of spread.

That kind of data should help alleviate concerns among teachers and staff and guide district officials across the state in reopening schools as soon as possible — something health and education experts have repeatedly said is critical to counteract the isolation, academic decline and other devastating effects of distance learning. So far, however, fear has been more of a driving factor in deciding when and how schools should open, said Assemblyman Phil Ting, D-San Francisco, who has proposed legislation to require schools to reopen when state and county officials say they can.

Some Bay Area teachers have said they don’t want to return if there’s even the prospect of one case coming into a school. Others have said they would go on strike if schools start reopening in January. Labor unions in some districts, including San Francisco, are prescribing the type of ventilation needed in classrooms or the frequency of site-based staff testing, rather than trusting state and local health standards. In many districts, officials are not focused on returning.

EdSource, December 9, 2020
Responding to a surge in student anxiety and depression — exacerbated by the pandemic — a state commission has called for California schools to move quickly to become “wellness centers” addressing mental and physical health needs among K-12 students and their families. Through agreements with nonprofits and government health agencies, schools would offer psychological services, basic medical care and other services to help families navigate trauma and other challenges, according to a recently released report by the state Mental Health Services Oversight and Accountability Commission.
US Education News
Reuters, December 9, 2020
Shortly before school began in September, administrators in Schenectady, NY, laid off more than 400 teachers, aides and other employees -- roughly 1 out of every 5 school workers.

Now teachers in this aging industrial city outside Albany must handle classes of up to 32 students, with few aides to help. Pre-kindergarten has been canceled and high school is taught entirely online. A support program for kids who often come to school hungry and unwashed has been eliminated. With budgets battered by the coronavirus pandemic, state and local governments across the United States have laid off nearly 700,000 workers this year, according to U.S. government data, equal to 8.4% of the workforce. Advocates warn that Schenectady’s experience could become commonplace if Washington does not provide more help.

NY Times, December 8, 2020
As some school buildings reopen this week, the NYC mayor has found himself presiding over a starkly unequal school system in which many white families have flocked back to classrooms while most families of color have chosen to learn from home indefinitely.

That gulf is illustrated in a startling statistic: There are nearly 12,000 more white children returning to public school buildings than Black students — even though there are many more Black students than white children in the system overall. Latino students are returning at a rate roughly proportional to their overall representation in the school system.

Politico, December 9, 2020
Around the country, districts big and small show no signs of reopening or lack plans for how to get kids back into school buildings. Officials in some districts continue doing battle with unions over the science and politics of reopening or remain wedded to their own approaches.

Though he has pushed for schools to remain open, New Jersey Gov. Phil Murphy also has said the more than 700 districts and charter schools in his state should make their own decisions based on the needs and outbreaks in their communities.

The Chicago Teachers Union is fighting Mayor Lori Lightfoot’s plan to offer young and high-needs students the option of returning to the classroom starting in January. The union filed a request with the Illinois Educational Labor Relations Board on Monday for an injunction against what they called Lightfoot’s arbitrary reopening date. CTU is calling on the school district — the nation’s third-largest — to bargain over the decision to return to school and create enforceable safety standards. They say the district has failed to test school ventilation systems for their ability to curb the spread of the virus and has failed to hire a promised number of custodial workers.

Wall Street Journal, December 8, 2020
With the fall semester winding down, there is a growing sense that next semester will be different, with colleges bringing more students back to campus, increasing testing and taking advantage of lessons learned from the pandemic’s first nine months.

College Crisis Initiative Founding Director Chris Marsicano expects to see more schools increase in-person operations, despite the continuing coronavirus surge. “I’m expecting more and more institutions to say, ‘Hey, these are the tools, this is the playbook, we can follow that same framework,’ ” he said.

Not every campus is looking to be fully open next semester, though. At the University of Michigan the housing system, which can accommodate about 10,000 students, was two-thirds full. Next semester the school will house only up to 3,000 students. While most classes were already online this semester, even more will be taught virtually next term.
Covid-19 survivor warns others
William "Bump" Roddey is well-known in his South Carolina community. He's a councilman, an advocate for wearing masks, and now he's warning others to do everything they can to remain healthy after he struggled through Covid-19.

