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Orange County’s pace of hospitalizations and deaths from coronavirus have been consistently rising faster than its neighbors in recent weeks, and its rates have now overtaken three of the surrounding counties.


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For the better part of the pandemic, which took hold locally in mid-March, Orange County’s deaths and hospitalizations for coronavirus were lower than all four of its surrounding counties on a per-resident basis.

But while other counties have seen hospitalizations and deaths rise more slowly or decrease, OC has jumped in recent weeks. For the last several days, Orange County’s rates have been higher than San Diego, Riverside and San Bernardino counties, as OC continues to climb.

OC’s pace of hospitalizations and deaths from coronavirus are now at their highest levels so far of the pandemic, with 83 people dying in the past two weeks and 364 people in the hospital as of Tuesday, according to data published by the California Department of Public Health.

“Covid cases are on the rise and we expected that when we reopened the economy,” county CEO Frank Kim told Voice of OC regarding the county overtaking most of its surrounding counties’ rates.

He noted that Dr. Nichole Quick, the county’s former health officer, repeatedly said cases would rise as the economy re-opened.

“As we reopen our economy, the positive cases will go up,” said Dr. Clayton Chau, director of the Orange County Health Care Agency and acting health officer, in a statement to Voice of OC Wednesday about the rising hospitalizations and deaths.

“To mitigate this,” Chau said he’s asking the community to limit the virus’ spread by, among other things, wearing face coverings when a 6-foot distance can’t be maintained from people outside of their household, unless it’s unsafe to wear a mask.

“Transmission is most likely when people are in close contact with an infected person, even if that person does not have any symptoms or has not yet developed symptoms,” Chau said.

“Certain groups, including people aged 65 or older and those with serious underlying medical conditions, such as heart or lung disease or diabetes, are at higher risk of hospitalization and serious complications. So, please remain at home and only go out for essential services,” he added.

Nursing homes have been hit particularly hard by coronavirus in Orange County, with about half of the 243 deaths so far in the county, according to the latest data from the county Health Care Agency. County officials have said group living facilities like nursing homes, jails and homeless shelters are at higher risk of outbreaks, because of the way the virus spreads from person to person.

Chau also urged the public to “avoid contact with people who are sick, do not gather in groups, stay out of crowded places, [and] avoid mass gatherings.”

“I think with the increased exposure with business opening, it’s natural” there would be an increase of coronavirus cases, Supervisor Doug Chaffee said in an interview Wednesday about the rising numbers in OC.

“[It] seems to me we’re getting a ramp up in the number of cases,” Chaffee said. “It does seem to be that the higher [numbers] are getting higher. I hate to see that, but…as long as we’ve got the hospital capacity and the ability to treat people, we’re still okay.”

Supervisor Don Wagner, who has called for a safe re-opening of the economy, said the rising hospitalization and death rates are concerning and encouraged residents to wear masks.

“That [the rates] are climbing is a concern. And it’s important that we get a handle on it,” Wagner told Voice of OC in an interview Wednesday.

To prevent the virus’ spread, Wagner said people should wear masks when they can’t maintain a 6-foot distance from people who don’t live in the same household.

People shouldn’t interpret the county’s pulling back of a mandatory mask order as a sign that masks aren’t recommended anymore, Wagner said.

“Masks do work. If you can’t maintain social distancing, wear a mask. If you are sick, wear a mask,” Wagner said.

Lucy Dunn, president and CEO of the Orange County Business Council, echoed that concern, saying mask-wearing is effective and crucial for ensuring businesses can stay open by preventing spikes in infections.

“We watch other countries that are ahead of us. And as a result, we know that the number-one preventative measure [against] exponentially increasing infections is to wear masks,” Dunn told Voice of OC Wednesday.

“Now that businesses are open, we want to keep them open. Please wear a mask.”

Local hospitals have been weighing in as well, with the Children’s Hospital of Orange County (CHOC) expressing concern about rising hospitalizations if mask wearing continues to be rejected by many in the community.

“Safe reopening is critical, and mask wearing is among the limited remaining tools at our disposal to protect ourselves and one another from rapid escalation of disease,” CHOC executives wrote in a letter last week to county supervisors.

“We fear two likely outcomes if our community continues to reject the necessity of mask wearing,” including “rapidly rising COVID-19 caseloads and hospitalizations, potentially triggering widespread closures shortly following reopening.”

