Orange County reported 4,204 new cases of COVID-19 and 43 additional deaths Saturday, bringing the county's totals to 185,481 cases and 2,041 fatalities.
The number of patients hospitalized with the coronavirus decreased from a record 2,259 Friday to 2,221, with intensive care unit patients climbing from 514 to a record high of 528, according to the Orange County Health Care Agency.
Ten of Saturday's 43 reported deaths were residents of skilled nursing facilities, while 15 were residents of assisted living facilities. Since the pandemic began, 683 of the dead were skilled nursing facility residents and 221 were from assisted living facilities.
There have been 140 fatalities reported this week. The death reports come from a variety of sources, so they are staggered and happened last month.
There were 17,080 tests reported Saturday, raising the cumulative to 2,223,962, according to the OCHCA. There have been 111,854 documented recoveries.
Orange County CEO Frank Kim, referring to the expected surge of Christmas and New Year's-related cases, said the current wave of the pandemic is going to get worse.
"People were not behaving around the holidays, so I'm fearful the numbers will be worse," Kim said. "Our case rates have not come down and the testing positivity rates are climbing."
The positivity rate is about 18%, Kim said.
Orange County Supervisor Lisa Bartlett said the county had only 41 intensive care unit beds available.
"They are starting to put patients in cath labs and other parts of the hospital," Bartlett said. "There aren't available rooms and space so they're using every single opportunity of space within a hospital environment for patients."
State officials are pushing hospitals to get patients who are recovering into assisted living facilities or elsewhere to free up hospital beds, Bartlett said.
Hospital officials are also instructing staff on rationed care and to prepare for it, Bartlett said.
"And we have not yet hit the Christmas and New Year's spikes," Bartlett said, adding the beginning of that surge is happening now.
Help is on the way with vaccines. Orange County Fire Authority firefighters have been vaccinating frontline workers, but now state officials have widened the pool of available medical workers who can inoculate residents, Bartlett said.
Nursing students and physician assistants are among those who can now vaccinate residents, she added.
"We have a new pool to choose from for vaccinators," she said.
County officials are working on setting up two super sites, which will be announced next week, where vaccines will be distributed. Kim said it is an effort to help out hospitals dole out vaccines as doctors and nurses are too overwhelmed with caring for patients now.
The Orange County Jail's recent outbreak saw a steep decline on Friday with the number of infected inmates dropping from 1,020 to 465. The county is awaiting the results of 979 tests.
The number of hospitalized inmates remained at six, according to Orange County Sheriff's Department Sgt. Dennis Breckner.
Part of the reason the number of infections has come down is OCHCA officials are catching up on analyzing test results, Breckner said.
The county's state-adjusted ICU bed availability remains at zero, and the unadjusted figure decreased from 5.6% Thursday to 5.1% Saturday. The state created the adjusted metric to reflect the difference in beds available for COVID-19 patients and non-coronavirus patients.
The Southern California region is at zero ICU availability.
The county's availability of ventilators inched up from 33% Thursday