Orange County set another record for COVID-19 hospitalizations Wednesday, while reporting another 4,406 coronavirus cases and two additional deaths.

Hospitalizations increased from 1,806 on Tuesday to 1,854 Wednesday, with 394 of those people in intensive care. The cumulative case count increased to 134,820, and the overall death toll rose to 1,781. One of the latest fatalities was an assisted living facility resident.

“Our numbers today are not good,” said Orange County CEO Frank Kim. “Anything with a four in front of it is terrible, three is terrible, two is terrible.”

The county reported 80 coronavirus-related deaths last week, up from 62 the week before and 41 and 26, respectively, in the two previous weeks. Since Sunday, the county has reported 21 deaths.

The county’s state-adjusted ICU bed availability remained at zero, but the unadjusted figure was 8.2% as of Wednesday, up from 7.5% Tuesday. The state created the adjusted metric to reflect the difference in beds available for COVID-19 patients and non-coronavirus patients.

Just because a county’s adjusted ICU rate may be zero, it does not mean there are no beds available, Kim said. The difference in the rates reflects what is historically expected from non-coronavirus emergencies, he said.

But county officials stressed that anyone with a medical emergency should still dial 911.

County officials are bracing for another surge in cases related to holiday gatherings piled on top of the Thanksgiving-fueled wave.

“We’re facing COVID spikes from Thanksgiving right now,” Orange County Supervisor Lisa Bartlett said. “And we’re very low on ICU bed capacity. Under normal COVID circumstances that may not raise a lot of red flags, but the difference now between the prior surge we had and now is we had excess surge capacity then and essentially now we have no surge capacity.”

That is why officials continue to admonish the community to skip any sort of mixing of households for small or large gatherings to celebrate the holidays, Bartlett said.

“We’re in the flu season and we have increasing COVID cases day after day,” she said. “We are truly running out of ICU beds.”

Hospital officials now have to discuss the possibility of rationing care if the system is overcome with patients, Bartlett said.

“We never wanted to get to the point where we ration healthcare and pick winners or losers for hospital beds. We never want to be in that situation,” Bartlett said.

The Transportation Security Administration reported that security screenings at airports nationally exceeded 1 million passengers from last Friday through Sunday. On Monday, the agency reported 954,782 travelers, and on Tuesday there were 992,167, which is far less than last year but still an indication there could be a similar wave to Thanksgiving as there were similar numbers of travelers in the ramp-up to that holiday.

The county has three mobile field hospitals operating, with 50 beds at UC Irvine Medical Center in Orange and 25 each at Fountain Valley Regional Hospital and Los Alamitos Medical Center.

The county has four more mobile field hospitals left that have 25 beds apiece, Kim said.

At the recently reopened Fairview Developmental Center in Costa Mesa, 21 patients with milder symptoms are being treated.

County officials received doses of Moderna vaccines on Wednesday. Larger hospital systems received doses directly on Tuesday, and the county expects Wednesday’s doses to be distributed to smaller hospitals, Kim said.

Next week, county officials will debut an app developed to help doctors and nurses track recipients of vaccines to ensure they get a booster shot and to monitor for side effects.

Orange County Supervisor Doug Chaffee said the app will be called Othena, which is an homage to Athena, the goddess of war.

The county sill has available personal protective equipment, Kim said, adding the state “is doing a very good job with PPE. When we make a request, it arrives with a matter of days… The PPE is flowing.”

The county, which has 44% of its ventilators available, has also seen a rise in interest in take-home coronavirus testing kits. Last week, 17,000 kits were requested, compared with 19,000 people showing up in person at the county’s testing super sites.

A moratorium on diverting patients from one hospital to another initiated last week was extended again on Friday. Kim said it is being monitored daily to see if it can be lifted.

Meanwhile, the outbreak in the county’s jails continued to worsen, with 968 infections, up from 908 on Tuesday. The county is awaiting the results of 675 tests. On Friday, the county had its first coronavirus death of an inmate.

Outbreaks in the county’s nursing homes also continue to rise, with 45 skilled nursing facilities and 47 elderly assisted living facilities reporting two or more positive cases within the last two weeks.

The county recorded 21,535 tests on Wednesday, for a total of 1,906,582. The county is testing 606.1 per 100,000 population on a seven-day average with a seven-day lag, up from 526.8 last week.

All of the county’s metrics now fall within the state’s most-restrictive, purple tier of the state’s four-tier coronavirus monitoring system.

Orange County’s adjusted daily case rate per 100,000 rose Tuesday to 51.8, up from 42.7 last week. The positivity rate increased from 13.2% to 15.2%.

The county’s Health Equity Quartile Positivity Rate, which measures the cases in highly affected, needier parts of the county, rose from 18.8% last week to 22.7%.

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