April 13, 2020
Dear Neighbor,
I hope this e-mail finds you healthy, safe and in good spirits, given the circumstances. I know many of you are experiencing high levels of stress from a range of challenges from a lost job or a shuttered business to the loss of child care.  In these times, as the death toll rises across the country, it is not our bank account, our successes, or our failures that count. What defines us is our character. 
In ways large and small, each of you is rising to the occasion. I see it in small gestures like freshly cut flowers left outside for passersby, friends offering each other household necessities (like toilet paper!), and giving each other physical distance of six feet during essential activities. 

In the weeks and months to come, what will continue to define us is our ability to persevere—to follow the instructions of our Health Officer even when it’s difficult—and to help one another, despite the uncertainty we face.  
Shelter In Place Order: What Can We Expect Moving Forward? 
Berkeley Health Officer Dr. Lisa Hernandez shared during a briefing call with the City Council on Fri., April 10 that our Covid-19 model predicted a peak in cases in May or June and only assumed a 25% reduction in mobility. However, since the Shelter In Place Order went into effect on March 17, data show that our individual actions are adding up: we have reduced our mobility by 40% to 50%, according to a Google Community Mobility Report for Alameda County.
Exceeding our model's mobility assumption means that we are doing better than anticipated in "flattening the curve."   

I know we’re all eager to understand when we would see an easing of the Shelter In Place Order . Our Health Officer said during the call on Friday that the Order is working and continues to be needed to reduce the spread of Covid-19. From all of the publicly-available information I have read and heard, I want to caution that we should not think of the May 3 end date for the Order as definite. In an April 10 Politico news report , Bay Area health officers and public health experts described the data they would want to see to consider changes to the Order:

Santa Clara County Health Officer Dr. Sara Cody, who was instrumental in calling for the initial Shelter In Place Order , reportedly told county supervisors that she wants “a sustained reduction in new cases for at least 14 days—or one incubation period—before considering changes to her Shelter In Place Order.”

The article goes on to note that Bay Area experts predict it could be “anywhere from two weeks to more than a month” until case numbers start to dwindle. Public health experts are coalescing around some benchmarks before rules are eased:
  • Sustained reductions in new cases and deaths
  • Widespread testing
  • Ample hospital capacity
  • Ability to monitor new patients and trace their contacts

When the Shelter In Place Order is finally eased, we will have a “new normal,” such as prohibited large gatherings, protecting high-risk residents, and cover-your-face restrictions, according to Contra Costa County Health Officer Dr. Chris Farnitano.

We need to make public health decisions based on scientific evidence, and I’m so proud of our local health officers and our state for doing just that. I understand the desire to get back to work, but the only way to safely reopen our economy is a laser focus on public health. The former Chair of the Council of Economic Advisors under President Obama Austan Goolsbee recently put it this way:

But I want to acknowledge another phenomenon that is of concern across the globe, and which Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, recently described hearing from public health experts around the world during a World Health Organization conference call:

“We need to make sure we keep our eye on the balance…if you’re too stringent in things like lockdowns and keeping people under wraps for long periods of time, you may have the unintended consequence of triggering—from an economic and societal standpoint—such a disruption that you get things like poverty and health issues unrelated to coronavirus.”
I call the concern described by Dr. Fauci as the “disease burden from economic disruption.” Some of the ways it manifests itself in our community is in the increasing numbers of those experiencing food insecurity, more calls for help from domestic violence victims, and the greater need for mental health services .

I created this schematic to help me conceptualize the factors that public health experts are telling us must be taken into account in order to determine when it's safe to ease the Shelter In Place Order :
I want you to know that I will always strive to be honest and fact-based in the information I share with you about Covid-19. My highest priority is to keep you healthy and safe.

If you have any questions, please feel free to contact me: rkesarwani@cityofberkeley.info or 510-981-7110 (please leave a voicemail and we will call you back). 
Covid-19 Cases & Deaths Update
We can look at county-level case data for select California counties in the charts below to get a sense of how we're doing in "flattening the curve." To my frustration and dismay, we are still not at a point where anyone who is symptomatic can get tested for Covid-19. This means that our detected case data provide an incomplete picture of what's actually happening.

