Nearly one in four residents in Orange County’s poorest neighborhoods are testing positive for the coronavirus as another surge is expected from the holiday season.
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According to state data, the positivity rate is 24.2% in the lowest socioeconomic quarters of census blocks in OC.
Those neighborhoods tend to be clustered mostly in North and Central Orange County, with a couple pockets in Lake Forest and San Juan Capistrano, according to data from the OC Health Care Agency.
But unlike the first wave, nearly all neighborhoods around OC are seeing increasing transmission rates, as the overall positivity rate is nearly 17%.
Parts of Aliso Viejo, Lake Forest, Laguna Niguel and Rancho Santa Margarita are seeing double-digit positivity rates — a scenario largely unseen during the first wave.
“One of the tragic things about this disease is that it’s impacting people of color more,” said Dr. Todd Newton, who treats patients in the emergency room at Kaiser Permanente. “It’s impacting people at lower socioeconomic levels with serious disease and death.”
Public health experts interviewed since the pandemic began last March attribute the disproportionate impact to the lack of health care, overcrowded housing and because many people can’t work from home.
Newton, also the OC medical director for Kaiser, said he and his staff have seen entire households get infected with the disease, with numerous family members ending up in the hospital and some dying.
During the first wave, Newton said there were two North and Central County patients to one South County patient.
“It’s not two to one anymore,” he said.
Meanwhile, state public health officials are bracing for a spike stemming from the holiday season.
“We are anticipating higher cases in the coming weeks coming out of this new set of conditions over the last two weeks,” said Secretary of the state’s Health and Human Services Agency, Dr. Mark Ghaly, at a Monday news conference.
He said it’s even more of a reason for people to stay home as much as possible because the virus is so prevalent.
“It is just more likely you’re going to be exposed to somebody who has COVID,” Ghaly said.
At the Monday news conference, Gov. Gavin Newsom said the state is facing a critical juncture as officials expect a “surge on top of a surge coming within days.”
“It remains more deadly today than at any point in the history of this pandemic,” he said. “We are entering into what we anticipate is a surge on top of the surge. It’s going to put a lot of pressure on hospitals and ICUs coming out of the holidays.”
Orange County has been grappling with skyrocketing hospitalizations since late November.
Despite some slight decreases over the holiday weekend, hospitalizations increased again to a new high water mark.
As of Monday, 2,178 people were hospitalized for the virus, including 500 in intensive care units — the highest overall hospitalizations, so far.
Numerous doctors interviewed during the second wave have all told Voice of OC that hospitals are discharging patients as quickly and safely as possible in an effort to make space for more virus patients. Stabilized virus patients are put on home oxygen programs and get telehealth visits from physicians, the doctors said.
Newton said the daily increases in hospitalizations don’t paint the full picture.
“If we go up, let’s say 20, in our Anaheim hospitals, we may have discharged 80 or 60. So it’s important for people to understand those net increases reflect a turnover of a large number of patients. It’s not like we’re seeing 20 new ones, we’re seeing 50 new ones,” he said.
The county Health Care Agency also reported 8,990 new virus cases Monday, although that number covers the holiday weekend also.
State public health officials estimate roughly 12% of all newly infected people are hospitalized within three weeks.
“If we get another surge on what we’re seeing right now, that’s a concern. We are rapidly entering the worst case scenario for Southern California, there’s no doubt,” Newton said. “It’s exceeding what most people thought would occur.”
The tsunami of virus patients flooding OC hospitals caused county Emergency Medical Services Director, Dr. Carl Schultz, to force hospitals to take ambulance patients — even if they’re full.
In normal times, if an emergency room is full, hospital staff can tell ambulances to drive to the nearest hospital in a practice known as “diversion.”
Schultz suspended diversion in a Monday directive — like he did last month.
He originally suspended diversion in a Dec. 15 directive because patients were sitting in ambulances too long.
OC’s emergency rooms are seeing increasing average wait times to offload ambulance patients, according to a Dec. 31 situation report from the OC Emergency Medical Services.
As of last Thursday, the latest available report, 14 emergency rooms had a wait of more than 30 minutes and eight had more than an hour wait.
And mobile field hospitals — tents with beds — are being rolled out to hospitals around OC to help handle spiking virus hospitalizations.
Newton said he’s never seen anything like that in his career.
“I don’t think anyone else has either,” he said.
OC’s situation isn’t as grim as Los Angeles County’s.
LA County’s Emergency Medical Services Director Dr. Marianne Gausche-Hill issued two directives Monday, urging medics to not bring in patients who have the slimmest survival chances and to limit the use of oxygen.
“Due to the severe impact of the COVID-19 pandemic on EMS and 9-1-1 Receiving Hospitals, adult patients in blunt traumatic and nontraumatic out-of-hospital cardiac arrest shall not be transported if return to spontaneous circulation is not achieved in the field,” reads the directive.
The virus has now killed 1,926 OC residents out of 170,579 confirmed cases, including 25 new deaths reported Monday, according to the OC Health Care agency.
Newly reported deaths could stretch back up to three weeks because of reporting delays.
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 the 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.
The Fairview Developmental Center in Costa Mesa is being used to help with hospital overflow.
As of Monday, 37 people were hospitalized there, according to information given at Newsom’s news conference.
The Governor also said U.S. Army medical units will be going to Fairview.
“Staffing, staffing, staffing — that’s the most important issue,” Newsom said.
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio