Orange County’s coronavirus death count has numbered 140 new deaths over the past 14-day period ending Sunday, the highest since the pandemic began, which means the county is likely to remain on a state watchlist seriously limiting business for the foreseeable future.  

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Dr. Saahir Khan, who works at UC Irvine’s Medical Center in Orange caring for virus patients, said deaths are a lagging benchmark to measure virus progression. 

“I think deaths are the last indicator of what’s going on with the COVID-19 pandemic. So they really reflect the increase in cases and hospitalizations two weeks ago,” Khan said in a Monday phone interview. 

“I expect the deaths to start to plateau, if the plateau in hospital numbers is accurate,” he said. 

Last week, OC Health Care Agency staff said virus patients are being transferred from hospitals to long term care facilities and skilled nursing facilities. But, the agency isn’t keeping a detailed tally on who’s going where and how many people have been transferred. 

“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 an email last Thursday. 

Khan, who’s an infectious disease expert, said the transfer numbers need to be tracked to paint a complete picture of OC’s situation.

“Now I do think we need to look at how many patients are transferred to long term acute care facilities or other higher care facilities that may not be counted in the numbers. But assuming the hospitalization rate is truly plateaued, I would expect [those numbers] do that as well,” Khan said. 

The virus has now killed 566 people in Orange County, out of 34,646 confirmed cases, according to the county Health Care Agency.

As of Monday, more than 100 deaths have been reported since July 1. The agency notes there could be up to an eight-day lag time in reporting deaths. 

June was the deadliest month, so far, with more than 200 deaths reported that month. 

Longtime Dean of UCI Medical School, Dr. Thomas Cesario, said the deaths might not increase from the earlier case spikes because doctors and researchers have found better treatments for hospitalized patients. 

“We may be able to taper that a little bit as we learn better how to take care of these patients,” Cesario said. “I’m a little discouraged on how this is going — the overall trends. I was hoping by now we would begin to see some of this start to fade.” 

Hospitalizations remained somewhat steady at 661, including 204 people in intensive care units. 

Just over 393,000 tests have been conducted throughout OC, which is home to roughly 3.2 million people. 

A couple months ago, County officials announced a partnership with UCI researchers and doctors to determine the prevalence of the infection in OC residents. 

Khan is part of that team, which is conducting blood testing to look for antibodies from the virus to estimate what percentage of county residents have had the virus. 

“When I look at how many people have likely been infected in this county, most of us are still susceptible,” Khan said. 

The study is still ongoing, Khan said, which prevents him from releasing specifics on it. 

“But I will say that we are clearly not at herd immunity. We’re not close to herd immunity and our numbers do not seem far out of proportion to similar studies that have been done in other parts of the country, at least places that have not experienced a much greater surge than we have,” he said. 

Nearly all Californians are on the state’s coronavirus watchlist because their respective counties, including OC, are seeing dramatic increases in positive virus cases and hospitalizations and deaths. 

“We certainly have organized 93 percent of the population represented in those 37 counties,” Gov. Gavin Newsom said at a Monday news conference in Stockton. 

OC has been on the watchlist since late June, shortly after it was created. Newsom has gradually shut down gyms, nail salons, movie theaters, barbers, indoor shopping malls, churches and a host of other businesses since the beginning of the month by barring their indoor business operations. All bars are closed indefinitely. 

Newsom didn’t say when counties can come off the watchlist, but said each county will get an individual assessment. He didn’t say what metrics state health officials will evaluate counties on or any potential revisions to the current ones.  

“Each county has their different capacity, different needs, different expertise. All of those will be assessed on an individual basis as it relates to further modifications,” he said. 

Khan echoed what his colleague, UCI epidemiologist Andrew Noymer has repeatedly said, called for business reopenings to be phased in so experts can study the impacts. 

“So what I would do is any time you make a change, you want to give it two to three weeks to see the effect of that change. So I would probably start opening up outdoor areas, along with social distancing,” Khan said. 

Like Noymer, Khan said bars and indoor restaurants have a high likelihood of virus outbreaks. 

“To me the highest risk is indoor bars and restaurants, and so Ii would wait on that until we make some other steps and see the effect of those.” 

Cesario also agreed with his two colleagues. 

“The worst place is small, tightly closed quarters.” 

Here’s the latest on the virus numbers across Orange County from county data:

An earlier version of this story incorrectly referred to the two-week time frame as the highest average, instead of the highest two-week period of deaths. 

Spencer Custodio is a Voice of OC staff reporter. You can reach him at Follow him on Twitter @SpencerCustodio

Reporter Nick Gerda contributed to this story. 

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