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By Zach Cavanagh

For the first time in many months, there is broad optimism about the coronavirus metrics around the state and locally, as California lifted its regional stay-at-home orders on Monday, Jan. 25 and hospitalizations and positivity rates showed continued decreases on Tuesday, Jan. 26.

As the stay-at-home orders lifted, it brought back the returned focus on the state’s four-tiered, color-coded, county-by-county coronavirus monitoring system – where Orange County remained deep in the highest-risk purple “widespread” tier, despite decent decreases in all of its metrics.

The lifting of the order also brought questions, particularly in the Southern California region. The orders were set to lift when the state’s four-week projections on available ICU capacity went back above the 15% threshold, but as of Tuesday, the Southern California region remained at 0% adjusted ICU capacity available.

Based on the state’s projection model, Southern California is set to be at 33% ICU availability on Feb. 21, which made the region eligible to exit the order. In a video conference on Tuesday, Health and Human Services Secretary Dr. Mark Ghaly explained the state’s math (as shown in the slide below) and defended the state’s decision to lift the orders when it did.

Graphic: California Department of Public Health

“We did, for a period of time, over the holidays, made sure that the testing numbers were solid, that they were tracking with what we expected them to be on average, that we could account for any changes,” Dr. Ghaly said, “so that when we made a final projection… they were reliable and we could be confident in what is a fairly weighty decision for three major areas and regions of our state.”

Dr. Ghaly also defended the use of stay-at-home orders in general, which have seemingly provided results with decreases in nearly every metric across the board after reaching post-holiday peaks.

“We were concerned that without mitigation, without the stay at home order, without the hard work many Californians put in in the month of December,” Dr. Ghaly said. “We think that meaningfully decreased up to 25,000 hospital admissions, 5,000 ICU admissions, which not only protect our health system, but translate into real lives saved across our state.”

Graphic: California Department of Public Health

Dr. Ghaly reported a 9% 14-day testing positivity rate in California with a 7.9% seven-day rate, both decreases from last week’s 11.6% 14-day average and 7.9% seven-day average as downward trends continued. The 14-day rate was 13.5% 14 days ago.

Hospitalizations saw even larger decreases than last week with a 20.4% decrease statewide over the last 14 days, and a 10.6% decrease in ICU patients over the last 14 days. As of Tuesday, Orange County hospitalizations had decreased 23.8% in the last 14 days, and ICU patients decreased 18.3% over the last 14 days.

While the death rate continued to rise, the increases were much smaller than in previous weeks.

Statewide, the 14-day daily new death average has gone up 17.2% in the last 14 days from an average 427.6 deaths per day to 501. Last week, the state average had increased 63.3% in the previous 14 days. In Orange County, the 14-day daily average has gone up by 105.5% in the last 14 days from an average 21.5 deaths per day to 44.2. Last week, the county average had increased 274.76% in the previous 14 days.

There have been 893 coronavirus-related deaths reported in Orange County in January. There were 1,875 deaths in the county over the previous 10 months, with August marking the previous one-month high reported at 376.

Tuesday also marked one year since the first two cases of COVID-19 were reported in California – one in Orange County and one in Los Angeles County. There have been 37,572 coronavirus-related deaths in California.

“I want to take a moment to share my own sadness and condolences with those families,” Dr. Ghaly said, “all those communities who’ve lost loved ones, who’ve had their world torn apart and turned over because of this disease.”

Nationally, the United States now tops 25 million coronavirus cases. There have been 421,129 deaths in the United States, and the national seven-day average testing positivity is at 9.08%, down from 10.42% last week.

The state’s total new cases and case averages have dropped considerably from their winter highs. The 14-day rolling average of daily new cases dropped to 28,992.7 on Monday, Jan. 25, way down from 38,902.4 on Monday, Jan. 18.

Nearly all of California is in the purple tier in the state’s four-tiered, color-coded coronavirus monitoring system, with 54 of the state’s 58 counties at the highest-risk level. There are only three counties at the red “substantial” risk level, one county at the orange “moderate” risk level and none at the yellow “minimal” risk level.

The four-tiered 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 decreased considerably but remained deep in the purple tier this week.

Daily new cases per 100,000 residents continued to dip as the metric dropped to an adjusted 46.6 daily new cases per 100,000, down from the 67.1 new cases last week and the 68.8 of two weeks ago. The threshold for the purple tier is 7.0.

The state reports an adjusted case rate, which is adjusted for the volume of testing. The unadjusted rate is 66.1 daily new cases per 100,000, down from 99.7 last week and from 91.3 two weeks ago.

The county saw a drop in its testing positivity, as the countywide number dipped to 12.9% from last week’s 16.7%. The metric was at 19.5% two weeks ago. The threshold for the purple tier is 8%.

The county’s health equity positivity rate was reported at 16.6%, down from last week’s 21.2% and the 24.2% of two weeks ago. The threshold for the purple tier is 8%. The health equity rate measures the testing positivity in a 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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