Questions and concerns continue to swirl on how exactly the Orange County Health Care Agency is going to roll out coronavirus vaccine distributions beyond medical staff at hospitals.
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OC isn’t the only county facing the vaccine concerns.
The rest of California is, too.
Gov. Gavin Newsom said the statewide efforts are “not good enough” at a Monday news conference.
“It’s gone too slowly,” Newsom said. “All of us want to see 100% of what’s received immediately administered into people’s arms.”
Newsom said only about a third of the 1.3 million vaccines have been administered.
On Tuesday, state public health officials warned the Orange County Health Care Agency to increase the coronavirus vaccine rollout after a slow start.
Officials also warned other counties.
Dr. Jason Cord, Orange County Medical Association president, said it’s difficult to inoculate on a wide scale with scarce resources and dwindling medical staff because of the tsunami of virus patients OC hospitals are facing.
“We’re all swamped with the work of the day to day to take care of the patients that are ill, that limits the ability to administer the vaccines,” Cord said. “We’re having to pull nurses and staff from clinical areas to do it.”
Cord sits on the OC vaccine task force, along with Orange County health officer Dr. Clayton Chau.
“You got to figure vaccine clinics are going to take staff as well — don’t get me wrong, we’re still doing it,” he said.
He said state public health officials require certain levels of staffing, similar to hospital surge plans that are required to be filed with the state.
“There’s not only a surge staffing requirement,” Cord said. “There’s vaccine staffing requirements as well.”
Numerous private care physicians and urgent care doctors have contacted Voice of OC, expressing their concern about when they’ll get the vaccine.
“I’m directly involved, right now, in working on making sure our non-hospital affiliated physicians and their staff get vaccinated as well,” Cord said.
At a news conference last month, Chau said there’s not enough vaccines for all of OC’s medical workers.
“As you can imagine it’s not enough. So we have to go down the line on tiering,” he said.
There’s various guidelines from health agencies at the federal and state level, along with national medical organizations — which could be adding to the vaccine rollout confusion.
Guidelines from the California Department of Public Health put hospital staff and paramedics in the top tier of the first phase, while primary care physicians and urgent care doctors are in the second tier of the first phase.
The OC Health Care Agency is using vaccine guidelines from the National Academies of Science, Engineering and Medicine, according to the agency’s website.
The CDC and the National Institutes of Health tasked the National Academies with producing the guidelines.
The group suggested a four-phased approach to vaccine distribution, with health care workers high up on the list — similar to the state’s tiering system.
“Included in Phase 1a would be ‘frontline’ health workers—health professionals who are involved in direct patient care, as well as those working in transport, environmental services, or other health care facility services—who risk exposure to bodily fluids or aerosols,” reads the guidelines.
Newsom said the state legislature is expected to consider $300 million in the upcoming budget to help with vaccine distribution, storage and other logistical issues — along with a public outreach campaign.
“We’re already working these last number of days to increase the distribution sites and, more importantly, to accelerate the efforts on who can administer the vaccines,” Newsom said, adding officials are looking into National Guard medical units, dentists and other clinics to help vaccine distribution.
Meanwhile, ambulance patients are facing longer wait times before being offloaded to Orange County hospitals as coronavirus patients continue to flood the local hospital system.
A Monday situation report from OC Emergency Medical Services shows 16 emergency rooms had wait times longer than 30 minutes and 10 emergency rooms had more than an hour wait times.
For comparison, 14 emergency rooms had a wait of more than 30 minutes and eight had more than an hour wait last Thursday.
And OC hit a new record Tuesday when it surpassed 2,200 hospitalized.
According to state hospital data, 2,236 people were hospitalized, including 504 in intensive care units — a 163% increase over the past month.
Orange County’s overall testing positivity continues to hang around 16%, with a 15.8% rate as of Tuesday, according to state data.
The poorest OC residents are again hit the hardest with nearly one in four people testing positive.
In a Tuesday email, OC Emergency Medical Services Director, Dr. Carl Schultz, said six hospitals have requested additional staffing support from the Health Care Agency.
“OC hospitals are requesting staff, but not specifically from the National Guard. After exhausting all their resources for staff, they request staff from the OC Health Care Agency’s (HCA) disaster coordinating center, the Agency Operations Center (AOC). They fill out several documents that describe their need and other issues. The AOC attempts to fill the requests from County assets. If there are none available, we send the request to the State,” Schultz said.
Schultz said if no state help is available, state officials coordinate with federal officials to get help to the hospitals.
“If this happens, the Federal management group may request deployment of the National Guard. At this time, there is no order to deploy National Guard assets to OC hospitals. There are nurses, respiratory therapists, and other medical providers that have been deployed to hospitals from other agencies and staffing companies,” he said.
The county Health Care Agency reported 1,376 new cases today — significantly down from the nearly 9,000 reported Monday.
Monday’s count stretched back at least two days because of maintenance on state servers.
OC is now averaging roughly 2,800 new cases a day over the past week.
State public health officials estimate roughly 12% of all newly infected people end up hospitalized within three weeks.
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 virus has now killed 1,926 people out of 171,955 confirmed cases in OC, 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 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.
In a Tuesday phone interview, UC Irvine epidemiologist and public health professor, Andrew Noymer, said January is shaping up to be the worst month of the pandemic.
“The fact of the matter is that January 2021 will go down in the annals of history as a crisis in the hospitals, you can take that one to the bank,” he said. “We’re in for a pounding, basically. I don’t know how else to put it. I’m not at all optimistic about the next six weeks.”
Spencer Custodio is a Voice of OC staff reporter. You can reach him at firstname.lastname@example.org. Follow him on Twitter @SpencerCustodio