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A second wave of coronavirus infections could be hitting Orange County after a series of upticks over the past week, with over 500 new cases reported Sunday.
The county hasn’t seen over 400 new cases reported since early August, when OC was coming out of the summer case spikes. Monday saw an additional 308 cases reported.
All of the counties surrounding OC, except for San Diego, are in the state’s most restrictive tier of business reopenings because of high positivity rates and daily case rates.
UC Irvine epidemiologist Daniel Parker said new cases could paint a picture of what was happening a couple weeks ago.
“The tricky thing is that when the cases start going up, that’s probably something that’s happened two, three weeks ago. So the transmission that’s happening right now, you’re not going to see that in cases for two or three weeks. So when they show up in the numbers it’s too late,” Parker said.
Last week, OC’s new daily case counts crept above 300 a day before hitting 512 on Sunday.
Parker said the best way to measure how much the virus is spreading in OC is daily new cases, hospitalizations, the positivity rate and new cases per 100,000 residents.
“It’s good to keep up with the different metrics. Because one metric could shoot up and it could be a statistical blip,” Parker said. “You could have a bunch of cases reported on the same day.”
By Sunday, there were 201 people hospitalized, including 72 people in intensive care units. That’s the highest hospitalizations have been since mid September.
The highest number of hospitalizations happened during the summer virus wave, when over 700 people were hospitalized at one point in July.
Parker’s colleague, UC Irvine epidemiologist Andrew Noymer said the number of people in ICUs could indicate a second wave.
“When the ICU stays above 70 for a few days in a row, that’s when we know the game’s on,” Noymer said. “But make no mistake about it, there’s going to be a second wave in Orange County and nationwide.”
At the same time, the positivity rate in OC has been hovering around 3.6%, but the average daily new cases is 6 per 100,000 residents — a metric that’s climbed over the past weeks. A couple weeks ago, OC had an average of 3.5 new cases per 100,000 residents.
If the average daily new cases hits 7 and stays there for a few weeks, that means OC could move back into the Purple Tier on the state’s reopening system.
For now, Orange County sits in the Red Tier.
That means retailers, malls, beauty salons, movie theaters, restaurants, gyms and places of worship are open under limited capacity.
Larger entertainment venues, like theme parks, sports stadiums and bowling alleys remain closed.
A move back to the Purple Tier would see movie theaters close, while restaurants and houses of worship would have to move their operations outside. It would also further limit the number of people allowed inside malls and retailers, depending on the specific guidelines for each industry.
“Certainly the increase in case counts is of a concern,” said Dr. Matt Zahn, director of the Communicable Disease Control Division Orange County at the county Health Care Agency, at a Friday news conference.
“But it’s really important at the same time we can’t let our guard down,” Zahn said. “You can’t lose sight of the fact that since we’ve done well in the last two or three months. That’s been a hugely important part, for one, our community to open up and go into the Red Tier, and two, to prevent serious illness and death in our community.”
He also said county public health officials have noticed fatigue around OC, meaning people may begin to stop wearing masks and avoid large gatherings or crowding indoors.
“By the same token, the virus is not gone. And I think we all know there’s COVID fatigue and i think we all feel it,” Zahn said, noting the upcoming holidays. “We all think of family gatherings, social gatherings, work gatherings. Unfortunately, you have to think about those gatherings differently, because there is a risk there.”
Most of the counties surrounding OC — Los Angeles, Riverside, San Bernardino — sit in the purple tier. San Diego remains in the Red Tier.
Speaking at a Monday news conference, Gov. Gavin Newsom said more counties are expected to move back to the Purple Tier during Tuesday’s weekly tier update.
OC is likely to stay in the Red Tier.
State officials are also warning of virus fatigue and a looming second wave.
“People are letting their guard down. They’re taking their masks off,” Newsom said. “We’re starting to see more people mixing … so this was anticipated, no one was surprised by it.”
Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, said public health officials across the state are seeing increased virus transmission from people holding parties and other gatherings.
“They mention private household gatherings as a major source of spread,” Ghaly said at the Monday news conference.
Since the pandemic began in March, the virus has killed 1,509 people, out of 62,563 confirmed OC 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. Of that number, cancer kills over 4,600 people, heart disease kills over 2,800, over 1,400 die from Alzheimer’s disease and strokes kill over 1,300 people.
According to those same statistics, the flu kills about 543 OC residents annually.
Hospitalizations continue to creep up also.
As of Monday, 205 people were hospitalized because of the virus, including 76 in intensive care units.
Meanwhile, some Orange County parents are driving their children to Arizona and Nevada so they can play youth sports games like baseball, soccer and softball because current state guidelines only allow for practice and not games.
Zahn said county Health Care Agency officials haven’t seen any cases stemming from the road trips, but said he worries about increased virus exposure because of what people may do when they get out of state.
It’s still unclear when state public health officials will update the guidelines to potentially allow for some games.
Parker said youth sports games are tricky during the pandemic.
“I would say something like soccer, if you don’t really have a high burden in the community and you’re getting around that indoor time with people, that seems like it’s not a high risk. We all have to find some acceptable levels of risk because we can’t just stay indoors forever,” Parker said.
Although he said sports like wrestling or indoor basketball is concerning because the virus spreads easier indoors.
“The outdoor activities where you’re not forced to be in real close proximity to people for a lot of time, that doesn’t worry me too much,” Parker said. “If you’re on a soccer field or football field, then you’re going to be coming into closer contact with people,” Parker said. “So it’s not completely risk free. But being outdoors helps a lot, really.”
Because of the ever-changing situation with the virus, Parker said people will have to constantly do risk assessments before trying to resume pre-pandemic activities.
“You’re not going to completely stop living, you’re just going to balance out risky behaviors. Like, how important is it for me to drink a beer in a bar tonight, which is a really risky thing to do. Or go to the park to play catch, which is less risky,” Parker said. “We just have to find ways to balance these things out.”
Here’s the latest on the virus numbers across Orange County from county data:
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio