The spread of coronavirus in Orange County has grown so fast in recent weeks that the county soon could be on the state’s watch list for possible renewed lockdown orders.
Locally, two key metrics used by state and local health officials to measure the spread of the disease — rates of new COVID-19 cases per 100,000 residents and the percentage of people who test positive for the virus — are already at or beyond the state’s watch-list threshold.
Orange County put one toe over one line on Friday, June 26, when the positive test rate locally hit 8.5%, just over the 8% limit set by the state.
Also on Friday, the county reported that COVID-related hospitalizations grew 17.6% over the previous three days, well over the state threshold of 10%.
It’s unclear if the new data will prompt the state to put Orange County on its watch list, which already includes Los Angeles, San Bernardino and Riverside counties, among others. State officials look for at least three days of data to establish a trend before deciding to add counties to the watch list.
If Orange County winds up on the list, and if recent trends aren’t reversed, a renewed lockdown could be on the table.
On Friday, Gov. Gavin Newsom called on Imperial County — where coronavirus cases and hospitalizations have surged — to reinstate stay-at-home orders that would limit operations at non-essential businesses and re-close many other areas of public life.
If such a move is taken in Orange County, it could come in stages.
Corey Egel, acting deputy director of public affairs at the state health department, said state officials first will work with local health departments and county leaders for “targeted engagement,” laying out specifics as to why a county is seeing higher levels of disease transmission, hospitalization, or is facing limited hospital capacity.
But without voluntary action at the county level, the state can step in.
“If the county makes insufficient or no progress, and the local jurisdiction refuses to act, the State Public Health Officer may take action,” Egel said.
By Friday, 15 of the state’s 58 counties were on the watch list. Egel said those counties might consider reviving limits on non-essential business, or issue more general stay-at home orders.
But before taking such actions, state officials will discuss other steps with the local health departments, such as more aggressive testing, additional contact tracing, and taking new strategies to manage healthcare resources and infection control.
Los Angeles County, for example, is seeing a high rate of coronavirus cases because of its high testing capacity, and because it’s testing all residents and staff at more than 200 skilled nursing facilities.
The latest data suggests Orange County is starting to breach state thresholds in another key metric — the number of new cases per 100,000 people reported over a three-week period.
In Orange County, that number has grown consistently since the start of the pandemic.
On April 1st, the rate was 17 new cases per 100,000 residents, according to county records. In early May, it was 31 and a month later it was 61.
On Friday, the county reported the new number was 98 — just under the state watch-list threshold of 100.
By comparison, Los Angeles County had a new-case rate of 199 per 100,000. And in Imperial County — which was put under stricter orders on Friday — the rate was a state high 680 new cases per 100,000 people. Both counties have been on the watch list since June 5.
On Friday, Newsom said the state has paused in issuing guidelines to help counties to ease restrictions on businesses and public facilities.
The Orange County Health Care Agency data that the Southern California News Group analyzed differs slightly from the data the state health department is using to track counties.
The state counts new cases by “episode date,” the earliest date a person could have been infected.
Orange County’s health agency, on the other hand, provides the number of new cases recorded by the agency on a given day, regardless of when a person was tested, resulting in different rates.
For measures such as case rates over two weeks, state health department analyses ignore data that’s less than three days old because of widespread delays in reporting test results.
Dr. Clayton Chau, Orange County’s acting health officer, said the Health Care Agency is talking regularly with the state health department and monitors data daily to inform response plans.
“If the monitoring metrics result in OC being flagged by the State, the HCA will work closely with the State to determine any additional mitigation strategies that may be needed,” Chau said.
