While it seems that the number of people hospitalized for Coronavirus in Orange County stabilized this week, there is concern that daily death counts seem to be creeping up, now well into the double digits with 22 people reported as killed by Covid on Thursday.
Orange Health Care Agency officials on Thursday also confirmed that they are increasingly transferring Covid patients from hospitals into skilled nursing facilities.
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An unknown number of Orange County’s coronavirus hospital patients have been moved to long term care facilities and skilled nursing facilities as hospitalization numbers ticked up the past couple weeks.
“Yes, hospitalized COVID-19 positive patients are being discharged to long term care facilities. The OC Health Care Agency (HCA) does not track individual transfers. However, when a hospitalized COVID-19 positive patient is transferred to a Skilled Nursing Facility (SNF), that patient would be subtracted from the hospitalized count (by the sending hospital) and added to the SNF count via the state daily reporting,” HCA staff said in a Thursday email.
A daily situation report from the county Office of Emergency Medical Services on Thursday shows there’s been an increase of over 500 virus-positive patients in skilled nursing facility cases since the beginning of the month to 1,837 cases. The report doesn’t note which cases are transfers and which ones are virus cases originating from the facilities.
At a Thursday news conference, OC interim health officer Dr. Clayton Chau said he hasn’t heard of any surges at the skilled nursing facilities.
In normal times, Chau said, “a patient gets into an acute hospital and … the next level of care that they need is a skilled nursing facility, then the hospital, as well as the family and their insurance company, will try and find a skilled nursing facility that is appropriate to place people.”
“As far as I know, I have not heard any surge in skilled nursing facilities,” Chau said. “I’ve not heard staff reporting that we’ve had an issue yet.”
UC Irvine epidemiologist Andrew Noymer said the transfers to nursing facilities could explain why hospitalizations are remaining relatively steady.
“So that could explain why all the hospital numbers looked like they plateaued,” Noymer said in a Thursday phone interview.
But, Noymer said, the deaths continue to increase.
“There’s no shirking the deaths, I mean 22 deaths today,” Noymer said. “I know the death reporting is clunky… but the seven-day average is 2.1 percent per day.”
When deaths are reported, they can span a window of up to eight days, the Health Care Agency notes on its website.
“So that’s the number that I’ve been watching and I’ve been doing seven-day averages precisely so we don’t go crazy over single day jumps because those are just reporting issues,” Noymer said.
Meanwhile, the virus has now killed 543 people out of 32,648 confirmed cases, according to the county Health Care Agency.
There are 690 people hospitalized, including 233 in intensive care units.
Over 380,000 tests have been conducted throughout OC, which is home to roughly 3.2 million people.
Dr. Paul Yost, who’s an anesthesiologist at St. Joseph’s Hospital in Orange, said it would be helpful to know how many hospital cases are transferred to skilled nursing facilities so the overall picture of the county’s healthcare system can be better understood.
Yost, the CalOptima board chairman, also noted the current system wasn’t designed for a pandemic.
“Our whole healthcare system is not designed something like this — a pandemic — that strikes a large percentage of the population,” he said. “It’s designed around providing high quality care around things like heart surgeries … but a global pandemic, it’s not designed for.”
Noymer said he can’t predict which direction OC heads from here, based on the recent patterns.
“So here’s the thing, we’re basically treading water. When I look at the OC numbers the past few days, I see a county that’s not changing very much. And compared to three weeks ago, we’re worse. But compared to last week, we’re holding steady. So you can say we’re about to turn the corner and do better or take the plunge into a precipice. And I can’t tell you exactly which of the two it is.”
Here’s the latest on the virus numbers across Orange County from county data: