By Spencer Custodio | July 23, 2020
While it seems that the number of people hospitalized for Coronavirus in Orange County stabilized this week, there is concern that daily death counts seem to be creeping up, now well into the double digits with 22 people reported as killed by Covid on Thursday.
Orange Health Care Agency officials on Thursday also confirmed that they are increasingly transferring Covid patients from hospitals into skilled nursing facilities.
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An unknown number of Orange Countys coronavirus hospital patients have been moved to long term care facilities and skilled nursing facilities as hospitalization numbers ticked up the past couple weeks.
Yes, hospitalized COVID-19 positive patients are being discharged to long term care facilities. The OC Health Care Agency (HCA) does not track individual transfers. However, when a hospitalized COVID-19 positive patient is transferred to a Skilled Nursing Facility (SNF), that patient would be subtracted from the hospitalized count (by the sending hospital) and added to the SNF count via the state daily reporting, HCA staff said in a Thursday email.
A daily situation report from the county Office of Emergency Medical Services on Thursday shows theres been an increase of over 500 virus-positive patients in skilled nursing facility cases since the beginning of the month to 1,837 cases. The report doesnt note which cases are transfers and which ones are virus cases originating from the facilities.
At a Thursday news conference, OC interim health officer Dr. Clayton Chau said he hasnt heard of any surges at the skilled nursing facilities.
In normal times, Chau said, a patient gets into an acute hospital and the next level of care that they need is a skilled nursing facility, then the hospital, as well as the family and their insurance company, will try and find a skilled nursing facility that is appropriate to place people.
As far as I know, I have not heard any surge in skilled nursing facilities, Chau said. Ive not heard staff reporting that weve had an issue yet.
UC Irvine epidemiologist Andrew Noymer said the transfers to nursing facilities could explain why hospitalizations are remaining relatively steady.
So that could explain why all the hospital numbers looked like they plateaued, Noymer said in a Thursday phone interview.
But, Noymer said, the deaths continue to increase.
Theres no shirking the deaths, I mean 22 deaths today, Noymer said. I know the death reporting is clunky but the seven-day average is 2.1 percent per day.
When deaths are reported, they can span a window of up to eight days, the Health Care Agency notes on its website.
So thats the number that Ive been watching and Ive been doing seven-day averages precisely so we dont go crazy over single day jumps because those are just reporting issues, Noymer said.
Meanwhile, the virus has now killed 543 people out of 32,648 confirmed cases, according to the county Health Care Agency.
There are 690 people hospitalized, including 233 in intensive care units.
Over 380,000 tests have been conducted throughout OC, which is home to roughly 3.2 million people.
Dr. Paul Yost, whos an anesthesiologist at St. Josephs Hospital in Orange, said it would be helpful to know how many hospital cases are transferred to skilled nursing facilities so the overall picture of the countys healthcare system can be better understood.
Yost, the CalOptima board chairman, also noted the current system wasnt designed for a pandemic.
Our whole healthcare system is not designed something like this a pandemic that strikes a large percentage of the population, he said. Its designed around providing high quality care around things like heart surgeries but a global pandemic, its not designed for.
Noymer said he cant predict which direction OC heads from here, based on the recent patterns.
So heres the thing, were basically treading water. When I look at the OC numbers the past few days, I see a county thats not changing very much. And compared to three weeks ago, were worse. But compared to last week, were holding steady. So you can say were about to turn the corner and do better or take the plunge into a precipice. And I cant tell you exactly which of the two it is.
Heres the latest on the virus numbers across Orange County from county data:
Spencer Custodio is a Voice of OC staff reporter. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio
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