Alexa Rivas (left), a student in her final year CSU East Bay, and Efrain Trujillo, a recent CSU East Bay graduate, answer questions a man had Thursday in the Fruitvale neighborhood of Oakland. Credit: Brian Krans

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Under overcast skies Thursday morning, four bilingual public health outreach workers walked up and down both sides of International Boulevard in the heart of Fruitvale, an epicenter of the Bay Area’s COVID-19 pandemic, which has disproportionately impacted Latino and Black people. 

Clipboards in hand, Raquel Marquez, Carolina Quintero, Alexa Rivas and Efrain Trujillo—recent or soon-to-be college graduates—approached people at random with a few questions: Have you been vaccinated? Do you need help making an appointment? Would you like more information? 

These “community vaccine ambassadors” are courteous and compassionate, and they’re on a mission: bridge the gaps that have kept people from getting vaccinated against COVID-19. 

“A lot of people tell us that they’re vaccinated and most of them I do believe,” Trujillo, a recent CSU East Bay graduate, said. “But sometimes you get that feeling that maybe they’re just not trying to talk.” 

Sometimes people want to argue about “facts,” reciting misinformation or expressing vague fears based on a lack of information. Others are eager to show off their vaccination card. 

One man in the Fruitvale Village who said he was vaccinated needed help making an appointment to get a COVID-19 test before traveling internationally. A man on a bicycle at International and Fruitvale gladly took a flyer directing him or anyone he knows to a nearby vaccination site. 

Stopping individual people on the street may seem like a slow and cumbersome process, but the 94601 zip code that includes Fruitvale continues to lag behind in the number of people who are fully vaccinated compared to the rest of the county. 

All told, 72% of people aged 12 and up in Alameda County are fully vaccinated, but only two-thirds of 94601 residents can say the same, according to the county’s COVID dashboard. Countywide, only about 55% of the Latino population and 51% of Black residents are fully vaccinated, compared to 75% of Asians and 65% of white people. 

The goal of the community vaccine ambassadors—created through a partnership with the Unity Council, La Clínica de La Raza, and UCSF—is to cut down on those inequalities and get more people to get their shots, one person at a time. Their campaign is named “Por mi, Por ti, Por Fruitvale” (For me, for you, for Fruitvale). 

“Two months ago when we were starting out, we would get maybe like 10 people [a day] signed up to get their COVID vaccine,” Marquez said. “But now, it’s more like maybe one or two, maybe even three if we get lucky.”

There’s a renewed sense of urgency: the delta variant of SARS-CoV-2. 

According to epidemiologists, the delta variant is far more contagious than other identified variants of the virus that causes COVID-19, and it has become the dominant strain in the United States. It’s prevalence has prompted Bay Area health officers to once again mandate masks indoors in public settings.

Arnab Mukherjea, chair of the Department of Public Health at CSU East Bay, says the spike in cases and hospitalizations in the Bay Area is fueled by the delta variant and “virtually everyone” hospitalized with COVID is unvaccinated. That, he said, should encourage more people to get vaccinated.  

“I would want to do anything I could to stay out of the hospital because of COVID,” Mukherjea said. 

The delta variant has mutated to be so infectious that the U.S. Centers for Disease Control Prevention says it’s similar to chicken pox, meaning a single infected person could easily spread it to up to five or more other people. 

Dr. Nicholas Moss, Alameda County’s Health officer, said he expects hospitalizations in the county to exceed last summer’s spike when 213 people were hospitalized in a single day because of the more infectious variant and fewer social distancing protocols in place. He first warned of a summer surge in mid-July and 200 people are being cared for in hospitals as of Thursday.

“We believe, and the data is still telling us, that our vaccines are very effective at preventing severe disease, so why are we seeing so many people in the hospital? There are a lot of reasons, and the first is that there’s probably a lot of COVID out there,” Moss said in an interview Thursday with The Oaklandside. “Delta is very efficient at being transmitted. It’s probably finding its way to those unvaccinated people who are vulnerable to severe disease very easily.”

A slowed vaccine effort

Carolina Quintero (blue mask) and Alexa Rivas (black mask) and other vaccine community ambassadors ask people walking along International Boulevard in Fruitvale if they need help getting vaccinated against COVID-19. Credit: Brian Krans

At the peak of the vaccine effort in April when multiple mass vaccination sites were open, more than 25,000 shots were being given out daily in Alameda County. Now, a tenth of that is considered a good day. 

