SANTA ANA, Calif. (CNS) — Orange County's COVID-19 hospitalizations are nearing 1,000 as health care providers struggle to provide staffing, according to data released Monday by the Orange County Health Care Agency.

Hospitalizations jumped up from 779 on Friday to 964 on Monday, with the number of intensive care unit patients rising from 122 to 140, according to the OC HCA, which doesn't provide updates on the weekends. 

"I did talk to a large hospital system CEO this morning, and they indicated things weren't as bad as prior waves," Orange County CEO Frank Kim said.

But the hospital executive said there were concerns with "staffing shortages," Kim said.

Many health care workers are getting infected or having to isolate due to an exposure, Kim said.

Fountain Valley Hospital recently brought on 25 nurses to help out, using funding from the state, Kim said. There have been requests for 100 more nurses from six local hospitals in recent days, according to Kim.

An epidemiologist said the numbers are not likely driven by asymptomatic cases.

"The hospitalizations continue to rise, and you have to figure that the incidental cases don't account for most of that — because that's kind of a fixed quantity if someone comes in for a broken ankle and they test positive," said Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention.

"They get counted, but unless broken ankles are strangely increasing, then it's not what's really driving this," Noymer told City News Service on Monday.

If incidental cases of COVID-19 were a factor then ICU cases would not be correspondingly increasing, Noymer said.

"It is unfortunate that (state officials) haven't sorted that out," Noymer said of hospitalization numbers including incidental cases. "But that's not really the biggest deal right now. The biggest deal is hospitalizations are increasing, and that's regrettable."

Noymer said the most common question he faces is: when will this fourth wave peak?

"Bob Uecker once said that the best way to catch a knuckleball is to wait until it stops rolling and pick it up. So the best way to call a peak is to see when it has gone down seven days in a row and to say the peak was seven days ago," Noymer said.

"I'm not trying to be glib, but no one can call the peak. As long as it is still increasing, the assumption is tomorrow it will be worse," Noymer added. "I think we're going to be in for a few more days of increases."

While some have pointed to a decline in omicron cases in South Africa, Noymer noted that the country is in the summer season.

"We're still not as bad as last January," but that's not a standard to aspire to, Noymer said.

The county logged 22,945 new cases over the past three days, increasing the cumulative total since the pandemic began to 397,805.

"You can look at the data in two different ways," Kim said. "We continue to see increases in daily positivity and case numbers, but that is also a function of increased testing. I also think that's underreported because so many individuals have access to rapid testing (at home)."

With the at-home testing, a request is made to use a QR code to add results to the database, but Kim said, "I suspect it's very little" in terms of participation.

There was some good news to be found in a decrease in patient drop-off times via ambulance. Last Thursday, the ambulance drop-off times were at 52 minutes and 36 seconds, but that was down to 40 minutes and 57 seconds as of Monday, according to Kim.

The CEO has recommended to the county Board of Supervisors that county employees be given 40 more hours of sick leave so they will be encouraged to stay home when under the weather. The board will consider the recommendation at Tuesday's meeting.

About 600 county employees, out of a total of about 17,000, have been infected since mid-December, Kim said. When an employee gets infected, they're out a minimum of five days given the need for quarantine. That can eat up all of a workers' sick leave so that they might be more inclined to show up for work with mild symptoms in the future, Kim said.

"Our hospitals are full," said Dr. Regina Chinsio-Kwong, the county's deputy health officer, during a weekly media call Friday.

The last time hospitalizations reached Monday's level was Feb. 10, during a post-holiday winter surge of infections.

Exactly one year ago — on Jan. 10, 2021 — hospitalizations were at 2,221, just as vaccines were being rolled out for front-line medical staff and first responders.

The county logged two more fatalities on Monday, one on New Year's Eve and the other one at the end of November. Kim said there were nine fatalities on Sunday, but those have not yet been confirmed and logged.

All of the three deaths logged Friday occurred in December. The death toll for last month is now 59. Chinsio-Kwong said 50 of those who died in December were unvaccinated and the rest were seniors.

November's death toll increased to 102. October's death toll stands at 127, 196 for September and 182 for August.

In contrast, the death toll before the more contagious delta variant fueled a summer surge was 31 in July, 19 for June, 26 for May, 47 for April, 202 for March and 620 for February.

January 2021 remains the deadliest month of the pandemic with a death toll of 1,596, ahead of December 2020, the next deadliest with 985 people lost to the virus.

Orange County had 21.3% of its intensive care unit patient beds available and 65% of its ventilators available as of Friday.

Chinsio-Kwong said officials get "nervous" when the ICU bed availability drops below 20%. Of the hospitalized patients, 87% are unvaccinated, and 88% of the ICU patients are not inoculated.

The county's adjusted daily case rate per 100,000 residents jumped from 64 Thursday to 71.8 Monday. The testing positivity rate soared up from 19.1% to 21.5%, and it increased from 19.3% to 22.3% in the health equity quartile, which measures underserved communities hardest hit by the pandemic.

The seven-day average for tests per 100,000 increased from 561.2 Thursday to 603.9 on Monday.

On Thursday, officials reported a child younger than 5 had died from the disease, the county's third pediatric death of the pandemic.

"We must continue to be mindful of protecting children," Chinsio-Kwong said. "I'm sad to see only 26% have started the vaccination process. I'm hoping more parents will choose to get their children vaccinated."

It's not certain whether the child had been infected with the delta or omicron variant, Chinsio-Kwong said. But she said the omicron variant is having more of an effect on children than previous variants, and she expects pediatric cases to rise locally, mirroring a national trend.

The wave of infections is also affecting entertainment and courthouse functions. 

In Orange County's jails, the number of infected inmates rose from 66 on Monday to 103 as of Friday, according to Carrie Braun, a spokeswoman for the Orange County Sheriff's Department. Of those, 25 were newly booked inmates and the rest were in the general population.

Of the department's 3,800 employees, 214 were infected, Braun said.