Orange County might be hitting the peak of the fourth COVID-19 wave that saw over 1,200 people hospitalized at one point, but it’s too early to tell for certain, say local public health experts. 

Simultaneously, there’s a persisting battle to close the Latino vaccination gap and other health disparities faced by working class, often minority communities throughout OC – all magnified by the pandemic.

“At this point it does look like we’re peaking and we’re headed in a downward trend. But of course one could never be completely sure until the surge actually passes,” said UC Irvine epidemiologist and public health expert, Sanghyuk Shin. 

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In a Monday phone interview, Shin said it looks like the trends are heading in the right direction.

“In terms of when the peak is occurring, I don’t think anyone could be 100% completely sure until a few weeks after. But it does look promising,” he said. 

According to state data, Orange County sat at a 21.2% positivity rate as of Tuesday, down from last week’s 24.4% 

But, Shin warns, that’s still a high rate – one in five tests are coming back positive.

At the same time, hospitals are feeling the crunch from a wave of patients, despite some decreases.

“The ER parking lot looks like an ambulance parking lot,” said Dr. Jim Keany, co-director of the Emergency Department at Providence Mission Hospital in Mission Viejo and former hospital chief of staff.  

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As of Tuesday, 1,114 people were hospitalized, including 191 in intensive care units, according to state data.

Keany, in a Friday phone interview, said many elective procedures – surgeries for conditions that aren’t immediately life threatening – have been paused due to the wave of COVID patients. 

“Most of the hospitals have curtailed it to some point,” Keany said. 

But, he warns rescheduling medical procedures can have profoundly negative effects on patients and the health care system down the road.

“There’s no question in my mind we’re going to see a backlash of health care that has not been given,” Keany said, adding that routine screenings for things like cancer and high blood pressure have been delayed for many people throughout the pandemic.

Dr. Shruti Gohil, an infectious disease physician at UC Irvine Medical Center, said COVID exacerbates chronic health conditions in some fully vaccinated people.

“It’s destabilizing underlying conditions for a lot of people. For example diabetes goes out of whack … so what we’re seeing is decompensated chronic diseases,” she said in a phone interview last Thursday. “But they’re not crashing and burning from COVID, per se.” 

But, Gohil said, the majority of virus patients are unvaccinated. 

“That’s the group that’s getting super sick,” she said. 

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Keany and other doctors also said COVID is impacting vaccinated people with chronic illnesses.

“We’re seeing people who are vaccinated, but with comorobitieis – they’re obese, they’re elderly, they have immunosurppression,” said Dr. Charles Bailey, medical director of infection prevention at St. Joseph and Mission hospitals.

He also emphasized the importance of vaccinations. 

“The further you make your way into the hospital, the unvaccinated are overrepresented,” Bailey said in a Monday phone interview. “I would bet that a lot of those in the vaccinated group had milder disease or among the group who tested positive that weren’t initially admitted with COVID.” 

Data from the Orange County Health Care Agency shows that 85% of all hospitalized patients are unvaccinated, and 87% of all people in ICUs are unvaccinated.

The virus has now killed 5,978 OC residents, including 10 new deaths reported Tuesday, according to the agency

Shin, also the director of the UCI’s infectious disease science initiative, said lawmakers avoided many public health measures to help prevent outbreaks and curb hospitalizations and deaths, like business capacity restrictions, temporary online schooling and enforced mask mandates. 

“Unfortunately, I think that most policymakers are short sighted and think about short term economic harms and short term political harms to themselves. And they really need to be pushed by the community and public health experts to take measures that are going to protect people and not just short-term bottom line,” Shin said.

The Fight to Close Health Disparities in Orange County

While doctors treat patients during the fourth wave, a vaccination gap in the Latino community persists.

According to OC Health Care Agency data, the Latino community makes up 35% of the county’s population, yet accounts for just 23% of the 2.2 million fully vaccinated residents.

Isabel Becerra, CEO of Coalition of Orange County Community Health Centers, said it’s extremely difficult to battle the misinformation surrounding the vaccines.

“The issue remains education and the misinformation about the vaccine. This is why we don’t have close to a 100% vaccination rate across the board,” Becerra said. 

It’s a concern that’s been echoed by numerous public health experts over the past year.

One statewide advocacy group for community based organizations said Gov. Gavin Newsom should’ve provided more funding in his proposed budget to help close health gaps exacerbated by the pandemic. 

“The California Health Equity and Racial Justice fund was not funded as part of the budget. While we did see the Governor continue his commitment to invest up to $300 million in the public health system, what was absent was the critical roles that community based organizations play in the public health system,” said Ron Colemman, managing director of policy for the California Pan Ethnic Health Network.

Coleman, and the organization he works for, advocates for legislators and public health officials to help close many of the health gaps in working class, minority communities – all of which the pandemic put under a microscope.

“Part of what we want to see here is being able to build the capacity of [community organizations] that are resourced. These [organizations] have made sure that for some communities this pandemic wasn’t even worse,” Coleman said. 

He said state legislators need to think about funding beyond local health departments. 

“I would say that certainly the legislature recognized that it takes a village, it takes local health care departments – but it also takes community organizations to serve California’s diverse populations. California, being a state that has a majority population of people of color – very racially and ethnically diverse on top of that – there is a need to make sure there’s reliable and trusted messengers to work to deliver services,” Coleman said.

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Locally, community based organizations like Latino Health Access, and the OC Asian, Pacific Islander Task Force, have been working closely with community health clinics to help link residents to COVID-19 testing and vaccinations.

Their efforts have been paying off, community organization officials have told Voice of OC over the past year – especially when they’re able to personally speak to people about their vaccine concerns.

“The pandemic has exposed underlying public health disparities that have been impacting minority and working class communities disproportionately. I would completely support strengthening and providing resources to community based organizations and supporting community based programs,” Shin said. 

A statement from the California Pan-Ethnic Health Network said more than one-time funding for testing and vaccination  is needed to help address persisting local health disparities.

“We need ongoing, flexible, and permanent solutions, not stop gaps and piecemeal measures. Additionally, while investments to state and local infrastructure are important, community-based organizations must be funded directly through the Health Equity and Racial Justice Fund as a critical component to a comprehensive public health system that will meet the needs of California’s diverse population. ” reads the Jan. 10 statement.

But, Newsom’s proposed budget does offer up some much-needed resources to local health clinics – like $1.7 billion in funding for health clinic efforts, including training new community health workers.

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Becerra said the proposed funding could greatly help community clinic efforts not just for the pandemic response, but closing overall health gaps.

“This additional investment in workforce strategies is exciting to us because we have more opportunities to recruit, train and certify 25,000 community health workers,” Becerra said in a Monday phone interview. 

Becerra and Coleman both said the proposal to open up Medi-Cal for all Californians, regardless of immigration status, will help address some of the health disparities. 

But, Becerra said, it’s an ongoing battle to close the various health gaps throughout Orange County.

“The social determinants of health for these communities were there before the pandemic, were exacerbated by the pandemic and, unfortunately, will still be there after the pandemic.”

Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio

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