Orange County is grappling with another Summer COVID-19 wave as the positivity rate climbs to over 18% – a spike not seen in some time. 

Yet it’s not impacting hospitals anywhere near the levels of the initial waves in 2020 and 2021, when hospitals had to use their parking lots as emergency rooms because they were filling up.

[Read: Orange County Stays Under State Shutdown Orders Given Snowballing Coronavirus Trends]

That’s because of widespread vaccinations and previous infections, said Dr. Shruti Gohil, an infectious disease doctor at UC Irvine’s Medical Center in Orange. 

“We are seeing more COVID positivity among those tested, but hospitalizations overall due to COVID alone are low. And probably because that’s the success of the vaccine and overall immunity,” said Gohil, who treats COVID patients and a host of others. 

Gohil said she and her colleagues expected the current wave. 

“People are out and about, they’re traveling, on vacation, a lot of crowded settings people are going to,” Gohil said in a phone interview last week.

”Just like we saw in the past with July waves, we’re seeing that now too. So that’s the main reason – there’s more interaction with other people in crowded settings,” she said, adding that the elderly and people with existing medical conditions are at a greater risk.

John Wayne Airport in Santa Ana. Credit: JULIE LEOPO, Voice of OC

She also said the positivity rate could be higher than what’s reported since testing isn’t as high as it once was during initial phases of the pandemic. 

Throughout 2020 and 2021, there were massive testing centers scattered across Orange County and the state – from parking lots at Disneyland to college campus parking lots in South County. 

But now, massive testing efforts – along with neighborhood test centers – have largely dried up, notes UCI epidemiologist Daniel Parker. 

“It’s just massive under testing on multiple levels – you used to have all these clinics where you could go get tested and get a bunch of tests sent to your house,” Parker said in a phone interview last week. 

He also noted that at-home tests don’t get reported to state and county officials, which makes it difficult to determine what the actual positivity rate is. 

“But all clues show us there is a wave right now,” Parker said, noting the uptick in COVID presence in wastewater surveillance. 

COVID’s Impact on Orange County 

There’s mounting concerns the current wave could again disproportionately impact working class communities because a combination of overcrowded living situations, inadequate health insurance and a lack of paid sick time exacerbates the spread. 

[Read: Nearly Half Million OC Residents Have Already Had Coronavirus, Latinos Hit Hardest, UC Irvine Study Shows]

Guillermo Alvarez, director of health promotion and disease prevention at Latino Health Access, said the lack of free at-home tests that used to be provided by the federal government is making it difficult to curb the spread. 

“We’re seeing there’s a difficulty finding tests. You can definitely find them at various pharmacies, but little by little it adds up. And that becomes a financial burden on the community,” Alvarez said in a Wednesday phone interview. 

“A lot of people live paycheck to paycheck,” he said. 

Parker echoed similar concerns.

“You can think about this as a poverty trap – if you’re just barely able to make things meet and you get sick, that just puts you in the hole,” he said. “It’s this cycle that keeps going so a disease like this really impacts that.” 

Latino Health Access was instrumental in getting county and state officials to address underserved neighborhoods during the initial stages of the pandemic.

A Latino Health Access promotora goes through her address checklist while she walks through neighborhoods in Santa Ana on Dec. 11, 2020. Credit: JULIE LEOPO, Voice of OC

The group, along with a host of other organizations and community health clinics, banded together and created a network to address the pandemic’s disproportionate impacts by providing tests, vaccines and isolation resources. 

[Read: Community Efforts to Bring COVID Vaccines to OC’s Hardest Hit Neighborhoods Are Paying Off]

Alvarez said that network continues today. 

“We also learned the ways in which we can collaborate with one another,” he said, adding that the various organizations share resources – like COVID tests – to give out to the community. 

[Read: OC’s Community Health Leaders Want a Seat at the COVID Decision Making Table]

“One way or another the collaboration between organizations continued because it was a big eye opening experience because all communities in Orange County were severely impacted,” Alvarez said.  

