Orange County, along with Southern California, will stay under the regional coronavirus shutdown order because the area’s hospitalizations continue to skyrocket, making intensive care unit beds scarce in places like Los Angeles County.
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“The order will remain because those projections do not show San Joaquin Valley and Southern California have not projected, four weeks out, ICU capacity over 15%,” said Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, at a Tuesday news conference.
The region’s ICU beds for coronavirus patients are used up, he said.
It doesn’t look like the situation will improve anytime soon.
“We are essentially projecting that ICU capacity is not improving in Southern California,” Ghaly said. “And that demand will continue to exceed capacity.”
OC hospitals continue taking a beating.
As of Tuesday, 2,106 people were hospitalized, including 473 in intensive care units.
The county is seeing its hospitalizations skyrocket at rates never before seen — all before a feared potential holiday spike, similar to what was seen after Thanksgiving.
A month ago, 648 people were hospitalized, with 158 in ICUs — a 225% increase.
“We fully expect it’s going to continue to get worse, until the vaccine quite frankly is rolled out and until people are really going to take masking and avoiding behaviors seriously,” said Dr. Shruti Gohil, an infectious disease doctor who treats patients in the intensive care unit at UC Irvine Medical Center in Orange.
Gohil said the winter weather allows the virus to spread more easily because the aerosol particles from people the virus travels on won’t dissipate as fast as during the summer months.
“This is the true, natural time for it to be spread. So it’s the perfect storm. We’re coming in with all this COVID, now temperatures dropped,” Gohil said in a Monday phone interview. “I see this getting worse and worse until something happens.”
She said an effective mass rollout of the vaccine, coupled with more people following the public health guidance could turn the tide.
“This is not rocket science,” Gohil said. “The answers are clear.”
Although the region has been under the regional shutdown order for a month, many bars and restaurants have continued to remain open as OC sees thousands of new coronavirus cases every day.
Orange County public health officials and the OC Sheriff have taken a hands-off approach to enforcement.
The order shut down nonessential businesses like nail salons, barber shops, gyms and outdoor dining. Although restaurants are allowed to do take out and delivery, similar to the previous stay home order in March.
But unlike March’s order, shopping malls and other retailers remain open. Although the malls and retailers are supposed to limit the number of people inside to 20% of the building’s capacity, numerous stores aren’t doing that.
Local and state public health officials have largely blamed the majority of case spikes on private gatherings.
But an LA Times analysis of outbreak data released daily by LA County officials found there were 505 active outbreaks at retailers last week — more than double than a month before.
Orange County public health officials refuse to publicly release the county’s outbreak data.
UC Irvine epidemiologist Sanghyuk Shin said public health departments around the country are too underfunded to accurately contact trace virus cases to figure out where many outbreaks started.
“I don’t think we’ve seen super great data on the distribution of COVID 19 spread here in the U.S.,” Shin said in a Monday phone interview. “So contact tracing and the investigation of these clusters that occur, that may occur in a shopping mall, in schools, at gatherings — they take a lot of work.”
Shin said there’s so many cases that don’t get investigated, much of the current data doesn’t paint the whole picture.
“I know that people are kind of pointing to family gatherings and things of that nature. I’m a little bit skeptical about that because those types of data being presented are only being based on the 10%, 20% of COVID-19 cases that are fully investigated. The vast majority of COVID-19 cases, we don’t know where people got it.,” he said.
He also said holiday parties and other private events are easier to investigate because people know each other, as opposed to trying to figure out who was exposed to an infected person in a crowded store.
Shin, other epidemiologists, public health experts and doctors interviewed by Voice of OC throughout the pandemic said masks, social distancing, outdoor activities and strict sanitization routines all add different layers of protection.
But with the virus so widespread, those different layers became less effective — especially as people crowd inside malls, restaurants and other places.
The virus has now killed 1,847 people out of 152,059 confirmed cases, including 2,452 new cases reported Tuesday, according to the county Health Care Agency.
State public health officials estimate about 12% of all new cases end up in hospitals within three weeks.
Orange County has averaged roughly 3,000 new cases a day for the past week.
Given that experts say about 12%b of cases end up requiring hospitalization, that means over 2,500 more people could be hospitalized in the coming weeks as hospitals are trying to discharge stabilized patients as quickly as possible.
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.
“We certainly know that Southern California hospitals are in crisis,” Ghaly said.
He said some hospitals in the region are using some “crisis care” techniques, which is when a hospital is stretched so thin, that doctors may have to prioritize who gets treated first. The crisis mode could also mean delayed care for some patients and longer ambulance waits.
While no Southern California hospital is in “crisis care” mode, Ghaly said he and other public health officials fear hospitals may have to ration treatment and supplies if trends continue.
“You are in situations where you occasionally have to ration supplies, care … not every patient gets the same level of attention as we hoped they would,” Ghaly said, urging people to “do everything in our power today to keep us from being in this situation.”
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio
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