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Orange County’s response to the coronavirus pandemic was largely marked by county Supervisors challenging Gov. Gavin Newsom and state public health orders at nearly every turn.

When the second wave began hitting in early November, Orange County Supervisors clamored for local control over public health orders in an effort to get more businesses open. 

During that time, hospitalizations and daily case rates were steadily increasing. 

In early December, Supervisors challenged Gov. Gavin Newsom on the regional shutdown order that took place after Southern California’s available intensive care unit beds fell below 15%. 

By the end of December, the region was out of ICU beds for coronavirus patients, according to state officials. 

Dr. Jim Keany, an emergency medicine physician at Mission Hospital in Mission Viejo, fears hospitals could soon be overrun if trends continue. 

“From all indications the way things are headed now, there’s no question that the medical systems in our area will be overwhelmed,” he said. “In a matter of weeks.” 

Hospitals have had to roll back some non-emergency procedures in an effort to free up staff to treat virus patients. 

Doctors interviewed by Voice of OC during the pandemic aren’t worried about building more ICU beds, but the ability to staff those beds. 

The governor’s order shut down nonessential businesses like barbers and beauty parlors. It also closed outdoor dining, but restaurants can still do take out and delivery. 

According to various social media posts and news reports, many businesses, like restaurants and bars, are defying the orders because they can’t afford to shut down again. 

The order also shutdown outdoor playgrounds and nixed overnight camping, although hiking is allowed and outdoor recreational facilities remain open. State public health officials quietly reversed the playground closure not long after issuing the order. 

Although the state is offering small business grants of up to $25,000, it’s unclear whether that’s enough money or not to float a business while they’re closed. State legislators are expected to examine the issue in January. 

Orange County supervisors also steered $75 million directly to local businesses earlier in the year along with a recent $10 million commitment to renew some sort of aid program.

Supervisor Don Wagner also successfully urged his colleagues to adopt a resolution to lobby Newsom for local control over public health measures. 

“I want to make it clear that what it (the resolution) is urging is that the Governor change his orders and allow for local control, not that this board ignore those orders. Those are individual decisions that businesses and the people that make up our communities are going to have to decide for themselves,” Wagner said at the Dec. 8 Supervisors meeting. 

The Orange County Health Care Agency and the Sheriff have taken a hands-off approach to enforcement, instead leaving it to various state agencies. 

Supervisor Lisa Bartlett said they have to balance hospitalizations and the economy. 

“We need to reopen our economy, we can’t keep reopening and closing,” Bartlett said. “The businesses need to stay open … it’s too detrimental and it’s terrible for the workforce to be hired and fired. So we got to look at a more balanced approach.” 

During that time, OC was quickly approaching 1,000 people in hospitals, with 974 county residents hospitalized, including 239 in intensive care units, as of Dec. 8. 

Bartlett also said they’re going to look at increasing hospital staffing and building more ICU beds. 

UC Irvine economics Ami Glazer said the economy will still suffer as many people don’t want to go out because the virus is so widespread. 

“People are afraid to go out and until the infection declines that would continue,” Glazer said. “The best evidence is China, where infections appear to have disappeared and they’re close to where they were before the epidemic started so if we close to eliminate infections the way China has we should also be doing well.”

Supervisors also hit on a key criticism of the state order — the mixed message it sends, prohibiting outdoor dining but permitting indoor malls and department stores to remain open.

At a Dec. 8 news conference, Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, said the decision to keep malls and retailers open stems from the need “to not do what we did the first time, which really was to isolate the experience to just a few retailers where we saw large numbers of people gathering indoors.”

Ghaly said having more stores open will help ease overcrowding stores. 

But local epidemiologists say state public health officials should’ve shut down malls and nonessential retailers, similar to the public health orders in March. 

At the Supervisors’ last meeting of 2020, OC health officer Dr. Clayton Chau gave his most impassioned plea since the pandemic began, nearly begging residents to follow public health guidelines

“Every day we break the record of the number of people who have [been] infected. So I’m pleading with the community: Please. Please. Do not gather. And make sure you follow the public health guidance,” Chau said at the Dec. 15 meeting. 

At that time, 1,486 people were hospitalized.

And doctors and other public health experts are worried the hospitals will be overrun with virus patients, jeopardizing non-virus care like treatment for stroke patients and potentially leading to a grim situation where doctors will have to choose who gets a bed or not. 