For what it's worth, the chart below (created using a Covid-19 data-visualization tool ) shows the total number of detected cases per 100,000 people in five California counties as of Sun., April 12. Alameda County has the lowest number of cases at 48 per 100,000 and San Francisco is the highest at 97 per 100,000.
Detected Cases Per 100,000 People in Select CA Counties
One of the key metrics that Santa Clara Health Officer Dr. Sara Cody is looking for when considering an easing of the Shelter In Place Order is a sustained reduction in new cases for at least 14 days. To get a sense of how we're doing in meeting this metric, I used the Covid-19 data-visualization tool to chart the total number of detected cases that are new in the past 14 days, shown below. The chart uses a log (or, exponential) scale on the vertical axis. Here, we can see that all five select California counties are "flattening the curve" in terms of no longer seeing sustained large increases in the total number of detected cases that are new over the past 14 days. Unfortunately, the data set has not yet been updated through the present, but what we will hope to see is a leveling-off and then a sustained decline in the total number of detected cases that are new for a 14-day period.
Total Number of Detected Cases that are New in Past 14 Days
Over the weekend, the U.S. reached a grim milestone of surpassing Italy to record the highest number of Covid-19 deaths worldwide , with 20,457 people losing their lives as of Sun., April 12. I was saddened to see Berkeley report its first Covid-19 death last week of an individual in their 40s with underlying health conditions . Every death is a tragic reminder of the seriousness of Covid-19, and the importance of following safety precautions and guidance from our Health Officer. Below, you can see how the death rate in the U.S. compares to other countries we are reading about in the news. 
Deaths Per 100,000 People in Select Countries
Widespread Covid-19 Testing & Prospects for a Vaccine: What We Know So Far
Covid-19 Testing. On an April 8 briefing call with Alameda County Interim Health Officer Dr. Erica Pan and other county leaders, I asked when we can expect to see widespread Covid-19 testing for anyone who wants a test. Dr. Pan noted that the situation is improving every week—with more labs coming online and expanded capacity at existing labs.
A Covid-19 testing lab. Photo: HM Treasury (Creative Commons License ).
Dr. Pan said she has "high hopes" that anyone who is symptomatic will be able to get tested "within the next several weeks," but acknowledged that there is currently a shortage of swabs needed to conduct the tests. The ability to ramp up testing is critical because public health experts have said that widespread testing should be available as a pre-condition for easing the Shelter In Place rules. Dr. Pan's comments about increasing test availability appear to be borne out by the data. In my last newsletter , I reported that a total of 28,886 tests had been conducted in California as of March 30. As of April 12, a total of 190,328 have been conducted, according to the Covid Tracking Project .

Last week, Berkeley joined other Alameda County cities Fremont, Hayward, and Oakland in opening a testing site for specific populations , including first responders, vulnerable populations, and essential City employees. However, I remain concerned that many of our essential workers like our grocery store workers do not have access to testing. I will keep pushing for answers and progress on the testing issue. I do want to note that the March 31 updated Shelter In Place Order requires essential businesses to put in place "social distancing protocols" to protect the health of employees and customers; the protocol is required to be posted at public entrances. 

Prospects for a Vaccine. Earlier today , New York Gov. Andrew Cuomo talked at his daily press conference about when this ordeal will be over. He described an economy that would slowly and gradually reopen with an eye on the infection rate to ensure it didn't creep upward. We can expect this type of approach until there are better treatments available or a Covid-19 vaccine.

Dr. John Swartzberg, Clinical Professor Emeritus of Infectious Diseases and Vaccinology at U.C. Berkeley's School of Public Health, spoke to our Assemblymember Buffy Wicks on Fri., April 10 in a Facebook Live video , and shared that there are a "remarkably large number of studies" currently taking place to study the efficacy of drugs to treat Covid-19. For vaccines, there are currently 50 vaccine trials occurring in the U.S. —with numerous other trials occurring overseas—in the hope that one of these treatments would be safe and effective. If one of these vaccines does work, the soonest it would be available is 14 months from now, according to Dr. Swartzberg.
New Health Officer Guidance on Cloth Facial Coverings
The City of Berkeley’s Health Officer and other Health Officers around the region and state are now recommending that everyone cover their nose and mouth with a cloth when leaving home for essential visits to doctor’s offices, grocery stores or pharmacies.

A bandana, fabric mask, neck gaiter or other cloth barrier can all be used to cover your nose and mouth.
Mona Lisa wears a face mask. Photo: "ODC Twist" by FolsomNatural (Creative Common License ).
Our Health Officer Dr. Lisa Hernandez said during a briefing call with the City Council on April 3 that the guidance on cloth facial coverings was changed out of concern for asymptomatic Covid-19 carriers and people with Covid-19 who haven't developed symptoms yet who may unknowingly spread it to others.

The guidance to cover your nose and mouth with a cloth is most important when you will be around others, such as as in a doctor's office, grocery store or pharmacy, according to Alameda County health officials. Significantly, this cloth facial covering guidance should NOT be considered a substitute for maintaining physical distance of six feet from others, washing your hands with soap for 20 seconds, and all of the other guidelines for protecting yourself and others .

How to make a cloth face mask:
  • U.S. Surgeon General Jerome Adams created a video on how to make a cloth face mask without sewing or cutting any material. Here are five more options for creating a no-sew face mask with at-home materials.
  • If you have basic sewing supplies like a a sewing machine, needle and pins, here's an instructional video on how to make a face mask with pleats.

