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By Zach Cavanagh

The second brand of the coronavirus vaccine has made its way to California, just as the state’s first regional stay-at-home orders enter their final week with a likely extension ahead.

In an update on Monday, Gov. Gavin Newsom said that 21 of the 31 sites that will receive the Moderna vaccine have received 110,000 of the 672,600 doses scheduled to arrive this week in California. The first shipments of the Moderna vaccine, which is easier to store than the Pfizer vaccine, are expected in Orange, Del Norte, San Luis Obispo, San Joaquin, Tehama and Tuolumne Counties.

For the Pfizer vaccine, 560,625 doses have arrived in California, according to Newsom. The full first allocation of 527,600 were received with a second allocation of 233,025 anticipated. Newsom said that 70,258 doses of the Pfizer vaccine were administered in the state in the first week.

Where California’s regions stand with the state’s stay-at-home order as of Dec. 22. Graphic: California Department of Public Health

As of Tuesday, Orange County and the Southern California region were in the third week of a three-week stay-at-home order with the region’s available ICU capacity well below the 15% threshold. Based on the current rates, Newsom said the stay-at-home orders are likely to be extended past their current Sunday, Dec. 27 end date.

The Southern California region and Orange County were both at 0.0% adjusted ICU availability on Tuesday.

According to the county, the adjusted ICU availability is being used “to preserve the capacity of the ICU to also treat non-COVID-19 conditions. …  If a disproportionate number of ICU beds are being utilized to treat COVID-19 patients, then patients with non-COVID medical issues may not be receiving or be able to receive the level of care they need.”

If a region is using more than 30% of its ICU beds for COVID-19 patients, an extra 0.5% is removed in the adjusted capacity for every 1% over that 30% threshold to preserve those necessary resources and beds.

As of Monday, Southern California had an unadjusted available ICU capacity of 12.3% and Orange County was at 7.5%.

The San Joaquin Valley (0.0%), the Bay Area (13.5%) and Greater Sacramento (15.7%) regions are the other three of the state’s five regions under the stay-at-home order. Northern California is at 29.5%.

State hospitalizations have risen 63% in the last 14 days, and state ICU patients have gone up 51% in 14 days. As of Monday, Orange County hospitalizations have risen 91% in the last 14 days with ICU patients increasing by 64%. Both the state and county are at a record number of COVID-19 hospitalizations at 19,961 and 1,806, respectively. Orange County is at a record number of ICU patients with 390.

Nationally, the United States is now over 18 million coronavirus cases. There have been 319,364 deaths in the United States, and the national seven-day average testing positivity is at 11.16%.

Where California’s counties stand in the state’s four-tiered, color-coded coronavirus monitoring system as of Dec. 22. Graphic: California Department of Public Health

As of the state’s tier update on Tuesday, Dec. 22, California’s case rate and positivity rate continued to rise as the state reached 80.7 daily new cases per 100,000 and the 14-day testing positivity average rose up to 13.4% from the 10.7% of last Tuesday and the 8.7% of the week before that.

The state has continued to see its record-high new cases and case averages climb higher. The 14-day rolling average of daily new cases rose up to 38,235.7 on Monday, Dec. 21 up from 28,012.9 on Monday, Dec. 14.

Nearly all of California is now in the purple tier with 55 of the state’s 58 counties at the highest risk level. There are only two counties at the red “substantial” level, one county at the orange “moderate” level and none at the yellow “minimal” level. Eight weeks ago, only nine California counties were purple.

The state’s four-tiered, color-coded coronavirus monitoring system is the main component of the state’s Blueprint for a Safer Economy for determining in what capacity different sectors, businesses and activities can reopen safely as the COVID-19 pandemic continues.

Orange County’s coronavirus monitoring metrics continued dramatic rises higher in purple tier this week. Daily new cases per 100,000 continued to trend sharply upward this week as the metric jumped to an adjusted 51.8 daily new cases per 100,000, up from the 42.7 new cases last week and the 30.3 of two weeks ago. The metric jumped to the purple level at 10.8 five weeks ago.

The state reports an adjusted case rate, which is adjusted for the volume of testing. The unadjusted rate is 78.1 daily new cases per 100,000.

The county also saw a marked rise in its testing positivity, as the countywide number climbed into the purple level to 15.2% from last week’s 13.2%. The metric was at 10.6% two weeks ago. The threshold for the purple tier is 8%.

The county’s health equity positivity rate was reported at 22.7% up from last week’s 18.8%, which was more than double the purple-level threshold. The health equity rate measures the testing positivity in county’s low-income and more racially diverse neighborhoods.

To move back down to the red tier, Orange County would need to have its metrics at red levels for two consecutive weeks. If the county’s daily case rate is stable or declining but not at the next level, there would be the possibility of moving down if the testing positivity and health equity metrics meet the level for two tiers lower—that is, orange tier levels while in the purple tier.

The red tier requires the case rate to sit between 4.0 and 7.0, the testing positivity between 5.0% and 8.0% and the health equity rate between 5.3% and 8.0%. The orange tier requires the case rate to sit between 1.0 and 3.9, the testing positivity between 2.0% and 4.9% and the health equity rate between 2.2% and 5.2%. The yellow “minimal” risk tier, the lowest of the four tiers, requires a case rate lower than 1.0, testing positivity below 2.0% and health equity rate lower than 2.2%.

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