The daily count of people hospitalized for coronavirus in Orange County reached a new high on Tuesday, with 364 patients – up from 251 people in the hospital a month earlier, according to the state data.

The number of deaths reported each day fluctuates significantly, so Voice of OC examined deaths reported over a rolling 14-day period, for a more accurate comparison of counties’ overall trends.

Over the 14 days ending Tuesday, 83 people died from coronavirus in Orange County, more than at any other time during the pandemic, according to the data from the California Department of Public Health.

That translates to 26 deaths per million residents in OC, compared with 3 per million in San Diego County, 10 per million in San Bernardino County and 21 per million in Riverside County over the same two-week period.

[Click here for a spreadsheet of the hospitalization and death rates by county.]

Medical experts said it’s important to recognize the virus continues to spread in Orange County and elsewhere.

“We’re now re-opening the county. And in my own personal observation, I think people have misinterpreted that to mean that they could go back to a lifestyle consistent with what they had before the pandemic,” said Dr. Thomas Cesario, an infectious disease doctor in Orange County and former longtime dean of UC Irvine’s medical school.

“We know the virus is still here, and we know that the curve of the cases in California in general, is on the upswing,” he added.

“Social distancing and masks, which combined with quarantining and tracking, have really been quite effective. And if you look at places in the world that have been strict in complying with those, it really does work,” Cesario said.

“The science now is getting overwhelming” about the effectiveness of masks, he said, pointing to journal articles like one published last week in the Proceedings of the National Academy of Sciences.

“We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic,” the authors wrote after analyzing data from Italy, New York City and Wuhan, China.

“I think if you don’t want to wear a mask you risk two things. You risk getting the virus, but you also risk giving it to somebody, or bringing it home to your family,” Cesario said.

“It’s going to be important that we do our best to ensure the safety of the public,” said Dr. Jason Cord, the incoming president of the Orange County Medical Association.

“I think that we want to maintain social distancing as much as possible. And I think that we have to be vigilant with the numbers and to make sure that we have adequate capacity to handle anything that’s thrown at us,” said Cord, who called the increasing hospitalization and death rates “concerning.”

“I believe that masking helps prevent the spread of the disease. And I certainly think that it would be best if we could social distance as much as possible,” he said.

Wagner noted that some of OC’s hospitalization increase is from out-of-county patients brought in from Imperial County and elsewhere, but that it accounts for only part of the increase.

As of Monday, Orange County hospitals reported having 26 coronavirus patients with out-of-county addresses, according to the county. 

That’s only about 8 percent of the 346 coronavirus patients reported in OC hospitals on Monday. 

San Diego County hospitals also received patients from Imperial County.

“It’s not a big number, but it is a number that inflates our rates,” Wagner said of the out-of-county patients.

The daily hospitalization counts come from mandatory data hospitals provide to the California Department of Public Health, which then publishes daily county-by-county data on its website.

The state data includes all 33 hospitals in Orange County. County officials recently switched to the state data for the hospitalization counts on the county’s official coronavirus website, though the county removes seven hospitals’ data from those numbers, which results in lower numbers reported on the county website.

Asked why they report data on 26 hospitals rather than all 33, county health officials previously said they keep the data to the 26 hospitals that have emergency departments and licensed ICU beds.

Asked again on Wednesday, county officials said they plan on switching to showing the complete state data for OC in the coming weeks.

“We will be switching to report [state] data for all 33 hospitals when we launch a new dashboard in the coming weeks – in order to [simplify] and streamline data processing/reporting,” said Curtis Condon, research manager at the county Health Care Agency, in a statement.

Before the June 3 switch to state data, the county website was reporting voluntary data the county collected from hospitals that was reported inconsistently and from fewer hospitals, with 25 reporting on some days and 21 on others.

Wagner, the county supervisor, said he hopes the re-opening of the economy is done safely, to prevent a surge in cases that could lead to a return to more restrictions.

“We’re headed towards a re-opening and opening more and more things. My hope is, and my expectation is, that [the county Health Care Agency] will keep a close eye on things. That, again, it will be done right, it will be done safely,” said Wagner, who has pressed county staff for clear answers on what thresholds would cause restrictions to be re-imposed.

“My real fear is that if there’s a second surge and we’ve got a mandatory [mask order] in place…we’ll have no fallback other than to shut things down again, and that would be a disaster,” he added. “I just don’t want to go to shutting down things again.”

Nick Gerda covers county government and Santa Ana for Voice of OC. You can contact him at ngerda@voiceofoc.org.

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