The county has continued to follow its “radical convenience” model with more targeted events, including funding local and trusted nonprofits to deliver the vaccine, often coupled with food distribution or other services. Supply has been outpacing demand since late April, so the size of the operations have been much smaller while efforts were made to address access and, ultimately, equity. 

Fremont High in East Oakland in the 94601 zip code was the county’s last large-scale vaccination site, but it closed without much public notice after July 10, when a “Vaxx Facts Awareness Concert” was held to promote vaccination for anyone 12 and older. 

The site administered 243 doses on its last day, according to the Alameda County Public Health Department. 

Along with local pharmacies, the county’s vaccination effort now primarily relies on “community-based mobile vaccine Points of Dispensing (POD).” On Tuesday, the Alameda County Board of Supervisors approved nearly $3.5 million in contracts for eight PODs through the end of September. That’s on top of groups reportedly going door-to-door for homebound patients, healthcare providers having steady supply of vaccine, and efforts to get kids 12 and up vaccinated as Oakland schools begin to reopen.

Itzel Diaz-Romo, a senior manager with the Unity Council, said the two UCSF ambassador teams—one in Fruitvale and one in San Francisco—aim to cut through barriers to vaccination, starting with conveying health information in the right language, including Farsi, Arabic, Cantonese, Mandrin, and, of course, Spanish. 

Ambassadors are also combating anti-vaccine misinformation that regularly circulates on social media. If vaccination is a race against a virus, community vaccine ambassadors are Olympic walkers—steady, paced, and always with one foot on the ground. 

“It’s moving slowly, but it’s moving,” Diaz-Romo said. 

Alameda County reached 80% of eligible people getting at least one dose of a COVID vaccine on June 10. It took 54 days to gain another 5 percentage points. 

“We’re doing a great job there, but we’re still talking about tens, even hundreds of thousands of Alameda County residents who are unvaccinated and a lot of those are kids, but a lot of them are adults,” Moss said.

While the current spike in Alameda County’s cases and hospitalization was expected after most restrictions were lifted, Moss said it came earlier than anticipated. 

“We knew we were going to open things up, we have a lot of people vaccinated and there’s going to be COVID. It hasn’t gone away,” he said.

Another curveball, Moss said, is recent data indicating that vaccinated people are contributing to the spread of the delta variant, even if they themselves mostly aren’t developing severe symptoms. And while some breakthrough infections—serious cases occurring in fully vaccinated people—were expected, the delta variant is surpassing initial estimates. 

“What’s emerging with delta is that breakthrough infections are happening, they’re happening more frequently than we would like,” Moss said. “Vaccine effectiveness is still good, but it’s not as good as it was against some of the other variants.”

Still, experts are urging people who can get vaccinated to do so because despite some cases sneaking through, the vaccines—particularly the Moderna and Pfizer rMRNA shots—are shown to provide the best available protection to those who encounter the delta variant. 

Unfortunately, Moss said the summer surge and the delta variant are not driving more people to get vaccinated so far, but work-related mandates could help get the vaccination rate up and hopefully prevent future large spikes. 

“If history is any guide, this will pass and we’ll get to another period of quiet hopefully soon,” he said. “I’m hopeful we’ll get through it.”

Masks and vaccine mandates

On Thursday, Gov. Gavin Newsom announced that California will require people who work in healthcare to be fully vaccinated against COVID-19 by Sept. 30. That’s the same deadline Oakland-based Kaiser Permanente gave all of its 216,000 employees and more than 23,000 physicians to be fully vaccinated. 

This comes after major tech companies began similar mandates, along with colleges and universities in the California State University and University of California systems that require all faculty, staff, and students to be vaccinated against COVID-19. 

In the meantime, to tamper down the current spike, Alameda joined six other Bay Area counties in issuing a health order mandating people wear masks indoors in public, regardless of vaccination status, beginning Tuesday. 

That, to CSU East Bay’s Mukherjea, shows that when Newsom lifted restrictions across the state on June 15, “we didn’t know the true power of the delta variant.” 

Mukherjea said he’ll gladly readopt the most basic protections to return to the classroom. 

“If a piece of cloth on my face is the difference between being able to teach my students in person and allowing kids to go to school, I’ll do it,” Mukherjea said. “If that’s what it takes, we should all do it.”