Orange County reported 3,200 new cases of COVID-19 and one additional death Sunday, bringing the county’s totals to 147,463 cases and 1,846 fatalities.

The county continues to set records for COVID-19 hospitalizations, as that number rose to 1,990 on Sunday, with 443 of those patients in intensive care, according to the Orange County Health Care Agency.

The county’s state-adjusted ICU bed availability remained at zero, and the unadjusted figure rose to 7.3%, an improvement from 5.7% on Saturday. 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, Orange County CEO Frank 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 Wednesday. “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 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 were 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.

About 100 Orange County firefighters received the Moderna COVID-19 vaccine Saturday morning, part of an effort by the county’s health agency to prioritize first responders. The vaccinations took place at the Orange County Fire Authority Regional Fire Operations and Training Center in Irvine.

The county reported another 11,647 COVID-19 tests on Sunday, for a total of 1,975,944. There have been 80,615 documented recoveries.

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 stood at 51.8. The positivity rate was 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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