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Thursday, Oct 6, 2022

COVID-19: First The Coast, Now Inland

When Orange County started to see increases in coronavirus cases in mid-March, two cities quickly reached the highest per-capita case counts in the county. It might not have been the places you’d expect.

The coastal, affluent cities of Newport Beach and Laguna Beach, with respective populations of 23,400 and 87,200, had about 100 total reported cases by the end of March, and averaged 15 and nine cases per 10,000 residents, respectively—the highest in the region.

Then, seemingly just as quickly as it had begun, those cities started to see sharp drops in new cases, with two other inland cities, Anaheim and Santa Ana, seeing their numbers spike.

Experts suggest there are several reasons for the switch, with socioeconomic factors playing a large role.

“Coronavirus is not an equitable disease,” said Bernadette Boden-Albala, the newly appointed dean of the future public health school at the University of California-Irvine (see related story, page 1).

Testing, Travel

Data provided by UCI suggests the two coastal cities had greater access to testing initially, with a positive correlation between test and case numbers, according to Daniel Parker, an assistant professor of public health at UCI.

Parker, who added that it is too soon to draw conclusive evidence from the data as “it’s still being smoothed out,” noted that this increased testing access could be related to the affluent population.

Another theory as to why these cities saw early increases is because of the heavy travel for much of the population, for both business and leisure, with “many having ties overseas,” notes Parker.

Inland Shift

In the past several weeks, the number of new cases in the two coastal cities has dropped significantly, with no new cases reported in Laguna Beach for the two weeks ending April 29, and seven reported in Newport Beach out of the city’s 97 total cases.

Meanwhile, new cases started springing up inland, specifically in Anaheim and Santa Ana; they have been the two largest generators of new cases in OC for the week ending April 29.

Together, the two cities have a population of nearly 700,000, representing about 20% of the county’s total 3.2 million residents. The two cities’ new cases, totalling 232, make up nearly half of OC’s totals for the week ending April 29.

One potential reason for the changing fortunes: residents in Laguna Beach and Newport Beach are often more able to work from home and social distance during this time, which could be contributing to the drop in new cases.

Meanwhile, the opposite is true in cities with a higher population of blue-collar workers.

“While social distancing is the right thing to do, it is not always equitable,” said Boden-Albala.

“In previous pandemics, like H1N1 and even back to the 1918 influenza, there was evidence that suggested the more disadvantaged neighborhoods would have higher, and more severe, infection rates, and we are seeing that start to play out in Orange County with COVID-19.”

Testing Availability

Unequal initial access to testing, a denser population, and a large pool of residents working in essential jobs like construction and delivery are all socioeconomic factors that have contributed to a rise in cases inland, notes Boden-Albala.

“Essential workers aren’t just the ones in well-respected fields, they are also the ones that are paid hourly, perhaps without health insurance, in grocery stores, restaurants, and jobs where you come into contact with lots of people,” Parker said.

“These are the same individuals who perhaps had a harder time getting tested at first.”

The Orange County Health Care Agency said late last month it had launched the OC COVID-19 Testing Network, with six initial locations at inland sites, designed for residents who are experiencing COVID-19 symptoms, but are unable to receive testing through a healthcare provider (see story, page 3).


The county appears to be getting closer to reopening, with testing figures that increase each week and a potential looming rollout of an antibody test.

OC Board of Supervisors last week approved safety and health guidelines for business owners in preparation for a reopening. The guidelines direct employers to, among other things, enforce social distancing, provide personal protective equipment and check employee temperatures before their shift start times.

The guidelines follow Gov. Gavin Newsom’s four-stage approach to slowly lifting the stay-at-home order enacted statewide March 19.

Expect to see another jump in case figures for the county when a reopening happens.

“There’s no way to get around that, but we also can’t stay inside forever,” Parker said.

“It will have to be done slowly, to avoid having to shut down again.”

The number of area hospitalizations related to COVID-19 climbed to 190 as of April 29, up from 158 a week ago. That includes 63 in intensive care units, up from 59 a week ago, according to the OC Health Care Agency, which collected data from 22 OC hospitals.

OC has more than 6,500 beds at 31 hospitals, according to the annual Business Journal list published in February.

In March, the communities that were the highest impacted by coronavirus were primarily along the coast and South Orange County.

The area, specifically cities with a high demographic of affluent residents like Laguna Beach, Newport Beach, San Juan Capistrano and Laguna Niguel, had the highest incidence of new cases, while the inland and North Orange County cities showed relatively fewer cases.

In contrast, the areas hit the hardest in March fell off dramatically in April, with most of the coast and South County seeing the lowest reports of new cases.

An evident shift occurred, with North OC seeing a heavier concentration of new cases, specifically in cities like Anaheim, Santa Ana and Huntington Beach. The latter city had about 200 cases as of April 22, with about half of these cases attributed to a large outbreak at the Huntington Valley Healthcare Center.

The South OC coastal areas with high initial case counts also received more tests, with Laguna Beach, San Clemente and Newport Beach appearing to have the most per capita tests done in March.

— Katie Murar

Reported Cases
Before and After April 9

Total cases for Newport Beach and Laguna Beach, combined above, rose to 116 as of April 9. In the three following weeks, there were just 18 new cases reported, indicating the curve is well on the downward trend for the two cities. The cities currently have 134 total combined cases.

Santa Ana and Anaheim, meanwhile, have been seeing sharp increases in new cases reported in recent weeks. The cities had 192 cumulative cases as of April 9; that figure continued to rise in following weeks, with the past week bringing the sharpest increases for the two cities—Santa Ana had 164 new cases in the week ending April 30; Anaheim had 107 for the same time frame. Between April 9 and 30, the two cities had 520 new cases reported, bringing their total to 712. 

— Katie Murar


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