Orange County Monday continued its record-setting pace of COVID-19 hospitalizations with 1,709 patients, including 380 in intensive care, and also reported another 3,753 new coronavirus cases and two additional virus-related deaths.
Hospitalizations increased from 1,682 on Sunday, when there were 375 ICU patients. Both numbers reported this afternoon are new records -- a daily occurrence dating back to early December.
The county's death toll, meanwhile rose to 1,777. Last week, the county reported 80 deaths, up from 62 the week before and 41 and 26, respectively, in the two previous weeks.
Six of the 15 deaths reported Sunday were residents of skilled nursing facilities, and another six were skilled nursing staff members. The county has logged a total of 632 COVID-19 fatalities at skilled nursing facilities, and another 165 deaths at assisted living facilities.
The county's ICU bed availability remains zero in the "adjusted" metric, and 10.2% in the unadjusted category, down from 12.1% on Sunday. The state created the adjusted metric to reflect the difference in beds available for COVID-19 patients and non-coronavirus patients.
Just because a county's adjusted ICU rate may be zero, it does not mean there are no beds available, said Orange County CEO Frank Kim. The difference in the rates reflects what is historically expected from non-coronavirus emergencies, he said.
Kim emphasized that anyone experiencing a medical emergency should still dial 911.
"Just because they're out of ICU beds doesn't mean a hospital can't treat you,'' he said.
"We don't want them to think maybe it's just heartburn, not a heart attack, and decide not to go and end up in worse condition," Kim said. "That capacity doesn't reflect surge capacity and the tents the county has set up at hospitals and (at) Fairview (Developmental Center),'' where beds area available for patients with milder symptoms.
A moratorium on diverting patients from one hospital to another initiated last week was extended again on Friday. Kim said it is being monitored daily to see if it can be lifted.
The county has 48% of its ventilators available.
Andrew Noymer, a UC Irvine associate professor of population health and disease prevention, warned of ``a severe period'' still to come.
"I can't promise we'll continue to set daily records, but this is going to be bad through the first week of January, and beyond that is too far to see,'' Noymer said. "But if people congregate in Christmas time like they did for Thanksgiving, then it will go on longer than that."
Nationally, the Transportation Security Administration reported that more than one million people passed through U.S. airport security checkpoints daily from Friday through Sunday, Noymer noted. There were four days in November when screenings exceeded one million, but none were consecutive, he said.
Normally this time of the year, there are about 2.5 million screenings, Noymer said.
"It's definitely down from what's expected, but it is up from normal recently," he said, adding it could be an indicator of another holiday surge of coronavirus cases as happened following Thanksgiving weekend.
Kim is worried about another surge, as well, pointing out that he saw store parking lots full over the weekend.
It's uncertain when exactly the county will receive the new Moderna vaccine, but it will be sometime this week, Kim said. The county is expecting 32,000 doses, he said. The county is also expecting 11,700 more doses of the Pfizer vaccine, which is less than originally anticipated. Booster shots from Moderna -- both vaccines require two doses several weeks apart -- are expected Jan. 10-16, Kim said.
Meanwhile, the outbreak in the county's jails continues to widen, with 834 infections currently, said Carrie Braun of the Orange County Sheriff's Department. None of the inmates are hospitalized, she said.
On Friday, the first jailed inmate in Orange County with COVID-19 died of complications from the virus.
Outbreaks in the county's nursing homes continue to rise, as well, with 35 skilled nursing facilities and 36 assisted living facilities for the elderly with two or more positive cases within the last two weeks.
As for reports of a mutated version of COVID-19 in England that experts say is more efficiently transmitted, Noymer advised Orange County residents not to panic.
"Basically nothing has changed in terms of what people should do in Orange County," Noymer said. "Nothing in the short term has changed."
He added, ``Mutations are inevitable. Viruses evolve. It was only a matter of time before mutations became apparent."
The 1918 flu pandemic strain mutated and devolved and there were strains of it that lasted until 1957, Noymer said.
"Mutations per se are not the enemy," he said.
The mutated strain of COVID-19 could affect vaccines "in ways that we really don't know, and it has a pretty high probability of affecting the antigen tests that have been much ballyhooed, and in my opinion, overly so,'' Noymer said.
The county recorded 4,060 COVID-19 tests on Monday, for a total of 1,855,903 to date.
The county is testing 526.8 people per 100,000 on a seven-day average with a seven-day lag, which is an all-time high.
All of the county's metrics now fall within the state's most-restrictive, purple tier of the state's four-tier coronavirus monitoring system.
Orange County's adjusted daily case rate per 100,000 rose Tuesday from 30.3 the previous week to 42.7, with the positivity rate increasing from 10.6% to 13.2%. The county's Health Equity Quartile Positivity Rate, which measures the cases in highly affected, needier parts of the county, rose from 16.2% last week to 18.8%.