"It was an experience I don't wish on my worst enemy," said Roddey.

He was diagnosed with the coronavirus in September, suffering through several symptoms from vomiting to fatigue. Then he reached a 104-degree fever. That's when his wife told him he had to go to the hospital as she called an ambulance. "If it can happen to me, it can happen to anyone," he added as he reflected on his journey to survive.

The 46-year-old diabetic with two young kids and a wife called a hospital room home for eight days. Once he was in the hospital, chest pain crept in as he found it hard to breathe. 
"I was probably just shy of going on a ventilator as my wife tells me cause she was in constant contact with the physicians, doctors and nurses," Roddey explained.

He's now back to a more normal life, but still following Covid-19 precautions like wearing a mask and social distancing as he battles a few lingering effects from the virus.

However, he is worried about what lies ahead. "I was expecting it, you know, I know people are tired and fed up," he said. "People want to live, but I'll stress, evaluate the situation, and see if it's really worth risking your life."

Source: WCNC News
International News
Wall Street Journal, December 9, 2020
Canada became the third country to authorize use of the Covid-19 vaccine produced by Pfizer, racing ahead of the U.S. FDA and Europe’s main regulator to approve shots for its most vulnerable citizens. Canada will now begin its immunization rollout as early as next week—a daunting challenge for a country that is the second-largest in the world in terms of land mass yet sparsely populated. The country is on schedule to begin inoculations next week, with a portfolio of vaccine candidates that it argues is among the most diverse among large economies.

Wall Street Journal, December 9, 2020
Some Asian countries that have been among the world’s most successful at containing Covid-19 are now struggling to beat back a winter resurgence, a sign of how elusive sustained progress can be until a vaccine gets rolled out widely.

On Wednesday, South Korean President Moon Jae-in convened an emergency meeting after the country saw a 9-month peak of 686 cases that has forced officials to use shipping containers to address a hospital-bed shortage. Japan on Wednesday recorded more than 2,700 new cases, according to public broadcaster NHK, its highest daily total yet. Vietnam reported community infections for the first time in around three months, prompting authorities to suspend all inbound commercial flights. Hong Kong, which had taken daily infections down to single digits, has seen cases surge past 100, requiring the reintroduction of limits on dine-in restaurant service and gym closures. Several regions of Malaysia went into lockdown after cases doubled within a month.

Though the virus tallies pale in comparison with the U.S., Europe and elsewhere, the uptick in outbreaks among Asia’s Covid-19 success stories come after life had been restored to pre-pandemic levels. But unlike more isolated outbreaks of prior months, this winter upturn is more diffuse, as places once considered havens—a family gathering at home or work sites long reopened—are now the outbreak origins.

NPR, December 9, 2020
Latin America is facing a pandemic of malnutrition. Hunger and obesity are rising side by side in the region. The working poor who can't afford a nutritious diet are suffering from at times a lack of food and at others an overabundance of poor-quality food.

A new report from a consortium of UN agencies finds that the number of people experiencing hunger in Latin America has grown steadily over the last 5 years. The report analyzes data through the end of 2019, prior to the arrival of Covid-19. But the social and economic inequality that were leading to malnutrition in the region, the authors say, have only gotten worse during the pandemic.

Bloomberg, December 8, 2020
Arguably, no region in the world has been hit as hard by the virus as Latin America. At the best of times, its health systems are wobbly. This pandemic year, with Brazil registering the world’s second-highest Covid death toll and Mexico the highest case-fatality ratio, they’re unraveling, aggravating rising inequality, crime, economic decline and public mistrust.

With 8% of the globe’s population and 30% of its Covid deaths, Latin America is facing the pandemic’s next phase -- mass vaccination -- with alarm. The virus has set back decades of gains in democracy and equality, and nearly tripled the number facing food insecurity. Given how poorly the region has fared over the past nine months and the ultra-cold equipment needed to store and transport two of the proven vaccines, many of its health leaders expect it to lag behind, with the risk of more virus waves still ahead.

