Orange County reported 244 new cases of COVID-19 and one additional death Sunday, bringing the county's totals to 55,775 cases and 1,341 fatalities.
County officials had said Friday that they were pleased to see new daily cases under 200, which keeps the county in the red tier of California's coronavirus monitoring system. To get to the less-restrictive orange tier the county would have to begin averaging closer to 130 daily cases.
The death reported Sunday was a person who lived in an assisted-living facility. Since the pandemic began, 486 of the COVID-19 victims who died were skilled-nursing facility residents and 104 resided in assisted-living facilities, according to the Orange County Health Care Agency.
Death reports are made sporadically from multiple hospitals and other sources, so fatalities did not necessarily happen the day before.
Hospitalizations declined from 169 on Saturday to 164, with the number of patients in intensive care dropping from 61 to 57. The change in the three-day average of hospitalized patients went from -1.9% to -4.1%. The county has 35% of its intensive care unit beds and 67% of its ventilators available.
The positivity rate, which was reported each Tuesday, inched up from 3.1% last week to 3.2%, and the daily case rate per 100,000 people rose from 4.4 to 5.2, which is higher than the cutoff of 3.9 to qualify for a move from the red to the orange tier.
Orange County CEO Frank Kim told City News Service on Friday that the county is averaging 4.9 per 100,000 residents, down from a peak of 5.4 on Oct. 5.
"Our numbers are heading in the right direction," Kim said.
To qualify for the orange tier, the positivity rate must be 2% to 4%, and the case rate per 100,000 must be 1% to 3.9%.
Moving to the orange tier means retail businesses could operate at full capacity, instead of 50% as required in the red tier. Shopping malls could also operate at full capacity, but with closed common areas and reduced food courts, just as in the red tier.
According to OCHCA data, 944,167 COVID-19 tests have been conducted, including 6,449 reported Sunday. There have been 49,780 documented recoveries.
Dr. Clayton Chau, director of the OCHCA and the county's chief health officer, said increased testing can lower the positivity rate, but it can also lead to an increase in the case rate per 100,000. The state introduced the health equity measure, which launched Tuesday, to help counties address high case counts concentrated within certain ZIP codes that include high-density housing and language barriers, among other issues.
Orange County got a head start on that weeks ago with its Latino Health Equity program, which raised awareness of coronavirus within hot spots in Santa Ana and Anaheim, Chau said. Positivity rates as high as 20% have fallen to single digits in some of those neighborhoods, Chau said.
There is an "accelerator" in the state's formula that if the positivity rate makes it to the least-restrictive yellow tier but the case rate is in the red, then a county can move up to orange, Chau said.
At a news conference on Thursday, Orange County Board Chairwoman Michelle Steel called for more "local control'' on determining the reopening of businesses, decrying "Sacramento's one-size-fits-all" policy that she said "punishes" Orange County with the health equity measure that makes it more difficult to move up to the orange tier.