Orange County's COVID-19 hospitalizations have eclipsed the peak of the first wave in July 2020, and officials on Friday reported a child younger than 5 has succumbed to the disease.
The number of COVID-infected hospital patients in Orange County increased from 673 Wednesday to 724 Thursday, with the number of patients in intensive care dropping from 116 to 109, according to the Orange County Health Care Agency.
The last time hospitalizations reached that level was mid-February, during a post-holiday winter surge of infections.
Exactly one year ago -- on Jan. 6, 2021 -- there were 2,251 COVID- positive patients hospitalized in Orange County, just as vaccines were being rolled out for front-line medical staff and first responders.
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The summer 2021 peak of hospitalizations was reached on Aug. 26, with 592 patients.
During the first virus wave in the summer of 2020, hospitalizations peaked July 14 at 722.
“This is now officially the second-largest wave in terms of peak hospitalizations,” Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention, told City News Service on Thursday.
The key differences in the summer of 2020 were “no vaccines and there were very few n95 masks in the public's hands,” Noymer said.
“The silver lining, I think, is that we may have fewer deaths as a proportion of those hospitalized because it seems Omicron results in less ventilator use and less severe outcomes even when hospitalized. It's possible this won't be as deadly as it looks at first blush, which is not to say it's a nothingburger, because hospitalizations are never to be taken lightly.”
In every other sense, however, "it's pretty much the same as before," Noymer said of this wave. "I don't think it has peaked. I still don't think it will exceed last January. I won't give you a water-tight guarantee on that, but I don't think it will."
Meanwhile, the county reported 6,266 new COVID cases Thursday, boosting the cumulative to 368,432. The county also logged two more fatalities, increasing the overall death toll to 5,903.
One of those fatalities was a child younger than 5. County officials did not say whether the child was a boy or a girl nor provide when the death occurred. It is the third child to succumb to COVID-19 since the pandemic started.
All of the deaths logged Thursday occurred in December. The death toll for last month is now 54.
The two fatalities were skilled nursing facility residents, hiking the number of deaths in that category since the pandemic began to 1,220. The overall death toll also includes 647 assisted living facility residents.
There has been a jump in outbreaks in nursing homes in this current wave. There are outbreaks in 23 elderly assisted living facilities and 17 skilled nursing facilities.
The county has officially sequenced 292 cases of the Omicron variant as of Sunday, the latest data available, according to the OCHCA's data.
It is possible the county may have peaked and can look forward to a downturn of cases, but it is too early to tell, Orange County CEO Frank Kim said Wednesday.
On Tuesday, the latest data available, the county had 973 positive specimens collected, according to the OCHCA. There were 3,364 specimens collected Monday.
On Sunday, 1,899 tested positive, much fewer than the 3,729 on Dec. 31, 6,138 on Dec. 30 and 6,337 on Dec. 29, the peak day of this most recent surge. Those numbers are fluid and updated, however.
“It's hospitalizations is where it's at," Noymer said of gauging the pace of the wave. "The testing is all over the place. ... And right now it's overwhelmed. I've heard stories it's hard to get tests.”
When hospitalizations trend downward for three consecutive days "then we'll known the worst is over,'' Noymer said.
“It looks a little better," Kim said of the trend of positive cases on Wednesday. "But testing labs and hospitals are delayed three or four days in terms of reporting testing, so looking at the data today we have a blind spot of three or four days, so it's hard to see a trend. But it looks like we're hitting a peak, but I don't want to say that for sure. ... We're coming off a peak at the end of December -- that's what it looks like -- but we can't validate that until we get another five days out or so.”
It is also difficult to determine just how many residents are getting infected because some get their results from at-home kits, Kim said.
“Everyone's buying an at-home test from CVS or Walmart and Amazon and there is a QR code so technically you should scan the QR code so there's a record, but I suspect very few people are doing that," Kim said.
Orange County Board Vice Chairman Doug Chaffee, who's in line to become to board chairman next week, said, "A big bugaboo and unknown is what happens over the New Year's -- all those celebrations. We haven't seen any data out of that yet so it's hard to say. But hopefully people are finally realizing that the people in the hospital and sick are those who did not get vaccinated. Maybe that's an incentive to go and do it now."