NY Times, December 9, 2020
The United Arab Emirates approved a Chinese coronavirus vaccine on Wednesday, citing preliminary data showing that it was 86 percent effective. The move, the first full approval of a Chinese vaccine by any nation including China, could bring the vaccine a step closer to widespread use around the world.

The announcement by the Emirates’ Ministry of Health and Prevention was the first official indicator of a Chinese vaccine’s potential to help stop the pandemic. If trials elsewhere produce similar findings, the Chinese vaccines could offer a lifeline to developing countries that cannot afford vaccines developed in Western nations that are likely to be more expensive and more difficult to store and distribute.
Dr. Julia Marcus, The Atlantic, December 9, 2020
What happened over Thanksgiving is about to happen again, as millions of Americans travel for the winter holidays and decide whether and how to gather with relatives. Public-health messaging and policies during the pandemic have acknowledged that trips to grocery stores and pharmacies are essential, while grossly underestimating the strong need people feel to be close to one another. Lecturing showed its limits in late November: While millions heeded the recommendation to stay home, millions of others did not.

When a public-health approach isn’t producing the desired outcome, it’s time to try something different. Instead of yelling even louder about Christmas than about Thanksgiving, government officials, health professionals, and ordinary Americans alike might try this: Stop all the chastising. Remember that the public is fraying. And consider the possibility that when huge numbers of people indicate through their actions that seeing loved ones in person is nonnegotiable, they need practical ways to reduce risk that go beyond “Just say no.”  

Sarah Shipley Hiles, NPR, December 8, 2020
In August, local officials in Washington, Mo., a small city an hour west of St. Louis, voted against requiring residents to wear masks to prevent the spread of the coronavirus. On Nov. 23, with Covid-19 cases surging and the local hospital overflowing, the City Council brought a mask order back for another vote. As protesters marched outside, Councilman Nick Obermark, an electrician, was the sole member of the nonpartisan council to change his vote, causing the mandate to pass.

One of his many reasons? He has a child the same age as Washington Middle School student Peyton Baumgarth, 13, who on Halloween became the youngest person in Missouri to die of Covid-19 complications. "That hit pretty hard," Obermark said later. Though the councilman doesn't like wearing a mask, he said it's worth it to prevent even one or two people from getting Covid-19.

Todd S. Purdum, STAT, December 9, 2020
It is a paradox of Covid that in the very midst of a crisis in which mourners might most crave solidarity and shared company, the virus’ infectiousness has forced grieving families into virtual isolation. A survey by the Kaiser Family Foundation in midsummer revealed that more than half of American adults reported that their mental health had been negatively affected by the pandemic, up from 32% in March, while more than 10% noted an increase in alcohol use or substance use.

Already, some experts have said they expect prolonged grief syndrome to “become a major public health concern” because of the pandemic. Columbia’s Shear said she has yet to see detailed clinical studies of the effects of Covid on grieving, and says that more time will be needed to gauge the ultimate impacts. In fact, it will likely take decades before the full burden of the pandemic can be measured.

Maddy Savage, BBC, December 6, 2020
Divorce applications and break-ups skyrocketing across the UK and around the world. Leading British law firm Stewarts logged a 122% increase in enquiries between July and October, compared with the same period last year. In the US, a major legal contract-creation site recently announced a 34% rise in sales of its basic divorce agreement, with newlyweds who’d got married in the previous five months making up 20% of sales.

Stewarts partner Carly Kinch believes this trend ties in with the findings of numerous studies of working parents’ lives during Covid-19, which suggest that a disproportionate share of housework and childcare is still falling on women, even in heterosexual couples where the male partner also works from home. Relationship experts believe that even strong couples who weren’t facing problems before the pandemic, and avoided major shifts in household health or dynamics may also be susceptible to break-ups.

