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Tuesday, Oct 3, 2023

Once a Model County, OC Cases Now Rising

In the first months of the coronavirus pandemic, Orange County fared better than other counties in the state, with lower reported case, death and hospitalization figures.

Now, the story has flipped, based on a reading of recent data.

OC has seen a coronavirus surge over the past five weeks that’s put it in a worse place, statistically, than many other Southern California counties.

The uptick in cases could end up postponing or altering back-to-work plans for many area businesses, stores and entertainment venues that have already been devastated by the pandemic (see economic stories, page 1 and 3).

“We went from doing extremely well in flattening the curve to seeing a disturbing spike in cases,” notes Bernadette Boden-Albala, dean of the new public health school at the University of California-Irvine.

“We had a false sense of security.”

This false sense of security might be one explanation for this increase, with 6,274 new cases reported in the five weeks ending June 24, a time during which much of the county took steps toward reopening. The figures are nearly double from the 3,366 new cases in the preceding five weeks, a period ending May 20.

“We never got that initial peak of cases, but that didn’t mean that we had gotten rid of coronavirus. Now, many are getting back to their normal lives, not wearing masks, gathering in groups and not being vigilant,” Boden-Albala said.

Data comes from the Orange County Health Care Agency, California Department of Public Health (CDPH) and Business Journal research.

Model County No More?

When compared with four surrounding Southern California counties—Los Angeles, San Diego, Riverside and San Bernardino—Orange County was initially better off across the board.

In recent weeks, the county’s death and hospitalization rate has sunk to worse than all but Los Angeles.

According to data from the CDPH and analyzed by the Voice of OC, in the two weeks ending June 16, Orange County had the second-highest number of deaths, with 2.6 deaths per 100,000 residents, when compared with the other four counties. OC also had the second-highest number of hospitalization rates, with 11 patients per 100,000 residents.

It even surpassed Los Angeles as the county with the highest number of ICU patients, with 4.7 patients per 100,000 residents, compared to L.A.’s 4.1 patients.

“We are no longer the model county we were at the start of the pandemic,” Boden-Albala said.

North vs. South

Within the county, there are still disparities.

As the Business Journal reported in May, North OC has seen disproportionately more cases than South OC, a fact that remains even as cities in the southern part of the county have seen a recent uptick.

In the first five weeks of the pandemic, South County cities saw more cases per capita due to increased initial access to testing for residents in those areas, and a larger population base that travels for business and leisure.

That switched in the next five weeks ending May 14, when cases in coastal and other south county cities saw a sharp drop off, while north county cities saw a steep increase.

In the most recent five-week period, South County cities have seen figures return to their initial high figures, while North County cities have deteriorated even more (see chart, this page).

Data shows an increase in coronavirus cases for four North OC hot spots and a dozen South OC cities, including those south of Irvine, along the coast and those more inland, like Rancho Santa Margarita, Mission Viejo, and Coto de Caza.

In the five weeks ending June 18, the four North County cities had roughly 30 cases per 10,000 residents, more than seven times the South County cities.

New increases in the North County region are largely coming from Anaheim and Santa Ana, the two largest cities in the county by population with a combined population of about 700,000. Anaheim and Santa Ana had a combined total of about 2,498 new cases in the five weeks ending June 18, more than twice the 1,088 cases reported in the five weeks ending May 14.

When adjusted on a per capita basis, the top five cities with the most cases are all in North OC: Los Alamitos, Santa Ana, Anaheim, Buena Park and Placentia.

Socioeconomic factors play a role in this disparity between the two counties, with North County cities having more density and a larger population of essential workers that are unable to work from home.

“With more people living under a single household, isolating may also present a challenge because you don’t want one person to get the whole house sick,” Boden-Albala said.

“We need to address these structural barriers, as well as target the highest risk cities with intense testing, contact tracing and increase personal protective equipment for essential workers.”


Some county officials have pointed to increased testing figures as a reason for higher cases, but in recent weeks, case surges have far outpaced the number of tests conducted.

For the two weeks ending June 23, there were 3,910 tests done each day on average, up nearly 5% from the 3,735 tests done in the prior two weeks.

Meanwhile, new cases during that time have jumped 55%.


Orange County had 485 hospitalizations and 174 ICU patients as of June 24, according to a state database, which is up by 26.3% and 5.5% in the past two weeks, respectively.

The county has nearly 40% of its ICU beds available and 65% of its ventilators, according to the same state database, which tracks some 6,000 hospital beds.

“While our numbers are still getting higher, they are still manageable. We don’t want to get to a crisis situation like New York City,” Boden-Albala said.

“We need to be aggressive with staying vigilant, staying home, wearing masks, washing hands and flattening the curve once again.”

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