Orange County Friday continued its record-setting trend of COVID-19 hospitalizations and recorded the first death of an infected inmate in its jails.

The county logged 2,594 new coronavirus infections, hiking the cumulative case total to 116,377, and three more fatalities, raising the death toll to 1,734.

Since Sunday, 54 deaths have been reported in Orange County. Last week, the county reported 62 fatalities, up from 41 and 26, respectively, in the two previous weeks.

Hospitalizations jumped from 1,519 Thursday to 1,557 Friday, including 358 intensive care unit patients, up from 343 the previous day. Both are new records — a daily occurrence dating back to last week.

The county’s ICU bed availability increased from 7.1% Thursday to 9.2% Friday, but in the “adjusted” metric, it remained zero. The state created the adjusted metric to reflect the difference in beds available for COVID-19 patients and non-coronavirus patients.

The 11-county Southern California region’s percentage of available ICU beds remained at zero for the second consecutive day.

Dr. Clayton Chau, the director of the Orange County Health Care Agency and the county’s chief health officer, issued two orders this week in an attempt to reduce the spread of the coronavirus in nursing homes and to follow suit on quarantine durations recommended by the Centers for Disease Control and Prevention.

Chau issued an order Tuesday prohibiting communal dining and group activities in residential care facilities for the elderly when a patient or staffer is diagnosed with the coronavirus.

The group dining and activities can resume after two consecutive rounds of COVID-19 tests of all residents and employees at least a week apart come back negative.

On Thursday, Chau also shortened quarantines from 14 days to 10 days to follow the new guidance from the CDC.

Orange County CEO Frank Kim said the health order for care facilities for the elderly came about after state officials asked the county to help the nursing homes.

“Based on our review it appeared that in a lot of (the facilities) they were eating together in dining rooms and not taking as many precautions as recommended,” Kim said.

Kim said he was “concerned” about the rising case counts and hospitalizations.

Beyond ramping up testing and setting up mobile field hospitals to help overflowing medical centers, Kim said, “All you can do is implore people to change their behavior.”

Hospital executives and doctors have told him, “their biggest fear is Christmas,” Kim said.

“They’re looking at the trend and they don’t see the end of the tunnel yet,” Kim said. “They’re concerned. They’re activating their surge plans. Several are requesting mobile hospital units and we’re responding immediately.”

Without closer compliance to social distancing, hygiene, face masks and staying home as much as possible, “We won’t be able to change the course of this disease, at least not until vaccines are available in large quantities.”

Orange County Supervisor Lisa Bartlett noted how some neighboring counties are seeing double the coronavirus cases than Orange County and are at zero capacity for patients, so Orange County will likely have to take some of them on.

County officials received a bit of good news when it was discovered that the county received extra doses of the new Pfizer vaccine.

“Some of the vials have extra doses,” she said. “So we’re getting more doses than anticipated, so that’s a good thing.”

Bartlett said residents just have to be more mindful of COVID-19 safety guidelines.

“It’s better to have COVID fatigue than COVID,” Bartlett said.

Hospital officials are “very concerned they won’t have enough hospital beds” if there is another surge matching the one from Thanksgiving.

“And certainly they won’t have enough staffing,” Bartlett said.

If the hospitals are “overwhelmed” then doctors will have to make “difficult choices’ when triaging patients, Bartlett said.

“We don’t want to get to that point,” she said. “We want to serve every single individual who comes into the ER.”

The annual Christmas Boat parade in Newport Beach was canceled this year, but that didn’t dissuade some boat owners from organizing an unofficial one.

John Pope, a spokesman for Newport Beach, said the city’s police are partnering with the Orange County Sheriff’s Department’s harbor patrol to provide enough staffing to aid boaters in any emergencies, but that they won’t attempt to stop the parade or break up any crowds of spectators.

“As far as the city is concerned it is a public safety issue,” Pope said. “Harbor patrol and lifeguard boats are out there with a presence on the water for safety purposes and coordinating with the Orange County sheriff to provide basic public safety protections.”

The Orange County Health Care Agency this week issued an order suspending the ability of hospitals that take part in the 911 system to request a diversion of ambulances to other medical centers.

Dr. Carl Schultz, the agency’s EMS medical director, said in a statement that hospital emergency rooms have become so overwhelmed due to the COVID-19 surge that “almost all hospitals were going on diversion.”

“If nothing was done, ambulances would soon run out of hospitals that could take their patients,” Schultz said.

“Therefore, we temporarily suspended ambulance diversion. While this will place some additional stress on hospitals, it will spread this over the entire county and help to mitigate the escalating concern of finding hospital destinations for ambulances.”

Schultz added: “To the best of our knowledge, this has never happened before.”

The county has rolled out mobile field hospitals to help with the overflow. UC Irvine Medical Center, Fountain Valley Hospital and Hoag Memorial Hospital Presbyterian received 50 more beds each, and St. Joseph’s Hospital in Orange got 25 more beds.

About 5 a.m. Friday, 68-year-old murder defendant Eddie Lee Anderson, who was hospitalized Sunday for COVID-19, was pronounced dead, making him the first inmate in the county to die of the virus.

As of Friday, 615 inmates in county jails were infected with COVID-19, including 35 from new bookings.

Orange County’s adjusted daily case rate per 100,000 rose Tuesday from 30.3 the previous week to 42.7, with the positivity rate increasing from 10.6% to 13.2%. The county’s Health Equity Quartile Positivity Rate, which measures the cases in highly affected, needier parts of the county, rose from 16.2% last week to 18.8%.

The county is testing 526.8 people per 100,000 on a seven-day average with a seven-day lag, which is an all-time high.

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.

Prior to this month, the record for ICU patients in Orange County was 245 during the mid-July surge. Overall hospitalizations have been breaking records daily since Dec. 2.

The county received its first shipment of Pfizer’s coronavirus vaccine Wednesday. About 25,000 doses were delivered.

Vaccines continued to arrive in Orange County on Thursday, and county officials are expecting about 32,000 doses of the Moderna vaccine next week. A Food and Drug Administration advisory committee has recommended approval, paving the way for full emergency authorization by week’s end.

The county is also dealing with an uptick in outbreaks at skilled nursing and assisted living facilities. As of Friday, 33 skilled nursing facilities have had two or more confirmed cases of COVID-19 within the past two weeks, and 35 assisted living facilities had two or more cases.

County officials have been asked to provide personal protective equipment, more training or staffing to help curb the spread of COVID-19 in those facilities, where the main reason for the spread is likely from employees who contract the virus off-site, Kim said.

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