ORANGE COUNTY, CA — Orange County reported 15 coronavirus-related deaths and 187 new diagnoses Tuesday, raising the death toll to 581 and the cumulative case total to 34,833. The county's top health officer said the number of hospital nurses falling ill with the virus was a "point of concern," according to Dr. Clayton Chao of the Orange County Health Care Agency.
The number of patients being treated for COVID-19 in Orange County hospitals dropped from 661 on Monday to 640. Of those hospitalized, the number of patients in intensive care units decreased from 204 to 203, according to the Orange County Health Care Agency.
A total of 19 people have died since Sunday, the county has reported. Last week, the county reported 70 COVID-19-related deaths, down from 73 the week before.
One-third of the deaths reported Tuesday involved skilled nursing facility residents.
Of the total deaths, 253 were skilled nursing facility residents, 21 lived in assisted living facilities, and one was homeless. Of the total cases, 1,556 were skilled nursing facility residents, 472 were jail inmates and 136 were homeless.
The county has administered 399,424 coronavirus tests and estimates 21,066 recoveries, according to the HCA.
As of Tuesday, here are the current coronavirus totals in cities across Orange County:
Aliso Viejo - 265 Total Cases
Anaheim - 5954 Total Cases
Brea - 338 Total Cases
Buena Park - 968 Total Cases
Costa Mesa - 1140 Total Cases
Coto de Caza - 24 Total Cases
Cypress - 386 Total Cases
Dana Point - 178 Total Cases
Fountain Valley - 348 Total Cases
Fullerton - 1623 Total Cases
Garden Grove - 1856 Total Cases
Huntington Beach - 1643 Total Cases
Irvine - 1132 Total Cases
La Habra - 822 Total Cases
La Palma - 113 Total Cases
Ladera Ranch - 113 Total Cases
Laguna Beach - 130 Total Cases
Laguna Hills - 214 Total Cases
Laguna Niguel - 278 Total Cases
Laguna Woods - 39 Total Cases
Lake Forest - 584 Total Cases
Los Alamitos - 148 Total Cases
Midway City - 63 Total Cases
Mission Viejo - 564 Total Cases
Newport Beach - 793 Total Cases
Orange - 1613 Total Cases
Placentia - 637 Total Cases
Rancho Mission Viejo - 46 Total Cases
Rancho Santa Margarita - 242 Total Cases
Rossmoor - 29 Total Cases
San Clemente - 319 Total Cases
San Juan Capistrano - 251 Total Cases
Santa Ana - 6570 Total Cases
Seal Beach - 212 Total Cases
Silverado - 39 Total Cases
Stanton - 409 Total Cases
Trabuco Canyon - 149 Total Cases
Tustin - 821 Total Cases
Villa Park - 39 Total Cases
Westminster - 644 Total Cases
Yorba Linda - 479 Total Cases
Orange County remains on the state's watch list for counties experiencing high rates of new cases and hospitalizations. It has shown some improvement, but with some continuing concerns.
The county's case rate per 100,000 residents dropped from 188.9 to 150.8, but is still far higher than the California Department of Public Health threshold of 25 per 100,000 residents. The rate of residents testing positive for COVID-19 dropped from 11.7% to 11.1%, which is still higher than the state's desired rate of 8%.
The change in the three-day average of hospitalized patients was - 1.9%, much lower than the state's threshold of 10%.
Available ICU beds increased from 32% to 40%, and the percentage of ventilators available dropped from 63% to 58%. The state's threshold is 20% of ICU beds available to handle a surge and 25% ventilators on hand.
Dr. Clayton Chau, director of the Health Care Agency and interim chief health officer, told the Board of Supervisors that the county's positivity rate "has seen a trend of decreasing, so that's a good sign," but is still at a "concerning level."
Chau, however, said the most important statistics to keep an eye on are the number of ICU beds and availability of ventilators and, "from that perspective we're doing quite well."
Heightened hygiene, physical distancing and the wearing of face coverings "seems to be working to slow down the spread," he said, though the main concern has been "staff fatigue."
Chau added that many nurses "have been infected," so "the availability of nurses to make sure hospitals function is a point of concern for us ... We have people who cannot go to work because they have been exposed or infected."
Three larger hospitals in the area have been "requesting support from the state for more staffing, specifically nursing staffing," Chau said. "So that's something we're watching very closely... It does not mean those beds are available if you don't have the nursing staff."
Supervisor Don Wagner grilled Chau as to why the state has set 8% as the threshold for positivity rates, questioning its legitimacy. Chau said he could not say, but said it could have something to do with studies globally showing the positivity rate ranges between 8% to 18%.
Wagner also asked Chau about a recent study out of South Korea that concluded children 10 and younger transmit the virus at a lower rate than any other age group. Chau noted the study was done while schools were not in session.
Chau said experts still do not know at what rate children transmit the virus to adults. He said the county is working on a contact tracing study with experts from UC Irvine and Children's Hospital of Orange.
"That will answer some of the questions we have," Chau said.
Wagner questioned why the state is preventing students from returning to classes until the county meets the 8% threshold for positivity rates.
"Doesn't the flu kill more people than COVID?" Wagner said. "Don't we keep schools open during the flu season?"
Chau objected to comparisons between the flu and COVID-19. "When I hear people compare the regular flu to COVID, I feel like we've been missing the point," Chau said.
Wagner, board Chairwoman Michelle Steel and Supervisor Andrew Do pressed Chau to lean on state officials to parse the number of people who go to a hospital for another reason, but test positive for COVID-19 after admittance versus patients who are taken to a hospital with coronavirus.
Supervisor Lisa Bartlett encouraged Chau to press state officials to allow indoor malls to open to alleviate crowded outdoor malls, where she said it is increasingly difficult to socially distance. Bartlett argued that indoor malls are more uniquely situated to promote social distancing because of the space as opposed to other businesses such as movie theaters and gyms.
Santa Ana has the most cases in the county with 6,570, and a case rate of 1,945.4 per 100,000 residents, followed by Anaheim with 5,954, and a case rate of 1,656.9 per 100,000 residents. They are the county's two largest cities by population, and home to many care facilities.
Two of the county's other biggest cities have much lower case rates, with Huntington Beach at 806.3 per 100,000 and Irvine with a case rate of 404 per 100,000.
In the jails, 53 inmates are in medical isolation with symptoms, with 419 having recovered. Officials are waiting for the results of 83 tests.
City News Service, Patch Editor Ashley Ludwig contributed to this report.