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By Zach Cavanagh

Orange County opened up its COVID-19 vaccine eligibility group to include individuals 65-years-old and older, and the state reported its lowest hospitalization increases since October for two optimistic notes against the winter surge of the coronavirus pandemic on Tuesday, Jan. 12.

In concert with new federal guidelines opening up to individuals age 65 and over and younger individuals with other health issues, the Orange County Health Care Agency opted to open its vaccine distribution to that older group, as well as emergency service workers.

“I reached this decision after carefully reviewing case, hospitalization/intensive care unit (ICU), and mortality data related to older adults and noting the especially concerning outcomes for this specific population here in OC,” Dr. Chau, County Health Officer and Director of the OCHCA said. “My aim is to reduce hospitalizations and deaths as rapidly as possible, and we must prioritize our vaccine allocation to protect the most vulnerable in our community.”

Both the age 65 and older group and emergency service workers were originally slotted into Phase 1B of the state’s vaccine distribution plan. California is currently in Phase 1A of its vaccine distribution plan, which provides the vaccine to healthcare workers and long-term care residents.

In an update on Tuesday, California Health and Human Services Secretary Dr. Mark Ghaly said the state should release updated guidelines based on the earlier federal announcement within 24 hours.

Orange County’s announcement comes ahead of the opening of the county’s first super point of distribution (POD) site at Disneyland later this week. Voice of OC reports that five Super POD sites are expected in the county, with two likely in South County at Soka University in Aliso Viejo and the Great Park in Irvine.

California has committed to opening many of these Super POD locations throughout the state, including Disneyland, Dodger Stadium in Los Angeles and Petco Park in San Diego.

Appointments will be needed for those looking to receive the vaccine at the Disneyland Super POD site. The OCHCA encourages those interested to register to be notified when the county’s vaccine and testing management app, Othena, has appointments available and is ready for use at and filling out the online form.

The federal guidelines also came with the release of all of the extra doses of the COVID-19 vaccine that had been held back to be used as second doses of the vaccine.

On Monday, Jan. 11, Gov. Gavin Newsom committed to state’s goal of administering 1 million more vaccinations by the weekend. Newsom said 783,476 doses of the 2,466,125 total vaccines had been administered as of Sunday, Jan. 10.

On Tuesday, Dr. Ghaly a little more than 99,000 second doses had been administered in California.

Dr. Ghaly also reported that coronavirus hospitalizations in the state are up 5.5% over the last 14 days, which is the lowest rate since October. ICU patient totals are up 10.6% over the last 14 days. As of Tuesday, Orange County hospitalizations had risen 4.5% in the past 14 days, with ICU patients increasing by 13.1%. California is again at a record number of hospitalizations at 22,665. Orange County is just under record numbers at 2,200 hospitalizations and 535 ICU patients.

“Hospital numbers don’t lie,” Dr. Ghaly said. “To see a reduction in our hospital numbers in the last days, in terms of rise, is a good sign, but we’re not out of the woods. We must continue to keep our guard up and work together to reduce transmission.”

Where California’s regions stand with the state’s stay-at-home order as of Jan. 12. Graphic: California Department of Public Health

As of Tuesday, Jan. 12, the Southern California region remains under the state’s regional stay-at-home order, as the state’s four-week ICU projection for the region still does not meet the 15% available criteria to exit the order.

After the initial three-week period of the stay-at-home orders passed on Dec. 27, the state will now make a daily review of each region’s projected four-week available ICU capacity, and if that projection remains under 15%, the order shall remain in place. Once the region’s four-week projection shows 15% availability or greater, the region will be released from the order.

The projections are based on the region’s current ICU capacity, seven-day average case rate per 100,000 residents, transmission rate and rate of ICU admission.

The Southern California region and Orange County were again both listed at 0.0% adjusted ICU availability on Tuesday, Jan. 12.

According to the county, the adjusted ICU availability is being used “to preserve the capacity of the ICU to also treat non-COVID-19 conditions. … If a disproportionate number of ICU beds are being utilized to treat COVID-19 patients, then patients with non-COVID medical issues may not be receiving or be able to receive the level of care they need.”

If a region is using more than 30% of its ICU beds for COVID-19 patients, an extra 0.5% is removed in the adjusted capacity for every 1% over that 30% threshold to preserve those necessary resources and beds.

As of Tuesday, Southern California had an unadjusted available ICU capacity of 9.3%, and Orange County was at 6.4%. Both are slightly up from last week with Southern California at 9.2% last week and Orange County at 4.9%.

The San Joaquin Valley (0.0%), the Bay Area (4.7%) and Greater Sacramento (9.4%) regions are the other three of the state’s five regions under the stay-at-home order. Currently, the San Joaquin Valley and Greater Sacramento are the other two regions to go through its initial three weeks and will also receive the daily four-week projections. Northern California is at 17.6%.

Where California’s counties stand in the state’s four-tiered, color-coded coronavirus monitoring system as of Jan. 12. Graphic: California Department of Public Health

Nationally, the United States now tops 22.6 million coronavirus cases. There have been 376,060 deaths in the United States, and the national seven-day average testing positivity is at 12.99%.

As of the state’s tier update on Tuesday, Jan. 12, California’s case rate and positivity rate both rose back up as the state jumped to 97.1 daily new cases per 100,000 from 74.1 last week and the 14-day testing positivity average went up to 13.5% from the 12.4% of last Tuesday and from the 12.6% of the week before that.

The state saw increases in total new cases and case averages, but it is still down from its record-highs. The 14-day rolling average of daily new cases dropped to 40,004.8 on Monday, Jan. 11, up from 37,666.2 on Monday, Jan. 4.

Nearly all of California is now in the purple tier in the state’s four-tiered, color-coded coronavirus monitoring system, with 54 of the state’s 58 counties at the highest-risk level. There are only three counties at the red “substantial” risk level, one county at the orange “moderate” risk level and none at the yellow “minimal” risk level.

The four-tiered 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.

Orange County’s coronavirus monitoring metrics continued to climb higher in the purple tier this week. Daily new cases per 100,000 residents continued to trend sharply upward this week as the metric jumped to an adjusted 68.8 daily new cases per 100,000, up from the 67.8 new cases last week and the 53.5 of two weeks ago. The threshold for the purple tier is 7.0.

The state reports an adjusted case rate, which is adjusted for the volume of testing. The unadjusted rate is 91.3 daily new cases per 100,000, up from 74.8 last week and down from 98.5 two weeks ago.

The county also saw a small rise in its testing positivity, as the countywide number climbed to 19.5% from last week’s 17.1%. The metric was at 16.9% two weeks ago. The threshold for the purple tier is 8%.

The county’s health equity positivity rate was reported at 24.2%, up from last week’s 23.4% and the 24.2% of two weeks ago. The threshold for the purple tier is 8%. The health equity rate measures the testing positivity in a 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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