SANTA ANA, Calif. - Orange County set another record for hospitalized COVID-19 patients, but the number of those in intensive care fell by 19 and 17 additional fatalities were reported.
The number of hospitalized patients increased from 2,236 Tuesday to 2,249 Wednesday as the number of patients in intensive care fell from 504 to 485, according to figures from the Orange County Health Care Agency.
Of the 17 additional fatalities, five were skilled nursing facility residents and a dozen were from assisted living facilities. The death toll is 1,943 with 655 of the dead from skilled nursing facilities and 198 from assisted living facilities.
County officials also reported 3,077 new diagnoses of coronavirus, raising the cumulative total to 175,032.
There have been 42 fatalities reported this week. The death reports come from a variety of sources, so they are staggered.
Last week, the county reported 56 COVID-19 fatalities, down from 85 the week before.
Orange County CEO Frank Kim said Tuesday hospital officials have told him they were "concerned obviously" about the surge of patients, but, added, "They seem like they were managing it."
There were 20,003 tests reported on Wednesday, raising the cumulative to 2,147,743, according to the Orange County Health Care Agency.
Larger regional hospital systems received vaccines directly from the state, but the county was put in charge of delivering the medicine to smaller, stand-alone hospitals, Kim said.
County officials are working on a plan to help all hospitals vaccinate residents because medical workers are "swamped" with caring for patients, he said.
"We have to quickly work on a large-scale vaccination plan," Kim said Wednesday. "We can't rely on CVS, Walgreens and the local hospital system. They're overwhelmed."
"We need to pitch in and every county has been asked by the state to increase support for vaccine distribution. We hope to turn it into implementation very soon. We're very close to completing agreements on sites," Kim added.
County officials are eying large sites such as school gyms or parking lots to be central vaccination locations.
"We want to do thousands" of inoculations a day, Kim said.
One issue is finding enough qualified medical workers to vaccinate residents, Kim said. Only nurses, doctors and paramedics are authorized, but discussions are ongoing about expanding the types of qualified medical workers to provide vaccinations, he added.
A dispute erupted among county officials when Orange County District Attorney Todd Spitzer complained about when law enforcement officers were scheduled to receive the vaccine.
Spitzer accused the Health Care Agency of "not prioritizing frontline law enforcement... for first-tier vaccinations" in a letter to Dr. Clayton Chau, its director and the county's chief health officer.
Spitzer added, "I also learned that dentists jumped over police as a priority by the Vaccination Taskforce, an unbelievable development... This is an urgent matter that has been overwhelmed by bureaucratic red tape and quite frankly, utter nonsense."
Chau responded that the agency was "following guidance from the federal as well as the (state's vaccine plan)."
Dentists have been placed by the state in Phase 1A Tier 3, while police are in Phase 1B Tier 1, but that it could be changed, Chau said.
"Because of the recent eruption in cases in correctional facilities, we have asked our Vaccine Taskforce for approval to move up the law enforcement teams in the correctional setting even though only correctional medical providers are part of Phase 1A Tier 2."
In a note to Spitzer, Orange County Board of Supervisors Vice Chairman Andrew Do said he was "taken aback at the unprofessional manner in which you chose to express yourself" on the issue of law enforcement vaccinations.
Do told City News Service that Spitzer was wrong.
"The priorities as to who gets the vaccine is determined or set by the state,'' Do said. "This is not just a personal decision or a willy nilly decision made by Dr. Chau."
Kim said Wednesday a compromise has been worked out that would push some law enforcement officers who are working beats that put them at heightened exposure to COVID-19 further up in line for vaccinations.
Officers working in areas with larger outbreaks, correctional facilities, homeless shelters will be moved up in line, Kim said.
The Orange County Jail's recent outbreak saw a decline on Wednesday with the number of infected inmates dropping from 1,154 to 1,120. The county is awaiting the results of 491 tests.
The number of hospitalized inmates decreased from five to four, according to Orange County Sheriff's Sgt. Dennis Breckner.
Orange County Superior Court Judge Peter Wilson, who is overseeing a lawsuit filed by the American Civil Liberties Union against the county seeking to reduce the jail population to better conform with physical distancing guidelines, has ordered Sheriff Don Barnes to provide details of each inmate's charges, criminal history, and medical status by noon Thursday.
Wilson also allowed Santa Ana to intervene in the lawsuit. A hearing is scheduled Friday to go over Wilson's order to reduce the jail population by half, with Barnes claiming he has released as many lower-risk inmates as he possibly can.
The county is struggling with a surge fueled by Thanksgiving-related family and friend gatherings. Another surge related to Christmas and New Year's celebrations is expected soon.
The county's state-adjusted ICU bed availability remains at zero, and the unadjusted figure increased from 4.9% Tuesday to 6% Wednesday. The state created the adjusted metric to reflect the difference in beds available for COVID-19 patients and non-coronavirus patients.
The Southern California region is at zero ICU capacity.
The county's availability of ventilators inched up from 31% Tuesday to 32% Wednesday.
Outbreaks at the county's skilled nursing facilities and elderly assisted living facilities -- defined as two or more cases within 14 days -- are an ongoing problem for the county. The county has seen 44 outbreaks at skilled nursing facilities and at 56 elderly assisted living facilities.
On Monday, Orange County officials again suspended ambulance diversions.
"After allowing ambulance diversion... for more than a week, the previously described metrics that measure hospital capacity to receive ambulances from the field have again deteriorated,'' according to a memo from the county's Emergency Medical Services Director Dr. Carl Schultz.
As of Wednesday, 90% of paramedics were averaging 45 minutes and 48 seconds waiting at hospitals to drop off patients.