Chaffee is concerned about how the surge will affect staffing at local hospitals. "The hospital numbers are high and we have capacity, but do we have the workers to take care of people," Chaffee said.
"There's a lot of stress on them, too. It all comes back to most cases are people who didn't get vaccinated and they're stressing everybody else out. It's not very fair, but we just got to keep pushing, pleading and hoping that suddenly the light turns on and people get a shot."
Noymer encouraged residents to get a booster shot. He noted that most people completed the two-dose regimen of the mRNA vaccines from Pfizer and Moderna as of July, so they are eligible for a booster shot and should get one as soon as possible.
'I absolutely recommend booster shots and they're on the way for those 12 and up, but those 16 and up can already get a booster shot if they're eligible," Noymer said.
Orange County had 17.2% of its intensive care unit patient beds available and 66% of its ventilators as of Thursday. Of the hospitalized patients, 87% are unvaccinated, and 88% of the ICU patients are not inoculated.
The county's adjusted daily case rate per 100,000 residents jumped from 53.6 Wednesday to 64 Thursday. The testing positivity rate soared up from 16.2% to 19.1%, and it increased from 16% to 19.3% in the health equity quartile, which measures underserved communities hardest hit by the pandemic.
The seven-day average for tests per 100,000 increased from 513.9 Wednesday to 561.2 Thursday.
Rising patient numbers have meant delays for people going to hospitals. The average time to drop off a patient at a hospital as of last Thursday was between 46 and 47 minutes, according to OCHCA. By Thursday it was up to 52 and 53 minutes.
Orange County Supervisor Lisa Bartlett said Tuesday that county officials are encouraging hospitals to erect surge tents to help with triaging patients, as was done during last winter's surge.
"We're trying to encourage the hospitals to put up their surge tents because that will help process people faster and reduce the number of ambulance wait times," Bartlett said. "And it increases capacity for the hospitals."
As of last week, nine of the county's 25 hospitals had surge tents put up, she said.
The wave of infections is also affecting entertainment and courthouse functions.
Soka Performing Arts Center is postponing its season opening by two weeks. Officials at South Coast Repertory in Costa Mesa has canceled live performances for Saturday and Sunday because some of its theater company has tested positive for coronavirus. The theater hopes to resume performances Jan. 16.
At the Orange County Superior Courts, attorneys were being encouraged to do more virtual appearances for most hearings, reserving live appearances for evidentiary hearings and trials.
Starting Thursday, anyone wanting to use the Mission Viejo Library must make an appointment so the staff can socially distance patrons.
November's death toll stands at 101, 127 for October, 196 for September and 182 for August.
In contrast, the death toll before the more contagious Delta variant fueled a summer surge was 31 in July, 19 for June, 26 for May, 47 for April, 202 for March and 620 for February.
January 2021 remains the deadliest month of the pandemic with a death toll of 1,596, ahead of December 2020, the next deadliest with 985 people lost to the virus.
The case rate per 100,000 residents for the unvaccinated jumped from 60.6 on Dec. 25 to 180.1 as of Jan. 1. For the vaccinated the case rate increased from 37.9 on Christmas Day to 108.5 by New Year's Day.
The number of fully vaccinated residents in Orange County increased from 2,328,647 to 2,341,562, according to data released Thursday.
That number includes an increase from 2,176,795 last week to 2,189,337 of residents who have received the two-dose regimen of vaccines from Pfizer or Moderna.
The number of residents receiving the one-dose Johnson & Johnson vaccine increased from 151,852 to 152,225. Booster shots increased from 837,313 last week to 900,815.
In the relatively recently eligible age group of 5 to 11 years old, 46,791 kids have been vaccinated versus 221,789 who have not gotten jabbed.
It's the least vaccinated age group in the county. The next worst vaccinated age group is 25 to 34 with 312,736 inoculated and 146,665 who have not gotten a shot.
The most vaccinated age groups are seniors.