Field ICUs Sprout At Orange County Hospitals As Cases Surge

ORANGE COUNTY, CA —Orange County reported another near-record day Wednesday, with 4,514 new coronavirus cases and 27 additional virus deaths. Orange County CEO Frank Kim said there was the hope of a cresting of the Thanksgiving wave as Wednesday showed another day of the county's positivity rates declining slightly.

The number of hospitalized patients rose from 2,106 on Tuesday to 2,145, with intensive care unit patients rising from 473 to 479. The county has 40% of its ventilators available, according to the Orange County Health Care Agency.

To combat the rise in patients, UC Irvine is one of three area hospitals adding a mobile setup to their arsenal of care. The hospital constructed a temporary mobile field hospital in their parking lot this week to serve up to 40 more patients. This unit will ease the strain on inpatient care units during the coronavirus surge. Each unit can hold 50 people, according to CEO Chad Lefteris. Medical personnel from across the country are coming to help keep every hospital bed open during the December rise in coronavirus cases. Meanwhile, medical professionals are getting their doses of the coronavirus vaccine. Next in line are residents of nursing homes and care facilities, followed by essential workers, then adults with underlying conditions, and at last all other adults, UC Irvine Health reports.

Along with UC Irvine Medical Center in Orange, another mobile hospital with 25 beds each at Fountain Valley Regional Hospital and Los Alamitos Medical Center.
The county has four more mobile field hospitals left that have 25 beds apiece.

Of the 27 newly reported fatalities, one was a skilled nursing facility resident. The fatalities are spread out over the past few weeks. The deadliest days so far this month were Dec. 13 and Dec. 14, when 15 people died each of those days from complications of COVID-19.

The county's state-adjusted ICU bed availability remained at zero, and the unadjusted figure decreased from 8.9% Tuesday to 5.9% Wednesday. 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 capacity.

The 4,514 new cases in Orange County came close to a record 4,606 cases reported on Dec. 20. On the day after Christmas, 5,953 cases were reported, but that reflected a total of over two days because statistics were not updated on Christmas Day.

The cumulative case count stands at 156,573, and the death toll rose to 1,874.

All of the county's metrics remain within the state's most- restrictive, purple tier of the four-tier coronavirus monitoring system.

Orange County's adjusted daily case rate per 100,000 —released on Tuesdays—increased from 51.8 last week to 53.5 this week. The positivity rate rose from 15.2% to 16.9%.

The county's Health Equity Quartile Positivity Rate, which measures the cases in highly affected, needier parts of the county, rose from 22.7% last week to 24.2%.

The positivity rate was 16.5% Wednesday, down from 16.7% Tuesday, and 16.9% on Monday.

"Today is the first day that the seven-day average case rate came down," Kim said. "It's nothing wild to write home about. But the positive news is there is a minor lull or plateau."

But officials are bracing for a post-Christmas surge, followed by a potential New Year's wave.

Experts say it takes five to 10 days for a surge to take shape and Wednesday was the fifth day since Christmas.

UC Irvine Medical Center activated its mobile field hospital with 40 additional beds on Wednesday.

Andrew Noymer, a UC Irvine associate professor of population health and disease prevention, said it's hard to say if the county has reached its peak from Thanksgiving. Still, even so, it's likely a Christmas surge is coming.

"We saw with Thanksgiving it took a while to build," Noymer said. "I'm expecting January to be severe. We haven't seen the worst yet. But nobody can predict the future of this."

Noymer noted that the county's positivity rate has been "highly volatile."

With hospitalizations at such a high level, officials want to use the Fairview Developmental Center in Costa Mesa, but only six patients are currently being treated there. A total of 51 have been treated at the state facility, Kim said. He said some of the obstacles to treating patients at Fairview include a shortage of staff needed for the beds there.

Outbreaks at the county's skilled nursing facilities and elderly assisted living facilities—defined as two or more cases within 14 days—are an ongoing problem for the county. As of Tuesday, 40 skilled nursing facilities and 55 elderly assisted living facilities have outbreaks.
"We need to hurry up and inoculate those individuals and staff working with those individuals," Kim said. "The virus is coming in through the employees, so we need to get those employees vaccinated quickly."

Transportation Security Administration figures for security screenings nationally reflect more traveling over Christmas than Thanksgiving. On the day before Christmas Eve, nearly 1.2 million screenings were done at U.S. airports, compared with 1.9 million on the same date in 2019.

Preliminary data indicates that traffic at John Wayne Airport was down during Christmas compared with Thanksgiving.

From Nov. 24 through Nov. 30, 64,947 passengers passed through the Orange County airport for a daily average of 9,278. From Dec. 20-26, 60,193 passengers went through the airport for an average of 8,599 a day.

Noymer said he is not as concerned about travelers contracting coronavirus at the airport or on a plane.

"More people pass through South Coast Plaza than the TSA checkpoint at John Wayne (Airport)," Noymer said. "But we're churning the whole country, moving people around from college kids from Overland, Ohio, going back to home and people going to see in-laws or grandmothers, or whatever. That's moving the virus around, increasing the motion and commotion of people and therefore of the virus, and it's not what the doctor ordered."

While it is generally understood that COVID-19 poses the greatest risk of fatality to elderly patients, Noymer pointed out that in Orange County, 25% of the deaths are residents younger than 65. Most of those deaths are in the 55 to 64 age group, he added.

Meanwhile, there were 1,229 inmates infected Wednesday, down from 1,246 on Tuesday. The county is awaiting 179 test results.

Two inmates are hospitalized with "minor symptoms," Orange County Sheriff Don Barnes said Wednesday. One inmate has died.

The county recorded another 12,340 COVID-19 tests taken on Wednesday, for a total of almost 2 million, 23 thousand tests overall.

City News Service, Patch Editor Ashley Ludwig contributed to this report.

This article originally appeared on the Orange County Patch