Orange County hospitals are facing an unprecedented situation with scores of coronavirus patients filling intensive care units and emergency rooms across the county as 2020 comes to an end.
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“It’s not an emergency, it’s not a crisis — it’s a disaster,” said Dr. Todd Newton, an emergency care physician and OC medical director at Kaiser Permanente.
As of Wednesday, 2,145 people were hospitalized, including 479 in intensive care units.
“Maybe all the words we used early on were appropriate, but now I would call it a full-fledged disaster,” Newton said in a Wednesday phone interview.
Orange County’s hospitalizations have astronomically increased since the beginning of November, when there were 183 people hospitalized.
On Thanksgiving, 506 people were hospitalized.
Doctors like Newton, along with epidemiologists, at the time feared Thanksgiving would produce a spike on top of a spike.
Two weeks later, 1,122 people were hospitalized.
And daily case rates began skyrocketing.
When November ended, OC was averaging roughly 1,200 new cases a day, using a seven-day average.
Two weeks later, the average daily caseload was over 2,800.
As of Wednesday, Orange County is averaging roughly 3,100 new cases a day, down from nearly 3,400 a week ago.
The county Health Care Agency reported 4,514 new cases Wednesday.
State public health officials estimate roughly 12% of all new cases end up in hospitals within three weeks.
Given that experts say about 12% of cases end up requiring hospitalization, that means at least 2,500 more people could be hospitalized in the coming weeks as hospitals are trying to discharge stabilized patients as quickly as possible.
That estimate is just using average daily case numbers over the past week.
Now, doctors and epidemiologists fear a second holiday spike.
“My sense is we’re still going to face a surge within a surge here after New Years. We’re very concerned about the next two to four weeks,” Newton said.
UC Irvine epidemiologist Daniel Parker said the numbers aren’t looking good heading into the New Year holiday.
“It’s been looking bad since before Thanksgiving. We knew it was going to get worse with Thanksgiving and it keeps getting worse — it’s just bad,” Parker said in a Tuesday phone interview. “My best guess is we’re going to be well into January, maybe February before it kind of drops off.”
The coronavirus has now killed 1,874 county residents out of 156,573 confirmed cases, including 27 new deaths reported Wednesday, according to the county Health Care Agency.
The virus has already killed more than three times as many people as the flu does on a yearly average.
For context, Orange County has averaged around 20,000 deaths a year since 2016, including 543 annual flu deaths, according to state health data.
According to those state death statistics, cancer kills over 4,600 people, heart disease kills over 2,800, more than 1,400 die from Alzheimer’s disease and strokes kill over 1,300 people.
Orange County has already surpassed its yearly average 20,000 deaths, with 21,110 people dead as of November, according to the latest available state data.
It’s a difficult virus for the medical community to tackle because some people don’t show any symptoms, yet can still spread it. Others feel slight symptoms, like fatigue and a mild fever.
Others end up in ICUs for days and weeks before making it out, while other people eventually die from the virus.
Parker fears OC and Southern California could turn into grim situations faced in Italy or New York City earlier this year when doctors had to ration care and put dead bodies on freezer trucks.
“I hope it doesn’t turn into Lombardy, Italy, or New York City,” he said. “I hope we’re past that. It kind of feels like it to me … but on the other hand, in the public health sense, you wanna get people before that stage. From a public health standpoint, we’re kind of failing.”
While local and state public health officials are largely blaming private gatherings for skyrocketing case rates, Parker said there’s so many new daily cases that contact tracing has largely been rendered ineffective.
He said the household outbreaks are easier to investigate than outbreaks at malls or restaurants.
“Basically contact tracing is lost in the wash. So when you’re doing the contact tracing, the easiest contacts to identify are the ones in your own house. So we have pretty good data on what’s happening inside households,” Parker said.
“The strangers that you were around somewhere else or the people you maybe forgot you were around at work, the data is just a little bit different there,” Parker said. “I wouldn’t feel real confident in saying where transmission is going on at the most at this point.”
The situation has deteriorated to the point where the California Department of Public Health is requiring hospitals file plans for “crisis care,” which is where doctors may have to ration care and resources if hospitals get too full.
“Facilities must plan for crisis care now, both as a facility and with the county and region. Facilities should pay particular attention to planning related to the activation of triage teams for the allocation of critical care resources and following ethical and equitable principles and civil rights law in allocating scarce resources,” reads the guidelines.
While no hospital in OC is having to ration care, doctors fear it could get to that point.
“If you look at where we’re projected to be based on what we’re seeing now, in two weeks, the graphs go straight up — they’re not even curved. They go straight up to the sky,” Newton said. “We are now into having to plan for surges on top of our surge plans and I’m very concerned if we get another one after new years, the hospital system is going to be in very bad shape.”
He said ambulances have stopped bringing mortally ill people to die at hospitals or other facilities.
“They’re not transporting comfort care patients,” Newton said, adding packed hospitals and rollbacks on nonemergency procedures are “just various things I have not seen in my career and I don’t think anyone else has either.”
Spencer Custodio is a Voice of OC staff reporter. You can reach him at email@example.com. Follow him on Twitter @SpencerCustodio