Orange County moved much closer to escaping the most-restrictive tier of the state’s coronavirus monitoring system Tuesday, as the weekly update from the state showed that it meets a key criteria to be moved from the purple to the red tier.

The county’s test positivity rate improved from 7.8% last week to 5.4% Tuesday, and the adjusted case rate per 100,000 on a seven-day average with a seven-day lag improved from 20.7 to 11.9. The Health Equity Quartile Positivity Rate, which reflects the rates in lower-income and minority neighborhood hot spots, improved from 10.7% to 7%.

To get to the red tier, the county has to have a case rate per 100,000 of 4 to 7, positivity rate of 5 to 8% and a Health Equity Quartile rate of 5.3 to 8%. These metrics are updated every Tuesday.

The red tier allows for many more businesses and organizations to reopen. For instance, retail stores could allow for half capacity instead of 25%, and museums, zoos and aquariums could reopen for indoor activities at 25% capacity. Also, movie theaters, gyms and restaurants could open indoors at 25% capacity.

Dr. Clayton Chau, the county’s chief health officer and director of the Orange County Health Care Agency, told the Board of Supervisors that the county will be the first to allow for full-contact youth sports including football by this Friday.

The county has met the criteria for positivity rates for the past four days, Chau said.

“We’re waiting for the case rate to drop to the red tier,” he said. “If we maintain (all red tier metrics) for two weeks we can transition to the red tier.”

Also on Tuesday, the county opened up a new vaccine distribution site at the Anaheim Convention Center. The original plan was to open it on Wednesday, but with the delivery of 16,000 doses of Moderna vaccine on Tuesday, the county moved up the opening by a day.

“I received a text from staff that we actually did receive our allocation from last week this morning, so that will allow us to (reopen) our Super Pod (at Disneyland) tomorrow for the second dose,” Chau told supervisors. “We’re expecting (another) allocation for this week to come in sometime Thursday.”

Inclement weather back east slowed the delivery of doses, forcing a shutdown of some vaccine distribution points in the county.

Chau is expecting Johnson & Johnson to seek authorization for its vaccine Friday from the Food and Drug Administration.

“If it is authorized this Friday our first shipment would be here sometime next week, either Tuesday or Wednesday,” Chau said.

The Johnson & Johnson vaccine is different than the Moderna and Pfizer vaccines in that it does not require more than one dose and does not need to be stored in a freezer. But Chau pointed out it is not as effective in preventing illness as the Moderna and Pfizer vaccines, which are about 94% to 95% effective with a booster shot.

Chau, however, noted that all of the vaccines, including AstraZenca’s, which is expected to be considered for emergency authorization next month, will prevent infections leading to hospitalization or death.

Recent studies showed that even without booster shots from Pfizer and Moderna the effectiveness is about 85%, which beats Johnson & Johnson and AstraZeneca, Chau said. Also, Pfizer has determined its vaccine no longer requires deep freezing in storage.

“That is the game changer,” Chau said. “Up till now Pfizer has been difficult (to administer) because of the storage issues.”

The degrees of effectiveness has triggered a dialogue among public health professionals on which demographic should receive the Johnson & Johnson and AstraZeneca vaccines. Chau said seniors and those with chronic underlying health conditions should receive the more effective Pfizer and Moderna vaccines.

“I would not recommend Johnson & Johnson for seniors over 65” or those with chronic health conditions, Chau said. “Unless they choose to… It’s probably most appropriate for younger folks, folks without risk factors.”

Orange County Supervisors Don Wagner and Lisa Bartlett raised concerns about the state’s expanding the list of those qualifying for vaccines in the first phase to educators, childcare workers, food and agricultural industry workers and first responders. The county was already dispensing vaccines to first responders, but allowing all the other workers under 65 will slow vaccinations of seniors, Chau said.

The county is allocating 30% of its supply for the newly qualified and the rest for seniors 65 and older, Chau said.

Bartlett said the county has to figure out a way to make sure that food industry workers and educators prove their occupation and expressed concern that the influx of new vaccine seekers “could completely overwhelm our system and push out seniors from getting vaccine doses.”

Bartlett said “people are going to be screaming in the streets” if they don’t quickly get a vaccine despite being eligible.

Orange County CEO Frank Kim said it would help if state officials could provide three weeks’ notice on vaccine allocations so the county can schedule appointments further out than three or four days as is the case now.

“That would go a long way toward reducing the frustration of the community,” Kim said.

Chau said about half of the county’s seniors have been vaccinated so far. He believes the county can vaccinate all of its seniors by mid-March.

The county on Tuesday reported 250 new COVID-19 cases, raising the cumulative total to 245,135. There were no new fatalities, maintaining the death toll at 3,848.

Hospitalizations continued a downward trend, dropping from 556 Monday to 538 Tuesday, with the number of coronavirus patients in intensive care dropping from 179 to 152, according to the Orange County Health Care Agency.

The county has 18.9% of its ICU beds available and 61% of its ventilators.

The county reported 12,783 tests Tuesday, raising the total to 2,980,667.

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