SANTA ANA (CNS) — Orange County's hospitalizations for COVID-19 — a key metric officials are eyeing in this phase of the pandemic — dropped again Friday.

Hospitalizations declined from 213 Thursday to 206 with the number of intensive care unit patients declining from 49 to 44.

"The ICU numbers dropped again, but the hospital beds are a little above 200, so it popped a little bit" from a couple of days ago when it dropped below 200, said Orange County CEO Frank Kim.

But small upticks and declines have been typical over the past month and a half, Kim said.

"A lot of it has to do with when they did the patient survey," Kim said. "But an increase is still an increase and we prefer not to see it."

Andrew Noymer, a UC Irvine professor of population health and disease prevention, said that hospitalization rates are the key metric for the public to watch.

"As cases fall and testing goes up the case rates can be deceptively misleading," Noymer said Thursday. "The hospitalizations is what you really want to look for and they're going in the right direction."

Noymer pointed out that the intensive care unit numbers in the county haven't been below 50 in months.

"The number-one predictor of deaths is people in the ICU — like a few weeks prior," Noymer said.

And even if someone who gets vaccinated gets infected, the impact will be substantially lessened, he added.

"Some of these vaccines may fail, but they may just fail at the level that people still get sick, but not as severely," Noymer said.

"Imagine if Billy Joe gets sick and he thinks `How is this possible, I got vaccinated?' but he doesn't feel that bad and stays at home and toughs it out. That same infection in December would have meant a trip to the hospital."

The case rate in Orange County as of Friday was 3.7 per 100,000 residents. But that does not automatically propel the county into the orange tier of the state's economic re-opening system. That will not happen until April 7 at the earliest if the current trends continue.

The positivity rate as of Friday was at 2.1% and 3.1% in the so-called health equity category that measures the underprivileged neighborhoods hardest hit during the pandemic.

Kim said the county could make it to the orange tier sooner if the state authorizes it, as it did when officials moved up the county's graduation into the red tier on Sunday instead of Wednesday. Orange County Supervisor Lisa Bartlett said it could hinge on whether the state makes its goal of 4 million inoculations in the underprivileged communities by the beginning of April.

On Friday, the Orange County Health Care Agency reported 127 new COVID- 19 cases, upping the cumulative total to 249,308.

The county also logged 14 more fatalities Friday, with  most of the fatalities happening in January, the deadliest month of the pandemic.

The death toll for January is 1,422. The death toll for February is 468 and 32 for March. Two of the fatalities logged on Friday happened in December, upping the death toll that month to 908.

The county on Friday also reported 14,079 COVID-19 tests, raising the cumulative total to 3,227,549.

The county is doing 312.9 tests per 100,000 on a seven-day average with a seven-day lag.

The county's testing average mirrors the state average, Kim said.

The latest weekly update from the state, issued on Tuesdays, shows the county's test positivity rate improved to 2.2% from 3.2% from last Tuesday, and the adjusted case rate per 100,000 people on a seven-day average with a seven-day lag improved from 6 to 4.

The county's Health Equity Quartile rate, which measures positivity in hotspots in disadvantaged communities, improved from 4.1% last week to 3.5%.

That puts the county just one-tenth of a point away from meeting the threshold for the orange tier for case rate. If the trend continues, the county could move up to the orange tier by April 7, three days after Easter.

Lines are appearing at some Orange County pharmacies as the availability of vaccinations at drug store chains is increasing. County staff has estimated that the big drug store chains are vaccinating about 100 people a day in each location, Kim said.

State officials have indicated the county will continue to receive its usual allocation of vaccine doses. The county has inoculated about 1 million people, a little less than one-third of its population. 

Orange County Supervisor Lisa Bartlett said county officials are working on setting up a mobile vaccine distribution point at Saddleback Church to mirror the one set up at Christ Cathedral to reach out to congregants reluctant to accept inoculation because of concerns that some vaccines were developed from cells of aborted fetuses.

Roman Catholic leaders have assured churchgoers that the Moderna and Pfizer vaccines are OK and that Johnson & Johnson is acceptable if there is no other alternative.

"It gives those who are uncertain about getting vaccinated that it's OK to do it," Bartlett said.

"We have to do outreach in so many different ways" to reach various groups of people who are reluctant to get inoculated, Bartlett said.

Kim said the county saw an increase of about 120,000 registrants for shots after opening the Christ Cathedral POD.

"We're hoping that they were resistant or concerned Catholics who heard the message and changed their mind and agreed to get vaccinated," Kim said.

County supervisors on Tuesday will consider whether to approve a memorandum of understanding with the state or Blue Shield on vaccine distribution. Kim said the county is inclined to go with Blue Shield because it will be easier to transition its Othena app to the insurance company's data—collection system.