2019 Novel Coronavirus Update for Orange County Providers
April 13, 2020
From 3/1/2020 to 4/8/2020, Orange County reported over 1000 confirmed cases of 2019 Novel Coronavirus (COVID-19), including 17 (1.7%) deaths. Please check our website for daily updates on numbers of confirmed cases, as well as age and gender breakdowns: https://occovid19.ochealthinfo.com/  
Key Reminders For Providers
  • COVID-19 testing should be prioritized according to the CDC recommendations https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html;
  • The CDC includes hospitalized persons and symptomatic healthcare workers as priority 1 groups for testing.
  • OCHCA can assist with testing hospitalized patients, symptomatic healthcare workers and symptomatic residents/staff of long term care facilities (LTCFs); results from OCHCA’s lab can return SUBSTANTIALLY sooner than commercial labs.
  • Providers can consider testing additional CDC priority groups, including symptomatic persons 65 and older and symptomatic persons with underlying health conditions, as capacity allows.
  • Providers should only test persons with symptoms compatible with COVID-19 when a diagnostic result will change clinical management or inform public health response. Testing mildly ill ambulatory patients usually does not change management but depletes scarce PPE supplies and testing resources, and unnecessarily exposes other patients and healthcare personnel (HCP) to infection.
  • OCHCA does not recommend testing asymptomatic persons regardless of potential/documented COVID-19 exposure.
  • Please continue to report deaths of confirmed cases, confirmed cases that are hospitalized, and suspect/confirmed cases that are homeless or from a LTCF by telephone at 714-834-8180 within one business day.
  • Providers are encouraged to inform patients they are testing of positive results and educate them on home isolation and measures to prevent transmission in the household.
  • See OCHCA Guidance for Home Isolation of Patients with COVID-19 and OCHCA Guidance for Household Members and Caregivers of Patients with COVID-19 at: https://occovid19.ochealthinfo.com/health-professionals
  • CDC has revised the time period that a patient with COVID-19 is considered infectious to begin 48 hours before symptom onset instead of from the first day of symptoms starting. 
  • See CDC guidance at https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html
  • New guidance from OCHCA for removal of transmission-based precautions for hospitalized patients has been released and can be downloaded using the button below.
Review of Hospitalizations for Confirmed COVID-19 in Orange County
As of 4/8/20, approximately 235 residents of Orange County with confirmed infection with COVID-19 had been hospitalized due to the infection. Partial or complete data is available on 211 of these cases. 

For these 211 cases, 73 (35%) are female and 138 (65%) are male. The age range is 20-95, with average age 59. The breakdown of age groups is: <18: 0 (0%), 19-34: 21 (10%), 35-44: 21 (10%), 45-54: 34 (16%), 55-64: 54 (25.6%), 65-74: 37 (17.5%), 75+: 44 (17.8%).
 
Overall, 152 (72%) of the 211 had one or more medical comorbidities (CM) [e.g., obesity, diabetes mellitus (DM), hypertension (HTN), cardiovascular disease (CVD), chronic kidney disease (CKD), chronic pulmonary disease/asthma (CPD), immunocompromise (IC), etc]. Data on weight/height or BMI were not available on 114 (54%), so it is possible the percent with a comorbidity is higher; obesity was found to be the most prevalent comorbidity among hospitalized COVID-19 patients under age 65 in a recent CDC review https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm?s_cid=mm6915e3_e&deliveryName=USCDC_921-DM25346 ). 
Review of Initial COVID-19 Deaths in Orange County
Key preliminary findings from review of the first 17 deaths due to COVID-19 include:
  • Ten patients (59%) male, 7 patients (41%) female.
  • Age range 31 – 93; average age 67.
  • Complete data on comorbidities is available for 15 of the 17:
  • All 15 with complete data had medical comorbidities (e.g. DM, CVD, CKD, HTN, immunosuppression, obesity, others); 2 patients (both in age group 75+) did not have any identified medical comorbidities, but lacked data on BMI.
  • Ten of the 15 with known comorbidities had two or more conditions identified.

Summary:
  • Average age of hospitalized cases is 59, and average age of deaths is 67.
  • Male predominance in both hospitalized cases and deaths.
  • Presence of comorbidities, especially multiple comorbidities, is high in both hospitalized cases and in deaths.

Contact Information
For questions or concerns, please contact the Communicable Disease Control Division at 714-834-8180. Please note that this number is now operational 24/7 for medical providers. Please do not share this number with patients.
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