A masked and gloved customer purchases flour at the Berkeley Organic Market and Deli. Credit: Pete Rosos

Alameda County is in the midst of another winter COVID spike, and public health officials are urging the community to approach the holiday season with the same caution they did last year during the omicron surge—by wearing masks when going to indoor places like restaurants, bars, and stores, and taking other measures like testing and handwashing regularly.

On Dec. 9, Alameda County rose from “low” to “medium” on the Center for Disease Control’s COVID-19 Community Level chart, which is based on case rates, new hospital admissions, and inpatient beds. As a result, staff and residents at higher-risk settings such as homeless and emergency shelters, cooling and heating centers, and county correctional and detention centers are now required to wear masks. Masking in other indoor locations and public spaces remains voluntary but is recommended.

BQ.1 and BQ.1.1 are the two subvariants dominating California

Dr. Joanna Locke, COVID-guidance lead at the Alameda County Public Health Department, indicated that the current number of reported cases does not accurately reflect infection levels throughout the county. She said that PCR test data only provides an indication of possible trends, while wastewater surveillance, which detects and measures the amount of virus present at local wastewater treatment plants, provides a more accurate snapshot of how widespread infection levels are. 

“Our COVID has definitely been rising steadily since October and probably will continue rising for a bit,” said Locke. “I think we probably will not hit our peak before the holidays. How far after the holidays? It’s hard to say.”

A screenshot of the Cal-SuWers Network Dashboard on Dec. 14, 2022, shows steeply increasing levels of SARS-CoV-2, the coronavirus that causes COVID-19, in Alameda County wastewater. Source: California Department of Public Health

The current CDC data shows that BQ.1 and BQ.1.1 are the two predominant variants throughout the state, overtaking BA.5. All three are subvariants of the omicron strain

As more people become infected, Locke stresses the importance of testing and seeking treatment. Although last spring there was a shortage of Paxlovid, a medication used to treat COVID, she said there is currently a sufficient amount to treat patients whose underlying conditions put them at higher risk.

“You should contact your health care provider if you test positive for COVID and have symptoms,” she said. “Because a lot more people are eligible for therapeutics than they realize. A lot of people assume they’re not.”

Paxlovid can only be prescribed within the first five days of COVID symptoms. It is recommended that people who begin experiencing symptoms get a PCR test as soon as possible from a healthcare provider to confirm a positive result and obtain treatment if needed. COVID symptoms vary from person to person, said Locke, and PCR testing is the best way to detect small traces of the virus.

Home tests, while a useful tool and an important part of the county’s prevention strategy, aren’t as sensitive and are more likely to result in a false negative. If someone is experiencing symptoms and tests negative at home, they are encouraged to test again within 24-48 hours.

People experiencing symptoms who are also in groups considered high-risk for severe illness, are encouraged to get a PCR test so that can catch the virus in time to obtain treatment within the 5-day window.

“PCRs are sensitive. You can get a PCR test on day one of symptoms, and if you have COVID, it will pick it up,” she said.

Where to get tested, vaccinated, and boosted in Oakland

Although some privately-run testing sites like CURATIVE are closing down before the end of the year, county-run sites will not. Other private operators, like COLOR, will continue running testing sites across the county. Kaiser members will continue to have access to PCR testing and up to four free at-home tests per month that can be mailed or picked up at a local Kaiser pharmacy. 

Locke is also urging the community to stay up-to-date with their COVID boosters. The county continues to partner with community clinics and health centers to offer access to vaccinations and boosters. Bivalent boosters that provide greater protection against the trending subvariants are available for anyone 5 and up, at least two months after their last primary series or booster dose.

County health officials stress that vaccines and boosters provide excellent protection against severe illness, which can lead to hospitalizations and death.

“There are a lot of resources left in the county for folks,” she said. “Vaccines are not perfect when it comes to preventing infection, but they do help.”

When to test and mask before a holiday gathering

As the holidays approach and more people head out to family gatherings and indoor activities, Locke said that testing at home (if no symptoms are present) a few days before and on the day of an event is recommended. Small gatherings in well-ventilated places are ok, she said, but meeting outdoors (weather permitting) is better. And masking, she said, is still encouraged to help prevent the spread of COVID and other viral respiratory viruses currently circulating.

“We’re doing a lot of masking in my family,” she said. “Also, good hygiene practices and staying home when you’re sick.”

Outdoor gatherings aren’t limited to meeting friends and family. Locke said she has only dined indoors a handful of times since the pandemic started. 

“I’ve always opted for outdoors. I personally would not dine indoors right now. And when I go grocery shopping, I put my mask on,” she said. “I’m back to how we approached things a year ago when we were going into the Omicron surge—being really cautious.”

Universal masking, especially during winter months

Locke noted that many people are experiencing vaccine and masking fatigue. It’s a narrative she hopes will change, with a continued surge throughout the winter months imminent.

“We hopefully will get to a place where when you get into winter, and there are multiple viruses, people aren’t bothered by this idea of masking,” she said. “We are trying to normalize masks. They’re a really good prevention measure.”

Locke said it’s hard to predict where COVID will be a year from now or whether boosters will be needed yearly, similar to flu shots. 

“We don’t know what the next variant will be. Things could quiet down, but they could not. It’s hard to know. I think we probably wish we had forecasted early on that a two-dose primary series was not going to be enough,” she said. 

“I think people felt a little bit let down when they found out that they were going to have to be boosted again. I don’t want to make a mistake of saying, ‘Yeah, you’re done,’ because we absolutely can’t say that.”

Clarification: Public health officials stress that COVID vaccines and boosters provide excellent protection against severe illness and greatly reduce the risk of hospitalization or death.

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.