SANTA ANA (CNS) - Orange County today reported 13 more people have succumbed to COVID-19 and 233 more diagnoses of coronavirus were reported.

The death toll stands at 1,467 and the cumulative case count is 59,213. Of the deaths reported Wednesday, seven were skilled nursing facility residents, three were assisted living facility residents and one was a skilled nursing home staffer.

The relatively high number of daily cases continues to jeopardize the county's chance to move into a less-restrictive tier of the state's re-opening road-map. County officials have said the daily average would have to come down to about 130 for Orange County to move from the “red'' to the “orange'' tier, allowing for more businesses to reopen and for some already open to increase their capacity. Conversely, if the trend continues, the county could slip back into the most restrictive “purple'' tier.

“The seven-day average is still in the low 5's on case rates,'' said Orange County CEO Frank Kim. “Those high numbers have been spread out over the last week, so hopefully we stay in the red tier.''

Orange County Supervisor Lisa Bartlett said the county's “other numbers are looking pretty good to help us into the orange tier, but we're very concerned about surrounding counties,'' where case rates are rising.

“Everything is regionalized,'' Bartlett said. “We're a major job center so we employ a lot of people (from surrounding counties) and a lot of our residents go into other counties to work.''

Add in tourism and extended families traveling from county to county for visits, “It can be really problematic,'' Bartlett said.

The number of hospitalizations related to the virus jumped from 157 to 177, with the number of intensive care unit patients increasing from 56 to 60, according to the Orange County Health Care Agency.

The change in the three-day average of hospitalized patients went from -4.1% to 5.3%. The county has 34% of its intensive care unit beds and 68% of its ventilators available.

According to OCHCA data, 1,082,339 COVID-19 tests have been conducted since the start of the pandemic, including 7,089 reported Wednesday. There have been 52,852 documented recoveries.

The county's positivity rate, which is reported each Tuesday, has remained at 3.2% for the last three weeks, but the daily case rate per 100,000 population increased from 4.6 last week to 5.1. That leaves the county still close to moving up from the red to the orange tier in the state's four-tier monitoring system.

The county's Health Equity Quartile Positivity Rate, which is a mandate to focus on hot spots in counties, stands at 6%. The county has to reach at least 5.2% in that metric to move into the orange tier.

Moving into the orange tier would mean retail businesses could operate at full capacity, instead of 50% as required in the red tier. Shopping malls could also operate at full capacity, but with closed common areas and reduced food courts, just as in the red tier.

On Wednesday, however, a study released by UC Irvine found coronavirus infections in the county to be seven times higher than previously thought.

County officials hired UCI to do a serological study of a large cross-section of residents to check antibodies for COVID-19 to get a better handle on how prevalent the highly infectious disease has been in the community, according to Kim.

The study showed that “the disease prevalence is about seven times greater than previously identified by positive tests,'' Kim said. It also showed that coronavirus infections were “greater in Latino and lower-income residents, which we knew because they had a higher positivity rate.''

The reluctance to get tested can help fuel the spread of the virus, particularly among those who do not show any symptoms, Kim said. “Some don't want to submit to government testing, so if you don't test you might transmit it to a family member.''

Dr. Matthew Zahn, the medical director of the county's communicable disease control division, said at Thursday's weekly news conference on the county's response to the disease that while coronavirus is particularly risky for people with underlying health conditions and the elderly, “we have certainly seen significant illness and death in younger populations.''

Also, young adults should also be aware that they “can spread (the virus) to other people, to loved ones around them, who are particularly at risk,'' Zahn said. “And they're at risk themselves. This is not the flu. This virus remains difficult and is a significant risk for any age group.''

According to a memo Thursday from Dr. Clayton Chau, the director of the OCHCA and chief health officer for the county, efforts since this summer to tamp down the spread of COVID-19 in hot spots in Santa Ana and Anaheim have led to a 74.4% reduction in positivity rates -- from an average of 22.5% July 7 to 5.8% as of Oct. 19.

Dr. Margaret Bredehoft, deputy agency director of public health services, announced a new program by the county and the Orange County Department of Education to staff a team of school nurses who will be available to parents evenings during the week and from 8 a.m. to 11 p.m. on weekends. The nurses will help with preparing parents to quarantine infected students and provide other guidance to school officials on disinfecting classrooms and other measures to curb spread of the virus.

Bredehoft also announced a campaign encouraging mask usage among students. Students in elementary through high school grades are being encouraged to participate in a contest of essays, videos or art promoting face coverings to curb the spread of coronavirus to help win technology grants for their school.

Dr. Philip Robinson, medical director of infection prevention and hospital epidemiology at Hoag Memorial Hospital Presbyterian, told City News Service that experts expect another wave of coronavirus this fall. Zahn agreed that there is potential for another wave because colder temperatures drive more people indoors, where the virus can be spread more efficiently. The annual flu season can compound it, he said.

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