Not only did the pandemic bring the various community groups and health clinics together, it also spurred a wave of community activism – people advocating for a host of various things like open space and rent control. 

[Read: COVID Forged a New Generation of Community Activism Across OC]

The Toll 

As of Friday, COVID has now killed 8,702 people in Orange County since the virus initially hit in March 2020.  

“I don’t expect massive deaths like what we saw at the beginning, but I expect more deaths than we’ve been having,” Parker said. “It is worse than the flu, on average.”

From 2019 to 2021, Orange County averaged 484 flu deaths a year, according to data from the California Department of Public Health

COVID hospitalizations remain low, compared to the waves of 2020 and 2021.

UCI mobile field hospital on Dec. 22, 2020. Credit: JULIE LEOPO, Voice of OC

Daily reporting efforts on cases and hospitalizations have also been scaled back – making the data difficult to find.

As of July 27, there were 119 people with COVID in Orange County hospitals, including 10 in intensive care units, according to state data

“We have seen an increase in COVID hospitalization, though the increase seems less pronounced than COVID surges seen earlier in the pandemic. Looking at the data through July 16, the proportion of COVID admissions has increased from 0.5% in May to the current peak of 2.5% in early July as compared to a peak of 5.5% back in early January,” reads an email from the OC Health Care Agency – the county’s public health department.

OC Health Care Agency officials also say older patients are most impacted by the current wave. 

Gohil said people with existing medical conditions are also being impacted.

“Patients with congestive heart failure, diabetes, lung disease – these are the main patients we’re seeing on the hospital side coming in with COVID,” she said.  

Orange County’s positivity rate sits higher than the state average – mirroring trends of previous waves. 

As of Thursday, the county’s positivity rate was 18.2%, while the statewide positivity rate was 13%. 

Experts Urge Precautions 

While experts like Gohil and Parker estimate the wave can continue throughout August and hospitalizations remain relatively low, they’re also urging residents to take basic precautions.

It’s part of an effort to prevent COVID-19 from hitting vulnerable communities – like people with heart conditions, diabetes and the elderly. 

“I consider washing your hands and using a mask is a common sense precaution to take in circumstances where you’re in crowded locations or if you see somebody who’s visibly sick or symptomatic, try to maintain distance,” Gohil said. 

“We learned all these good things during the pandemic and there’s no reason why we shouldn’t apply some of these principles when needed,” she added. 

Orange County public health officials are also urging people to stay on top of vaccinations. 

“Everyone 6 months of age and older should protect themselves by getting vaccinated.  Everyone, particularly those with high risk underlying conditions, should consider masking in high risk situations, such as public travel settings like planes and trains,” reads an email from the OC Health Care Agency. 

People shop at an Orange County mall while wearing masks, following new health guidelines from state public health officials that allowed malls to reopen. Sept. 17, 2020. Credit: JULIE LEOPO, Voice of OC

Parker said the new variant – FLIRT – evades immunity easier than previous variants because that’s how viruses evolve and since public awareness has dropped, the spread is happening faster. 

“Put those two things together and yeah we got a pretty good wave going on,” he said.  

Gohil and Parker said awareness should be increased by some public health messaging. 

[Read: End of Pandemic Outreach Leaves Some OC Residents in a Difficult Spot]

But, they cautioned, officials have to balance the messaging because many residents are fatigued by the pandemic. 

“You want to arrive in a place now that has some sort of common sense attached to it,” Gohil said. 

Parker said public outreach campaigns shouldn’t mirror the efforts in the initial stages of the pandemic. 

“There is a sense that it’s going to be with us forever so you can’t stay in a state of emergency forever or else you’ll lose the urgency,” he said. 

“It would make more sense to be realistic with folks in that this is seasonal, like you should consider wearing a mask in public right now. To me, that’s not something that should freak people out – that’s just a matter of life.” 

Spencer Custodio is the civic editor. You can reach him at scustodio@voiceofoc.org. Follow him on Twitter @SpencerCustodio.

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