The pandemic has taken away “well-established routines that offered comfort, stability and rhythm”, explains Ronen Stilman, a psychotherapist and spokesperson for the UK Council for Psychotherapy. Without these, this leaves partners with limited opportunities to “seek other forms of support or stimulation” beyond their relationship, which can put them under strain. 
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 12/8/20
by day as of 12/8/20
Over the last seven days, Alameda County officials have reported 3,871 new coronavirus cases, which amounts to 236 cases per 100,000 residents.
Over the last seven days, Contra Costa County officials have reported 3,174 new coronavirus cases, which amounts to 280 cases per 100,000 residents.
Top 10 Locations of Cases in Alameda County, as of 12/7/20. Alameda County does not publish cases per 100,000 in the last 14 days by city.
Oakland: 11,833

Hayward: 5,145

Fremont: 2,670

Eden MAC: 2,178

San Leandro: 1,929

Livermore: 1,584

Union City: 1,390

Berkeley: 1,328

Castro Valley: 993

Newark: 928
Top 10 Locations of Cases in Contra Costa County plus (in parentheses) cases per 100,000 in last 14 days, as of 12/9/20
Richmond: 4,832 (450)

Antioch: 3,613 (371)

Concord: 3,445 (306)

Pittsburgh: 2,938 (464)

San Pablo: 2,376 (1,069)

Bay Point: 1,241 (393)

Brentwood: 1,241 (355)

Walnut Creek: 1,089 (284)

Oakley: 993 (421)

San Ramon: 833 (219)
East Bay Resources

California's Regional Stay At Home Order
Last week, Gov. Gavin Newsom announced a new stay at home order - linked to ICU bed capacity within 5 separate regions - to attempt to prevent the recent surge in Covid-19 cases in California from overwhelming hospitals. Here answers to common questions about the order:

What triggers the new stay-at-home order?
The order goes into effect within 24 hours in regions with less than 15% ICU availability. If and until this occurs, each county within the region is governed by the state four tier, color-code restrictions, called "Blueprint for a Safer Economy." Counties, however, can impose their own restrictions earlier then required by the state, as has occurred in the Bay Area.

How long does the order last?
The order will remain in effect for at least 3 weeks and, after that period, will be lifted when a region’s projected ICU capacity meets or exceeds 15%. This will be assessed on a weekly basis after the initial 3 week period.

What counties fall within each region?

  • Bay Area: Alameda, Contra Costa, Marin, Monterey, Napa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma
  • Northern California: Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Shasta, Siskiyou, Tehama, Trinity
  • Greater Sacramento: Alpine, Amador, Butte, Colusa, El Dorado, Nevada, Placer, Plumas, Sacramento, Sierra, Sutter, Yolo, Yuba
  • San Joaquin Valley: Calaveras, Fresno, Kern, Kings, Madera, Mariposa, Merced, San Benito, San Joaquin, Stanislaus, Tulare, Tuolumne
  • Southern California: Imperial, Inyo, Los Angeles, Mono, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Ventura

What does the order prohibit?
The order prohibits gatherings of any size, non essential travel, closes operations except for critical infrastructure and retail, and requires 100% masking and physical distancing. Specifically, the following activities and businesses must close:

  • Indoor playgrounds
  • Indoor recreational facilities and live audience sports
  • Hair salons, barbershops, nail salons and other personal care services
  • Museums, zoos, and aquariums
  • Movie theaters, family entertainment centers, amusement parks
  • Wineries, bars, breweries, and distilleries

What is allowed under the order?
The order allows access to critical services and outdoor activities to preserve physical and mental health. For example, you may leave your home to obtain healthcare at medical and dental offices, work at any business or other entity that is allowed to open, to engage in worship and protest activities consistent with public health directives, to patronize local businesses, or to care for friends or family members who require assistance.

You may also leave your home with or without a specific destination in mind (for example, to walk your dog, to engage in physical recreation, or simply to get some fresh air) as long as you wear a mask, maintain physical distancing and comply with any other applicable public health directives.

