Earlier this month I did sent a message on social media that caused many reactions. The post was simple enough and encouraged people to get tested for COVID-19 frequently, especially as social gatherings increase during the spring and summer months. After that, messages came from friends and strangers alike letting me know they had recently contracted COVID. Many of them were people who, like me, were vaccinated and boosted and took great care to avoid contracting the virus.
In the days and weeks that follow, more people than ever in my area seem to be getting COVID, and many others I’ve spoken to are saying the same thing. Not surprisingly, the Alameda County Health Department’s COVID-19 dashboard shows that the number of reported cases has increased, comparable to the increases in January and August 2021.
But why does this surge actually feel so much more widespread than it did last summer? Turns out, because it probably is – and we know that from sewage testing.
As early as April 2021, the California Department of Health and Human Services began processing wastewater samples from EBMUD. The water utility serves approximately 740,000 customers in Alameda County, including Oakland, Berkeley, Emeryville and others. By testing the wastewater, lab technicians can detect and measure levels of SARS-CoV-2, the virus that causes COVID-19. The sewage testing provides a snapshot of COVID levels in our area that is more accurate and timely than what we are currently getting from reported case counts.
The state’s dashboard, which collects data from EBMUD, currently shows that the concentration of SARS-Co-2 in East Bay sewage rose dramatically in late April and May — not to levels as high as Omicron’s peak in January , but at the level of and longer – more durable than last summer’s peak.
At the Roots Community Health Center in East Oakland, testing has tripled as more residents come in and report symptoms, Dr. Noha Aboelata in her latest virtual People’s Health Briefing. Aboelata believes sewage testing provides a more accurate picture of the pandemic in Oakland than the cases reported by the county. In the past 14 days, reported cases in Alameda County have jumped from 5,500 to 7,000.
“We know that given all the testing that’s being done in homes, that’s a very significant undercount,” Aboelata said, referring to rapid home testing that isn’t reported. “However, it’s definitely going in the wrong direction.”
As part of her work with Roots to educate and treat the Oakland community, Dr. Aboelata often spoke about the importance of wastewater testing when it comes to finding new ways to fight COVID-19.
“Sewage sampling could be a phenomenal tool. I just think it’s not necessarily fully and consistently implemented across the board right now,” she told The Oaklandside in March.
Sewage testing can also help public health officials and providers anticipate new virus mutations before they spread. “It’s really an early warning sign,” Aboelata said. “And even if they sequenced it, we could also find worrisome variants much faster.”
In Oregon, wastewater samples collected for a study between March and May 2022 revealed a new variant, B.1.351 (beta), that had not previously been found in that region of the state.
While the sewage data is troubling, there are some encouraging disparities between the surge that’s happening now and when the pandemic began, according to county health officials. In a statement emailed to The Oaklandside, a spokesman for the Alameda County Health Department wrote that positive COVID cases remain well below what has been observed during the omicron surge and the differences observed in previous waves of infection, are not that pronounced.
“While COVID case rates are highest in residents between the ages of 20 and 40, we do not yet see racial or location differences in case rates that characterized previous waves,” the statement said. “Hospitalization of people with COVID remains well below what we saw during Delta and well below Omicron, and ICU admissions are low. Deaths from COVID are now similarly much lower,” due in part to Alameda County’s immunization coverage (84% are fully vaccinated), immunity to previous infections, and better access to treatments.
As of this week, the California Department of Health and Human Services launched a program called “Test to Treat,” aimed at increasing access to COVID treatment, particularly for hard-hit communities and uninsured people. The test-to-treat locations (Oakland has four) provide testing and immediate access to antiviral pills for qualified people who have tested positive for COVID.
The city of Oakland lifted its vaccination requirement for indoor facilities on May 18. But county health officials still recommend getting tested if you think you’ve been exposed and wearing high-quality masks while gathering in large groups indoors.
“Daily reported cases in Alameda County have reached levels seen during the Delta Wave,” wrote Dr. Alameda County Health Officer Nicholas Moss, in a statement released May 13, “a good time to start masking again.”