There is currently a shortage of n95 respirator and surgical-style masks, which are more effective than cloth facial coverings and are needed by our first responders and front-line health care workers who are unable to practice physical distancing from others. If you have unopened or unused n95 or surgical-style masks, both the City of Berkeley and my office are accepting them to donate. If you've saved your used n95 masks from fire season, it is fine to keep wearing them as they will provide better protection than a cloth facial covering, according to Dr. Swartzberg (Clinical Professor Emeritus of Infectious Diseases and Vaccinology at U.C. Berkeley's School of Public Health).
Be Counted: Census 2020
Have you logged onto

to complete your census form yet?

I did it this past weekend, and it took me less than 10 minutes.

T he results of the 2020 Census will determine how billions of dollars in federal funding get allocated for the next 10 years. The Covid-19 pandemic is just one example of why the census is so important. Funding for streets, public health services, disaster response, unemployment resources, and more are all based on this once-every-decade count.
The City is hosting a weekly Twitter drawing to help encourage our community to get counted. Post on Twitter about why the Census matters to you using the hashtag #BerkeleyCounts . The City will select three winners every week; prizes will include gift cards to local businesses, ranging in value from $20 to $100. Winners will be contacted via direct message on Twitter, then announced in a Tweet. Please limit entries to one per person.
Personal Reflections on the Federal Response to Covid-19
Like so many of you, I have found the federal response to this pandemic to be—in a word—absent. Yes, there are still good individual public servants like Dr. Fauci who work hard and tell us the truth. But at this stage of the crisis, it’s also apparent that the federal administration under President Trump is simply not capable or willing to mount the kind of response that the American people deserve . The shortages of personal protective equipment and Covid-19 testing materials were predictable and avoidable. The need for a national strategy for gradually reopening our economy with the ability to do widespread testing, monitoring new patients, and tracing their contacts requires massive mobilization that doesn’t appear to be happening at the federal level.  

It is hard not to get angry about this failure of the federal government to rise to the moment, but I try to remember that the seeds of this moment were planted long ago. There were enormous stakes to electing an “entertaining businessman” to “shake up the system,” and now—in some senses—we have to live with those tragic life-and-death consequences.

But there is something else that gives me hope: I call it the “Next-Man-Up” spirit of America. This country is filled with so many hardworking selfless people that rise to the occasion and fill the void left by our president. It’s the governors who announced today that they would coordinate regionally on reopening their economies . It’s the health care workers who care for patients everyday at some risk to their own health. It’s the first responders. It’s the City staff working around-the-clock in Emergency Operations Centers all across this country to keep the public safe. It’s people like you—who have trusted and followed the guidance of our Bay Area Health Officers to stay home—collectively bending the curve and saving lives.

I know we will find our way through, and we will learn from our mistakes. Please stay healthy and safe.      
COVID-19 Teleconferences + Other Resources

  • Listen to the Mayor's Virtual Town Hall with City Manager Dee Williams-Ridley and Health Officer Dr. Lisa Hernandez from April 10 HERE.

  • Assemblymember Buffy Wicks held a Facebook Live meeting on April 10 with Dr. John Swartzberg, Clinical Professor Emeritus of Infectious Diseases and Vaccinology at U.C. Berkeley's School of Public Health

  • State Senator Nancy Skinner has held a number of Telephone Town Halls on various COVID-19 topics, which are available HERE, along with other resources.

General Resources. The Mayor’s Office has created a resource guide , with information about parking enforcement, senior hours at local grocery stores and other information.

If you have any questions about our local residential and commercial eviction moratorium or housing retention grants, more information is available HERE .

A Berkeley Mutual Aid website has been created for neighbors to offer and receive assistance, such as help with grocery shopping.

The state COVID-19 website is where you can get up to speed on what’s happening statewide and what resources and assistance may be available, such as unemployment insurance.

Meal Efforts . Double Helping Hands provides meals to the homeless from downtown Berkeley restaurants. You can make a donation HERE.

HelpBerkeley.org provides low-cost meals to individuals at high risk of developing complications from Covid-19, and they are in need of volunteers to help deliver meals.

East Bay Feed ER provides restaurant meals to hospital workers. You can make a donation HERE .

Resources for Mental Health and Wellness. The California Surgeon General has a Playbook for Stress Relief for Caregivers and Kids During Covid-19 .

The Alameda County Suicide Prevention line is 1-800-309-2131. The Alameda County Office of Education has a webpage on mental health and well-being as you shelter in place .

The Domestic Violence Resource Guide for Alameda County is available HERE .

If you have specific questions or concerns, please always feel free to reach out to me: rkesarwani@cityofberkeley.info or 510-981-7110.
My Website
For updates on community issues and links to City information resources, please visit my website: www.rashikesarwani.com.

This site is also where you can find an archive of all of my newsletters to date.

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