The following activities and business may operate with additional restrictions and 100% masking and physical distancing:

  • Outdoor areas like beaches, parks and hiking trails: overnight stays at campgrounds will not be permitted.

  • Recreational facilities: outdoor operation allowed only without any food, drink or alcohol sales.

  • Retail: indoor operation permitted at 20% capacity with entrance metering and no eating or drinking in the stores. Additionally, special hours should be instituted for seniors and others with chronic conditions or compromised immune systems. 

  • Shopping centers: indoor operation allowed at 20% capacity with entrance metering and no eating or drinking in the stores. Additionally, special hours should be instituted for seniors and others with chronic conditions or compromised immune systems.

  • Hotels and lodging: Open only for critical infrastructure support only.

  • Restaurants: Open only for take-out, pick-up, or delivery.

  • Offices: remote only permitted except for critical infrastructure sectors where remote working is not possible. Medical and dental offices remain open.

  • Places of worship and political expression: Outdoor services only.

  • Entertainment production including professional sports: Allowed without live audiences. Additionally, testing protocol and “bubbles” are highly encouraged.

What are critical infrastructure sectors?
These are sectors of the economy determined to be critical to protect the health and well-being of Californians. The list is lengthy, including workers in healthcare, food, agriculture, energy, utilities, transportation, communications, government operations, manufacturing, financial services and the entertainment industry.

How does the order impact schools?
The order does not modify existing state guidance for K-12 schools. Child care, pre-kindergarten and K-12 schools already open for in-person learning may remain open with masking and social distancing protocols.

What are the restrictions on travel?
In November, California issued a travel advisory that urged against nonessential out-of state trips and asked people to quarantine for 14 days after arriving from another state or country.

Under the new regional stay at home order, when triggered, the state is asking people to stay at home and not mix and move around. The order prohibits hotel use for tourism, leisure and other nonessential reasons, like nonessential travel, whether it be a vacation or a road trip to see family or friends.

Travel to access (or work at) critical services is permitted.

How does the new order relate to the state's March lockdown?
As reported by the Mercury News, the March stay-home order applied to all California residents, rather than regionally. It was of indefinite duration, and was modified in May with a multi-stage reopening plan, which was replaced in August with the color-coded “Blueprint for a Safer Economy.” The March order did not exempt schools or churches or allow non-essential retail to remain open at limited capacity.
In their December 3, 2020, podcast, Dr. Michael Osterholm and host Chris Dall discuss the status of Covid-19 in the US post-Thanksgiving, recommendations for how vaccine distribution should be prioritized, potential timelines for vaccine distribution, shortening quarantine, and how to talk to children about the pandemic.
NY Times, December 5, 2020
Lately, in the ongoing conversation about how to defeat the coronavirus, experts have made reference to the “Swiss cheese model” of pandemic defense.

The metaphor is easy enough to grasp: Multiple layers of protection, imagined as cheese slices, block the spread of the new coronavirus, SARS-CoV-2, the virus that causes Covid-19. No one layer is perfect; each has holes, and when the holes align, the risk of infection increases. But several layers combined — social distancing, plus masks, plus hand-washing, plus testing and tracing, plus ventilation, plus government messaging — significantly reduce the overall risk. Vaccination will add one more protective layer.
“Pretty soon you’ve created an impenetrable barrier, and you really can quench the transmission of the virus,” said Dr. Julie Gerberding, executive vice president and chief patient officer at Merck, who recently referenced the Swiss cheese model when speaking at a virtual gala fund-raiser for MoMath, the National Museum of Mathematics in Manhattan
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 Gordon Galvan, Chair, Mariellen Faria, Vice Chair, Roxann Lewis, Pam Russo and Thomas Lorentzen. 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.

Each bulletin includes a summary of the top health, Bay Area, California, national, education and international news on the pandemic plus links to a diverse range of commentary and analysis. We publish the Bulletin on Mondays, Wednesdays and Fridays, unless the day fall on a public holiday.

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