As Orange County comes off the state coronavirus watchlist, there’s still nagging questions about whether there’s more virus cases than county health officials have publicly stated.
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State counts for infected people with coronavirus in Orange County looks very different from the county’s. And both are still over the threshold established by the state to come off the watchlist.
When OC came off the list Sunday night, several state thresholds were reportedly met to come off the list.
Counties across the state were placed on the watchlist for worsening virus trends, like more than 100 new cases per 100,000 residents over a 14-day period, a testing positivity greater than 8 percent during a seven-day period, or increasing hospitalization rates.
According to county and state officials, Orange County met the thresholds for hospitals and testing positivity rates to come off the watchlist.
But there remains conflicting data on the number of cases per 100,000 people.
As of Monday, county Health Care Agency virus update website shows 85.1 cases per 100,000 residents, which is 15 below the state threshold.
Meanwhile, the state’s county monitoring website shows 186 cases, which is more than 100 above the state threshold. And the state’s virus watchlist shows 180 cases.
Despite stark differences in outstanding case estimates and the fact that both state numbers exceed the state threshold, state and county officials have apparently agreed to ignore the discrepancies on case estimates.
After interviewing a host of county and state public health officials, it still isn’t clear why the case estimates are so different.
OC Health Care Agency officials said they use state methods to report the data.
“OC reports the state’s calculation of 14-day case rate + 3-day lag. OC does not make a separate calculation,” said Health Care Agency Chief of Operations, Marc Meulman, in a Monday email.
The three-day lag accounts for delays in testing results, meaning Monday’s published calculation stretches two weeks back from Friday.
State health officials said they calculate the cases per 100,000 residents by both the date the test was reported and when the test results are completed or “onset date.”
“Both the CDT (County Data Tracking) website and the County Data Monitoring Process access the same data source. However, CDT calculates rates based on the date on which the case was reported to CDPH. Whereas, CDM calculates rates based on ‘episode dates’, which could represent patient onset date, diagnosis date, etc. Both rate calculations can vary depending on the lag with which cases are reported,” said California Department of Public Health officials in a Monday email.
Because OC is no longer on the watchlist, the rate per 100,000 people no longer shows on the watchlist, but an archived list from Aug. 16 — the latest available in the archives — showed 117.9 people. The county tracking dashboard shows OC with 186 cases per 100,000 people, which is calculated by the date cases are reported.
Some OC residents suspect county health officials are using a different lag time to artificially lower the number because they’re under pressure to stay off the watchlist.
Meulman said they’re using state methods.
“For State Monitoring Criteria, OC is posting the state calculations based on their methodology. OC is not using a two-day lag calculation,” Meulman said.
The standard is a three-day lag.
Gov. Gavin Newsom, at a news conference last Friday, said state health officials would sort out the data issue with Health Care Agency officials.
But Health Care Agency officials didn’t say how that was done over the weekend when asked by Voice of OC.
Since the pandemic began in March, the virus has now killed 897 people out of 46,307 cases, according to the county Health Care Agency.
For context, Orange County has averaged around 20,000 deaths a year since 2016, according to state health data. According to those same statistics, the flu kills about 543 OC residents annually.
As of Monday, 388 people were hospitalized with the virus, including 116 in intensive care units.
Nearly 598,000 tests have been conducted throughout OC, which is home to roughly 3.2 million people.
Meanwhile, if the county stays off the watchlist for 14-days, schools can begin reopening. Those decisions will have to be made by local school boards.
When Orange County first hit the watchlist in late June, state health officials shut down bars and halted indoor operations at movie theaters, malls, restaurants, beauty parlors and various entertainment centers. They also shut down non-essential office buildings.
Any business reopenings will be determined by state health officials.
Newsom, at a Monday news conference, said new reopening guidelines will be released Wednesday.
While the Governor didn’t elaborate what the guidelines will address or how reopenings will be handled, he said hair and nail salons will be included in the incoming reopening guidelines.
“Beauty and hair industry and the like, they absolutely are a big part of the conversation we’ve been having for weeks now,” Newsom said. “They are part of the guidelines that we’ll be putting out later this week.”
Here’s the latest on the virus numbers across Orange County from county data:
A previous version of this story incorrectly classified the county data monitoring list number as cases per 100,000 people. That number is tests per 100,000 people. We regret the error.
Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio