The Orange County Health Care Agency Monday reported one more COVID-19 fatality, raising the region’s death toll to 1,287, along with an uptick in hospitalizations.

According to the HCA, hospitalizations increased from 155 Sunday to 168 Monday, with the number of patients in intensive care up from 47 to 53. The change in three-day average hospitalized patients stands at -7.1%.

The county has 34% of its intensive care unit beds and 38% of its ventilators available.

The latest reported death involved a skilled nursing facility resident. Since the pandemic began, 463 skilled nursing facility residents and 89 residents of assisted living facilities have succumbed to the virus.

The HCA on Monday reported 120 newly confirmed coronavirus cases, hiking the cumulative case total to 54,760.

Supervisor Lisa Bartlett and CEO Frank Kim said the increase in case rates is not unique to Orange County.

“It’s not an anomaly, it’s happening in Riverside, San Diego and Los Angeles and Orange County,” Kim said. “It’s a result of reopening industry sectors and it was an expected outcome that we’d see rising case counts… But as long as we don’t blow up, we’ll call ourselves fortunate. Is it manageable? So far it is because it hasn’t affected our hospitals. Am I concerned? Yes, and we’re watching it.”

What’s causing the rising case rates is hard to pin down other than more businesses reopening, Kim said.

“There is no clear trend,” he said. “It’s spread across the population base under 44. The older population case counts are fairly low. So it’s people going to work, shopping, socializing.”

Bartlett said young adults socializing with each other is an ongoing problem.

“That’s why with universities opening up people are concerned,” Bartlett said. “While they have good health protocols you’ve still got multiple kids in dorm rooms and apartments and they tend to migrate around so we’ll just have to wait and see how the numbers turn out.”

According to HCA data, 900,010 COVID-19 tests have been conducted, including 3,393 reported Monday. There have been 48,923 documented recoveries.

One of the thorniest problems is young adults renting out vacation residences for parties, according to Kim.

The positivity rate, which is reported each Tuesday, stands at 3.1%, the same as the week before, but the daily case rate per 100,000 people went up from 3.6 to 4.4, which is higher than the cutoff of 3.9 to qualify for a move from the red to the orange tier in the state’s coronavirus monitoring system.

Students returning to school don’t appear to have been an issue, according to Dr. Matthew Zahn, the medical director of the county’s communicable disease control division.

“At this point, we see really minimal activity,” Zahn said last week. “What we’ve seen so far is quite encouraging.”

Bartlett has said there is concern about a seesawing back and forth between the red and orange tiers because if the county has to step back a tier, that locks it into place for at least three weeks even if the metrics match a less-restrictive tier.

State officials were expected on Friday to announce new guidelines for mass gatherings but did not do so. The mass gatherings include theme parks, concerts and sporting events. The expectation was that those types of activities will not be allowed until a county moves up to the least restrictive tier of yellow, which could take months.

Board of Supervisors Chairwoman Michelle Steel has criticized the state for “dragging its feet” on issuing reopening guidelines for theme parks like Disneyland in Anaheim and Knott’s Berry Farm in Buena Park.

“We need these parks to reopen not for our children and tourists but our businesses and communities that rely on them,” Steel said. “I am disappointed at the lack of progress California has made in this and every other area while other governments have made safe reopenings of their theme parks. California continues to delay and this has resulted in the loss of 28,000 jobs… All of this could have been avoided.”

To qualify for the orange tier, the positivity rate must be 2% to 4%, and the case rate per 100,000 must be 1% to 3.9%.

Moving to the orange tier means retail businesses could operate at full capacity, instead of 50% as required in the red tier. Shopping malls could also operate at full capacity, but with closed common areas and reduced food courts, just as in the red tier.

The orange tier boosts capacity for churches, restaurants, movies, museums, zoos and aquariums from 25% capacity to half capacity. Gyms and fitness centers could boost capacity from 10% to 25% and reopen pools.

The orange tier also allows family entertainment centers like bowling alleys and wall-climbing to open indoors at 25% capacity.

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