Orange County’s soaring coronavirus hospitalizations and daily case increases are at the highest levels ever, so far, while some public health officials and epidemiologists fear Thanksgiving cases will worsen the situation.
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“Duct tape your underpants,” UC Irvine epidemiologist Andrew Noymer said in a Thursday phone interview.
Noymer, a public health expert, said the situation is going to continue to get worse.
“We’re breaking records on the daily here,” he said. “Thanksgiving is starting to bite. Thanksgiving was a fortnight ago, exactly.”
Leading up to Thanksgiving, Noymer and other public health experts, alongside state and county health officials, were urging residents to only have dinner with the people they live with.
Normally, Thanksgiving dinners feature extended family and friends — something public health experts said would worsen the already growing virus spread.
OC managed to shatter two records in one day: overall hospitalizations and the number of people in intensive care units.
As of Thursday, 1,025 county residents were hospitalized, including 257 people in intensive care units, according to state data.
That’s a 460% increase since Nov. 1, when 183 people were hospitalized, including 60 in ICUs.
OC eclipsed its previous record from the July 14 peak, when 722 people were hospitalized, including 239 in intensive care units.
“It’s the first time we set a record on both of these statistics since July,” Noymer said. “These numbers look really bad.”
Dr. Todd Newton, an emergency care physician and area medical director for Kaiser Permanente, said this wave is hitting harder than the first.
“It’s definitely a stronger, deeper surge,” Newton said in a Wednesday phone interview. “We’re seeing more outpatients turn positive with the testing. We’re admitting more inpatients.”
During the peak July hospitalization period, OC was averaging a little over 800 new cases a day. By the end of the month, the seven-day average was 470 new daily cases.
Now, OC is averaging over 1,800 new cases a day. When December began, the average seven-day average was 790 new cases a day.
The virus trends forced county Emergency Medical Services Medical Director, Dr. Carl Schultz, to issue a directive to hospitals late Wednesday evening, urging them to activate surge plans and halt non-emergency surgeries.
“The health care system in Orange County is now in crisis resulting from an overwhelming increase in the number of COVID infected patients,” reads the directive
Orange County’s increasing daily case averages is likely to push hospitalizations even higher.
State public health officials estimate 12 to 13% of new cases will end up hospitalized.
On Wednesday, the county Health Care Agency reported over 2,600 new cases, a record high. Today, the agency reported 1,521 cases.
Without intervention, county officials warn that Orange County’s emergency medical services could collapse.
“At the current rate of deterioration, the EMS system may collapse unless emergency directives are implemented now,” Schultz wrote, referring to the services system that includes hospitals and ambulances.
Meanwhile, Supervisor Michelle Steel railed against the regional shut down at the weekly Thursday OC news conference.
“As I have said since the very first stage of this pandemic, we must take a balanced approach to slowing the spread of this virus while ensuring the least economic harm to families,” Steel said.
The regional order went into effect late Sunday because Southern California’s available intensive care unit beds dipped below 15%.
The order shut down nonessential businesses like barbers and beauty parlors. It also closed outdoor dining, but restaurants can still do take out and delivery.
Many businesses are defying the orders.
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 Wednesday.
Steel said Gov. Gavin Newsom “Has frankly created an inconsistent mess … moving the bar each time to justify their actions with no scientific base.”
But public health experts like Noymer said the order should’ve gone a step further and close down all nonessential retail, like malls and department stores.
“It’s more important now than March. I would’ve rather seen the malls open in March than now, of course that’s easy to say in hindsight,” Noymer said. “I would say yeah, indoor shopping needs to shut down. We’re really in a crisis.”
UC Irvine epidemiologist Sanghyuk Shin said university researchers found roughly 5% of OC residents could have the virus right now.
“So the best estimate right now is from Dr. Vladimir Minin (a biostatician) and his modeling suggests that it’s possible about 5% of Orange County residents today may be infected and infectious at this time. So this again, an exponential increase from a few days ago,” Shin said in a Wednesday phone interview. “He estimates about 150,000 people in Orange County, right now, have COVID.”
Noymer echoed his colleague Shin said, noting the virus is growing at exponential rates, with Thanksgiving boosting that growth.
“So two cases cause four, four cases cause eight and eight causes 16,” Noymer said. “Thanksgiving set in train a series of infections that are going to set in train a new series of infections. It’s not like Thanksgiving is done — it takes an explosion and makes it an even worse explosion … it’s not a road bump, it’s a mountain.”
The situation has deteriorated to the point where state public health officials have readied the Fairview Developmental Center in Costa Mesa to take stabilized virus patients.
“We have this overflow field hospital to ease the burden,” Dr. Anita Wang said in a Wednesday phone interview.
Wang said she expects to begin treating patients at Fairview next week.
At the Thursday OC news conference, health officer Dr. Clayton Chau said Fairview Developmental Center is slated to open next Tuesday.
“We’ll be doing a lot of treatment there and I’ll be there to respond to anyone who’s spiraling down the tubes and do a procedure,” Wang said.
At a Tuesday news conference, Secretary of the state Health and Human Services Agency, Dr. Mark Ghaly, said hospitals across California are dealing with cases from before Thanksgiving.
“We know that hospitals are dealing today with cases two weeks ago, maybe three weeks ago. And you look at our level of transmission and the number of cases we were reporting two weeks ago, three weeks ago, we were even less than half of what we are seeing today,” Ghaly said.
He warned the recent cases will start showing up in hospitals soon.
“We anticipate not just the ongoing slope of increase that we’ve seen, now we are worried about a rapidly accelerating increase and pressure in our hospitals,” Ghaly said.
“If we thought we were sort of peaking at this level, some of the regional stay at home orders might not have been necessary,” Ghaly said.
He said without some major change, hospitals are going to get overwhelmed.
“But the concern that with the Thanksgiving cases beginning to show in our daily numbers … without some major change in our overall behavior and movement, we will see hospitals continue to feel that pressure and get overwhelmed.”
The second wave is hitting Orange County, along with the state, all at once. And it’s a difficult virus to manage, because some people get it and don’t show symptoms — although they can easily spread it.
Other people show minor symptoms and can recover at home, while the virus sends others to hospitals.
Since the pandemic began in March, the virus has killed 1,640 county residents out of 94,647 confirmed cases, including seven new deaths reported today, according to the county Health Care Agency.
During the first wave in the summer, cases slowly built up, which led to a steady — but slow — increase in hospitalizations.
Newton said critical care doctors learned quite a bit from the first wave, which led to better treatments.
“The one saving grace I would say that the patients are not getting quite as sick this go-around because we’re better at treating them,” Newton said. “We know what to do and that’s helping. But yes, the surge is real.”
He also said the first wave hit parts of California differently, staggering the stress on hospitals.
“So there were some areas in the (hospital) system in California … that weren’t as impacted, so you always had a relief valve if you needed to move patients around. This surge — it’s more difficult for the state because every area is impacted, so that makes it more difficult to share resources.”
Spencer Custodio is a Voice of OC staff reporter. You can reach him at email@example.com. Follow him on Twitter @SpencerCustodio