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By Zach Cavanagh

As Orange County entered its first week of a new regional stay-at-home order, coronavirus case rates and hospitalizations continued to rise to record levels across the state, and the county climbed higher in to the purple “widespread” tier in the state’s latest tier update on Tuesday, Dec. 8.

The state’s four-tiered, color-coded coronavirus monitoring system is the main component of the state’s Blueprint for a Safer Economy for determining in what capacity different sectors, businesses and activities can reopen safely as the COVID-19 pandemic continues.

Nationally, the United States is now over 15 million coronavirus cases, with well over 100,000 new cases reported each of the last 35 days and over 200,000 new cases reported three days last week. There have been 283,703 deaths in the United States, and the national seven-day average testing positivity is at 10.47%.

Where California’s counties stand in the state’s four-tiered, color-coded coronavirus monitoring system as of Dec. 8. Graphic: California Department of Public Health

As of the state’s tier update on Tuesday, Dec. 8, California’s case rate and positivity rate continued to rise as the state reached 34.0 daily new cases per 100,000 and the 14-day testing positivity average rose up to 8.7% from the 6.6% of last Tuesday and the 5.6% of the week before that. The 8.7% 14-day average is a 55% increase from Nov. 24.

California Health and Human Services Secretary Dr. Mark Ghaly pointed out that the seven-day positivity is even higher at 10.1%, meaning the 14-day average will only continue to increase.

The state has continued to see its record-high new cases and case averages climb higher. The 14-day rolling average of daily new cases rose up to 18,290 on Sunday, Dec. 6 up from 13,123.8 on Sunday, Nov. 29. Saturday, Dec. 5 posted the largest single-day number of the pandemic by far with 30,075 cases.

Dr. Ghaly reported the state has seen a 70.8% increase in COVID-19 hospitalizations in the last 14 days and a 68.7% in COVID-19 ICU patients over the same span. Based on the OCHCA’s reported numbers, Orange County has seen a 104% increase in COVID-19 hospitalizations in the last 14 days and a 105% increase in COVID-19 ICU patients over the same span. Both the state and county are at a record number of COVID-19 hospitalizations at 10,567 and 946, respectively.

Where California’s regions stand with the state’s stay-at-home order as of Dec. 8. Graphic: California Department of Public Health

As of Monday, Orange County and the Southern California region were under a three-week stay-at-home order as the region’s available ICU capacity dropped below 15%. The Southern California region is at 10.1% ICU availability on Tuesday, and the state reports Orange County is at 6.7%. The OCHCA reported the county has 13% of ICU beds available.

The San Joaquin Valley is the only other of the state’s five regions under the stay-at-home order with 5.6% of ICU beds available. Greater Sacramento is at 18.8% available, the Bay Area is at 24.5% and Northern California is at 25%.

Nearly all of California is now in the purple tier with 54 of the state’s 58 counties at the highest risk level. There are only three counties at the red “substantial” level, one county at the orange “moderate” level and none at the yellow “minimal” level. Just six weeks ago, only nine California counties were purple.

Orange County’s coronavirus monitoring metrics continued to rise higher in purple tier this week. Daily new cases per 100,000 continued to trend sharply upward as the metric jumped to 30.3 daily new cases per 100,000, up from the 22.2 new cases last week. The metric jumped to the purple level at 10.8 three weeks ago.

The county also saw a continued rise in its testing positivity, as the countywide number climbed into the purple level to 10.6% from last week’s 8.8%. The metric was at 6.8% two weeks ago. The threshold for the purple tier is 8%.

The county’s health equity positivity rate was reported at 16.2%, more than double the purple-level threshold. Last week, the county reported a local estimate of 13%. The health equity rate was 5.5% when last reported by the California Department of Public Health on Nov. 10. The health equity rate measures the testing positivity in county’s low-income and more racially diverse neighborhoods.

To move back down to the red tier, Orange County would need to have its metrics at red levels for two consecutive weeks. If the county’s daily case rate is stable or declining but not at the next level, there would be the possibility of moving down if the testing positivity and health equity metrics meet the level for two tiers lower—that is, orange tier levels while in the purple tier.

The red tier requires the case rate to sit between 4.0 and 7.0, the testing positivity between 5.0% and 8.0% and the health equity rate between 5.3% and 8.0%. The orange tier requires the case rate to sit between 1.0 and 3.9, the testing positivity between 2.0% and 4.9% and the health equity rate between 2.2% and 5.2%. The yellow “minimal” risk tier, the lowest of the four tiers, requires a case rate lower than 1.0, testing positivity below 2.0% and health equity rate lower than 2.2%.

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