According to Dr. Moss, the home tests vary in quality. Some are better than others in terms of how sensitive they are for detecting infection. But they remain a good option. Credit: Amir Aziz

Back in June when COVID-19 cases were significantly lower thanks in part to the high demand of people wanting to get vaccinated, my family decided that we would feel relatively safe hosting a gathering that included close friends to celebrate my grandma’s 91st birthday the last weekend in August. The year prior, there was no huge birthday bonanza. Instead, our immediate social bubble held a small celebration for our matriarch. 

But when COVID-19 cases once again began to rise in mid-July, we were faced with the predicament of whether to scale down the party significantly or cancel it altogether. Ultimately, we decided that the best course of action was to trim the guest list from 50 to 25 people and host it outdoors. The most important safety precaution we decided on was to require every guest (all but two family members are not vaccinated) to get tested the morning of the party with a rapid result COVID-19 antigen self-test, the type that is sold at pharmacies for between $20 to $25. 

My family is not alone when it comes to figuring out how best to keep their loved ones safe from the threat of the delta variant and breakthrough cases among vaccinated individuals. Since the start of the pandemic, our team at The Oaklandside has tried our best to keep readers informed about the latest news and safety guidelines. We’ve created guides about where to get a free test, answers about the vaccine, resources for small businesses, the latest on the OUSD vaccine mandate for students, and more. 

Throughout the pandemic, the newsroom has also stayed in contact with Alameda County’s top health official, Dr. Nicholas Moss, to learn about how the county is doing in terms of COVID-19 vaccination efforts, hospitalizations, and deaths. 

The last time we chatted with Dr. Moss was back in February and a lot has changed since. As people continue venturing out to attend events, debate how to safely host family gatherings, or meet with friends, we felt it was time to chat with Dr. Moss again.

This interview has been edited for length and clarity.

Community gatherings where attendees are wearing to protect themselves from COVID-19
Community gatherings where some attendees are wearing masks to protect themselves from COVID-19. Credit: Amir Aziz

Is it safe for fully vaccinated people from different households to get together indoors, like for a dinner party?

If you’re talking about everybody being fully vaccinated, even if you know somebody happened to be sick and pass COVID on to people in that setting, we know that for the most part, people are going to be protected against severe disease. That’s why vaccination has been key to our public health efforts. If our local case rates are low, there’s not much COVID around. Then, the chance that somebody’s showing up who’s infected, is pretty small. Right now we’re still in pretty substantial levels of transmission. When you’re considering the risk of certain activities, the CDC has an easy color-coded website that you can go to and see what the county as a whole looks like, and how we’re doing better than most. 

Should people be getting tested before attending an event? How long should they wait to get tested after attending a large gathering or traveling?

If you’re feeling sick, the most important thing is to stay home. We often find that when we hear about outbreaks it is because somebody went to an event when they were sick. People who are feeling sick should get tested. Those are the people that we really want to be getting a test. For some large events, there’s a requirement for being vaccinated or getting tested. If you are using a home test kit, make sure you know how to read the results properly. For some people, it’s easy to manage all that stuff, but for others, it’s more of a barrier. 

If you’re not vaccinated and going to a big event, getting tested before you go can help protect people in the community, particularly if there’s going to be higher-risk folks present, as there were with the example of your grandma’s 91st birthday party. That’s a great example where older adults, even if they’re vaccinated, might not be as protected from the vaccine.  So you might want to be more careful, 

Or, if there are lots of children present, and they are not old enough yet to get a vaccine, you might want to be more careful. 

For anybody who’s traveling to a big event in another state, and you’re coming home, that’s a great time to get tested. The CDC has a page with travel guidelines. We don’t have our own travel guidance in Alameda County anymore and the state doesn’t have theirs either. 

What’s the best time to wear a mask?

In Alameda County, anytime people are going into public settings you have to wear a mask, even if you’re vaccinated. That is the mask mandate in public settings, and we also recommend it if people from multiple households gather together indoors. It’s not a requirement. But, we strongly recommend that fully vaccinated people and unvaccinated people wear masks anytime people from different households are gathering, and especially if people at higher risk are present.

COVID-19 home test kits run about $20. Is there any discussion of making these resources more affordable and accessible?

The home tests vary in quality. Some are better than others in terms of how sensitive they are for detecting infection. They all work better for people who are sick, but I think they are a good option. 

The state of California actually has provided a lot of rapid tests for specific settings. I’m not aware of any program to provide them for free. I have read that the federal government is trying to buy a large amount of rapid tests. I don’t know exactly what the plan is for distribution or what the goal is, but maybe some of those will be for a program like what you’re talking about.

We keep hearing it’s safer to go to events or meet up with friends outdoors. Is there any sense as to how many COVID-19 delta cases are contracted outdoors as opposed to indoors?

It is very hard to actually determine where people get infected (unless there’s an outbreak where you can investigate a cluster of cases at the same event) because people have many places where they could’ve potentially been exposed. Outdoors remains safer because there’s fresh air, the wind is blowing and it disperses any virus in the air, and people have more room to spread out. We haven’t seen anything to suggest that things are much different with the delta variant [which is a more contagious strain of COVID-19]. Now it’s still early. It takes some time for these types of studies to get done and for the results to get published so we may learn more in the coming weeks

There have been some well-documented outbreaks in which delta has spread at crowded outdoor events. But overall, most experts believe that the risk, even with delta, is still quite a bit lower outdoors compared to indoor settings. If we get some scientific evidence that shows otherwise that’ll be big news. 

Alameda County is under “substantial” community transmission according to the CDC. Credit: CDC Covid Data Tracker Credit: CDC Covid Data Tracker

The Oaklandside runs a weekly roundup of events called “This Week in Oakland.” Since delta started spreading, we chose to only include outdoor or online events. Is it safe to attend indoor events at the moment?

That makes a lot of sense and we may get another surge where case rates go high and it may make sense to take that approach. But, it brings up another issue which is that COVID is probably not going away. Everybody’s going to get it, probably even vaccinated people eventually might get it. And everybody who’s unvaccinated is going to get it if they haven’t got it already. They may get it more than once. And some of them are going to experience severe disease, so that really is not going to change. We are going to have to figure out how to live with it. 

People need to start thinking in terms of “I can go to this event, covid might be there, but I’m vaccinated and I’m probably going to be okay”. 

What should people be looking at in terms of infection rates to determine whether it’s safe to attend indoor events?

Because we no longer have a “blueprint” we haven’t said whether there is a number in terms of infections in a community above which it’s unsafe to do certain things. What is useful is the CDC website that tells you what the level of community transmission is. It is a map of the U.S. divided into counties and it’s color-coded by how much COVID is present. When Alameda County is red, that means there’s a lot of COVID spreading, and the risk is going to be higher in those indoor settings, particularly for unvaccinated people. If the county is orange, then there’s still a lot of COVID about but the risk is lower. People can feel much more comfortable when it is blue or yellow. That’s low or moderate levels of transmission. 

Clarification: the mask mandate is specific to indoor public settings.

Azucena Rasilla is a bilingual journalist from East Oakland reporting in Spanish and in English, and a longtime reporter on Oakland arts, culture and community. As an independent local journalist, she has reported for KQED Arts, The Bold Italic, Zora and The San Francisco Chronicle. She was a writer and social media editor for the East Bay Express, helping readers navigate Oakland’s rich artistic and creative landscapes through a wide range of innovative digital approaches.