Anaheim and Santa Ana have been hit the hardest by the virus, following pockets of Buena Park, Fullerton, San Clemente, Westminster, Orange and other working class areas in OC. 

The virus has also Latino community the hardest. 

Latinos, while making up roughly 35% of OC’s population, have over 44% of the total confirmed cases, according to county Health Care Agency data as of Dec. 30. 

Latinos also make up nearly 43% of all virus deaths. 

Public health experts said the virus’ sharp disproportionate impact on Latinos in Orange County is due to lack of healthcare access, overcrowded housing and not having the option to work from home.

The impacts to poor, often minority neighborhoods, caused state public health officials to roll out a health equity metric, requiring counties to reduce positivity rates in their most underserved communities before opening more businesses. 

Shortly after the state’s health equity metric was announced in October, Supervisors protested the metric and said they need local control to handle the situation better. 

But the last time the county had local control over such matters, OC saw a couple of public health order walkbacks and a health officer resign after receiving threats for a mask mandate. 

Former health officer Dr. Nichole Quick issued an order March 17 banning all public and private large gatherings, with exemptions on grocery shopping and other vital services, in an effort to slow the spread of the virus. 

At the time the order was issued, there were 29 confirmed cases in OC. 

The order initially applied to nonessential workplaces and encouraged telecommuting. 

By the next day, the order was relaxed and only encouraged residents to not gather in large crowds. Although it did still shut down bars, restaurants, gyms, movie theaters and other large entertainment venues. 

In late April, following growing protests against Newsom’s statewide shutdown orders, county Supervisors adopted business reopening guidelines. 

The guidance caused confusion among residents and the business community

By the end of April, the virus had killed 44 people out of 2,252 confirmed cases and hospitalizations were steadily growing.

When Quick authorized dine-in restaurants and shopping centers to reopen just before Memorial Day weekend, she also required people to wear masks when they’re in public. 

More businesses, like bars and gyms, were reopened following the holiday weekend. 

Heading into the Memorial Day weekend reopening, the virus had killed 88 people out of 4,500 confirmed cases

The mask order sparked protests and prompted a public backlash, with Quick eventually resigning by early June after receiving scores of threats, including one then-County Supervisors Chairwoman Michelle Steel classified as a “death threat.” 

Chau, who took over the health officer position, lifted the mask order June 11.

At the time, the virus had killed 202 people out of nearly 8,000 confirmed cases. Hospitalizations were also steadily increasing.  

A week later, Newsom required all Californians to wear masks when they’re in public places and shops. 

By then, the virus had killed 250 people out of 9,300 confirmed cases. 

Just before the Fourth of July weekend, Newsom ordered all bars and restaurants to halt indoor operations — effectively shutting down the establishments. By mid July, he ordered churches, malls, barber shops and gyms to close again

He also put OC on the state’s now defunct coronavirus watchlist. 

At the time, the virus had killed 424 people and 674 people were hospitalized. 

By the end of July, OC saw its highest two-week death count with 140 people dead from the virus. At the end of July, the virus had killed 566 people and hospitalizations were dropping, with 546 hospitalized. 

The first wave eventually pushed hospitalizations over 700 at one point in July. 

Now, as OC heads into the final stretch of 2020, roughly 2,200 people are hospitalized and more than 1,800 have been killed by the virus — that’s more than three times the average yearly flu deaths. 

Doctors and epidemiologists fear an incoming spike on top of a spike stemming from holiday celebrations. 

Dr. Todd Newton, an emergency physician and OC medical director for Kaiser Permanente, said hospitals are already stretched thin as 2020 comes to a close. 

“Boy, if we get a surge on top of this one, and the current one hasn’t stopped, I think the county’s going to be in bad shape,” newton said. 

Newton said the pandemic is beginning to take a mental toll on workers. 

“I’m an emergency medicine physician, I’m used to seeing people dying, it’s part of the field. But you don’t normally see 14, 15 people die a day,” Newton said. “Can you imagine talking to 10, 12, 14 families going through that? It’s something we could not have conceived of.” 

Newton said he and many health care workers will likely have to deal with the mental effects for years. 

“You have to tell families their loved one isn’t going to make it, people die alone because they can’t have people in the room,” he said. None of us are used to this amount of death. It’s one of the tough things that we’re going to be dealing with for years.” 

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

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