Coronavirus patients continue to stream into Orange County’s hospitals, with health officials Wednesday reporting 41 more patients than the previous day, including an increase of 13 admitted to intensive care units, a trend that is close to matching peak rates in July.
The Orange County Health Care Agency also reported 1,208 new COVID-19 diagnoses and one additional fatality, raising the cumulative case count to 80,551 and the death toll to 1,578.
Wednesday’s reported fatality was the first so far this week. The county logged 26 coronavirus-related fatalities from Nov. 22 through Saturday.
Deaths are a lagging indicator, however, officials say.
Andrew Noymer, a UC Irvine associate professor of population health and disease prevention, said deaths will rise a couple of weeks from now.
“I guarantee it,” he told City News Service. “There’s no cases without deaths.”
Hospitalizations jumped from 648 on Tuesday to 689 on Wednesday, with the number of patients in intensive care climbing from 158 to 171. On Monday, there were 605 hospitalized in county medical centers, with 146 in ICUs.
“In the last two days, we’ve picked up 84 in hospitals,” Noymer said. “That’s like a 50% increase. It’s getting worse before our very eyes.”
The peak was 722 hospitalizations on July 14.
“We can’t take much more than the 722 we had in July,” Noymer said. “It’s going to get worse is the problem. It’s going to exceed 722. We’re pushing into unknown territory.”
The last time hospitalization rates were this high was July 25 — with 687 patients — and the last time ICU rates were this high was Aug. 1.
On Tuesday, the county had 23% of its intensive care unit beds available, but that number dropped to 19% on Wednesday. The percentage of ventilators available decreased, from 61% to 59%.
Availability of beds is not as much of a problem as staffing them with the necessary medical personnel, Noymer said.
“You could rent all the motels in Orange County and have the beds, so it’s not the bed itself — it’s the staff,” he said.
Orange County CEO Frank Kim said the rising hospitalizations were expected based on rising case rates and demand for coronavirus test requests at the county’s supersites in Anaheim and Costa Mesa.
“We’re at 100% and we keep adding capacity” at the testing sites, Kim told CNS. “They keep being fully utilized, so that would indicate a lot of people in Orange County are experiencing symptoms or were in close contact with someone with symptoms.
“In the past we were below 50% and we’re operating basically at 100%, so based on those trends I would expect the volume of new positive cases we’ve seen recently to continue at those levels. And that’s a concern for us because we keep adding hospital bed usage and not as many people are exiting the bed as coming into a bed.”
County officials are eyeing a reopening of the Fairview Medical Center in Costa Mesa to care for the ill, Kim said.
“It’s a good thing we have that flexibility in capacity and can do that,” he said.
Hospitals are struggling with an ongoing nursing shortage, Kim said.
Orange County Supervisor Lisa Bartlett, who is president of the California State Association of Counties, expressed similar concerns.
“There’s plenty of space for ICU expansion and equipment like ventilators and (personal protective equipment), but there’s a potential major shortage of hospital staffing” for ICU beds, which require a higher-degree of care skills and experience, she said Tuesday.
Orange County “has been in a bit of a bubble … where we have significant hospital bed capacity that can be staffed and we’ve got ventilators and PPE,” Bartlett said. “But other counties may not be in the same situation we’re in, and that concerns me.”
Orange County’s hospitals, as they did this summer, will have to take on patients from other more stressed hospital systems in the state, Bartlett said.
The mounting numbers over the holiday weekend seem to confirm officials’ fears of a Thanksgiving-fueled surge. The full impact of the holiday and Black Friday shopping likely won’t be seen for another week, according to Kim.
The state’s tiered monitoring system metrics were updated again Tuesday. The adjusted daily case rate per 100,000 rose from 18.7 on Monday to 22.2 on Tuesday, with the positivity rate going up from 7.6% to 8.8%.
The county’s Health Equity Quartile Positivity Rate, which measures the cases in highly affected, needier parts of the county, stands at 13%, nearly three times higher than it was last reported Nov. 10.
All of the county’s metrics now fall within the state’s most-restrictive purple tier.
The county’s unadjusted case rate per 100,000, which doesn’t take into account testing rates and other factors, stands at 29.8. That is “middle of the pack” in Southern California with San Bernardino at 46.1 and Riverside at 28.5, Kim said.
He said he was encouraged to see the county’s testing rate per 100,000 at 411.2. Officials hope that testing will encourage the afflicted to quarantine and contact others about exposure, encouraging them to socially distance.
The number of tests conducted in the county stands at 1,482,285 including 12,851 reported Wednesday.
The county has also received about 500 some take-home testing kits that were disseminated starting last week. About 50 of them came back positive, in keeping with the general positivity rate, Kim said. The county expects another shipment of about 5,000 of the take-home tests soon, he said.
Officials recommend waiting at least two days after traveling or attending an event or gathering to get tested because the infection might not be detected right away.
The county is expecting to receive its first shipment of vaccines by mid-December, Kim said. Larger hospital systems will get them directly, but the county will receive vaccines to hand out to individual, stand-alone hospitals, Kim said.
Frontline health care workers will be among the first to receive vaccinations, along with people with underlying health conditions that make them especially vulnerable to the disease.
County officials are concerned about whether enough people will get shots to achieve herd immunity, so they sent out a survey and received about 20,000 responses that they hope to use to guide a public awareness campaign, Kim said.
Kim was also encouraged about news of a bipartisan group of senators floating an economic stimulus bill. Counties and cities need the money to continue financing widespread testing, he said.
“I’m hoping that’s a sign of good news that Congress will engage and do the right thing and return some of those tax dollars back into the community so we can continue our testing programs and other things,” Kim said.
Without stimulus funding, the county would have to cut back on testing and core public services fueled by the pandemic, Kim said.
“Ultimately, when you have a loss of revenue you have a growing demand for services with a matching-grant requirement — and you can’t say no because it’s an entitlement program,” Kim said. “I have to squeeze somewhere else in the county and it’s going to push up against public safety and public health unless I get stimulus.”
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