SANTA ANA, Calif. (CNS) — Orange County's COVID-19 overall hospitalizations appear to have leveled off since last week, but there are 13 more people in intensive care units since Friday, health officials said Monday.

Hospitalizations in Orange County due to the virus decreased from 454 on Friday to 453 on Monday, but the intensive care unit number increased from 71 to 84.

Hospitalizations are the most important metric public health experts said they are watching at the moment because infection rates could be driven by a higher demand in testing or breakthrough infections of vaccinated people who usually experience little to no symptoms.

"I'm encouraged that three days after Friday the hospitalizations are holding steady instead of going up," said Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention.

County officials report COVID-19 statistics Mondays through Fridays, but skip the weekends now. So the last report was from Friday.

"ICU is a little tricky to figure, but lower is better," Noymer said. "I'm encouraged it's not much higher, but we're definitely not out of the woods. It's more kind of wait and see. But I would characterize this as good news."

The last time the county had this many COVID-19 patients in ICU was March 7. The last time hospitalizations were this was high was Feb. 25.

The county has 24.6% of its ICU beds available and 72% of its ventilators.

"It is worth noting, if you look over the last 14 days, our hospital numbers have more than doubled," said Dr. Matthew Zahn, medical director of the Orange County Health Care Agency's communicable disease control division.

"While the numbers are stable, we have seen an increase in the number of people in ICU," Zahn added in a media briefing with Orange County Supervisor Katrina Foley.

Orange County Supervisor Lisa Bartlett told City News Service COVID-19 numbers are "creeping up" everywhere in the state, but added, "We still have a lot of excess capacity in our health care system."

That could change as temperatures drop this fall and winter, Bartlett said.

"As time goes on and we get toward flu season again people are going to get nervous," Bartlett said.

The case rate per 100,000 was at 18.4 as of Monday, according to Orange County CEO Frank Kim. The test positivity number was 8.3% and the test positivity for the health equity quartile, which measures the disadvantaged communities hardest hit by the pandemic, was at 8.5%, Kim said.

According to weekly averages released on Tuesdays, the county's average daily case rate per 100,000 residents last week increased from 8 to 12.7, and the test positivity rate jumped from 4.9% to 6.9%.

The county's Health Equity Quartile rate increased from 4.4% to 6.6%.

"Testing volume has been getting more robust," Kim said, adding it was at 284 per 100,000 residents, "which we haven't been at since May 5."

The county on Monday reported 28,210 tests, which would account for tests logged through the weekend.

The higher demand for COVID-19 testing might be driven by requirements from the state and employers, Kim said.

While out in the county this weekend, Kim said he saw about 80% of shoppers masking up.

Many students are returning to classes this week, but Kim said he does not believe that will fuel the case rates.

"I don't think it will make a significant difference," Kim said. "When I look at the parks, at retail stores, kids are already interacting with each other, so going to a school setting I don't know how it's different than anything else that's occurring."

Kim said he hopes more parents get vaccinated because children younger than 12 are not yet eligible to get inoculated.

The rates of children hospitalized for COVID-19 are "still quite low," but they are increasing, Kim said.

Children's Hospital of Orange County has admitted 27 child COVID-19 patients in July, Zahn said.

Zahn pointed out that last year contact tracers found that students were "not a driver of infections."

"We found that the vast majority of COVID spread was really not in school settings," Zahn said. "We know that the more cases there are of COVID just in the community, the more complicated it is in school."

The surge of infections does have Kim concerned, he said.

"We spent a significant amount of resources and time working with various community groups to ensure that those who wanted to accept the voluntary vaccine had access to do so," Kim said. "And when you see that over 90% of those hospitalized are unvaccinated it's frustrating. Our job is public health and to ensure people remain as healthy as they can."

The county on Monday reported 2,181 new infections, which account for figures logged on Friday, Saturday and Sunday, raising the cumulative to 271,197.

The county logged two more COVID-19 fatalities, which occurred on July 27 and July 28. That raised the month's death toll to 11.

The death toll for June is 15; 22 for May; 43 for April; 199 for March; 612 for February; 1,563 for January — the deadliest month of the pandemic — and 968 for December, the next deadliest.

The cumulative death toll is 5,150.

The county's vaccination rates "are very good in terms of statewide or national comparisons, but as a staff we had a mission to get above 80% and we haven't reached that point yet," Kim said.

The county will continue using its mobile pods to reach "any pockets in Orange County" where there are disadvantaged neighborhoods of residents or those who just need more information about the shots before accepting one, Kim said.

Orange County supervisors on Tuesday will consider a $4.5 million grant from the state to help the county offer administrative support for community groups who want to host stand up vaccination clinics, Kim said.

The number of people in Orange County who have received at least one dose of vaccine stood at 1,991,822 as of Thursday, according to the state's database.

The HCA's figures put the number of fully vaccinated Orange County residents at 1,922,696 as of Thursday, up from 1,897,664 last week. The county has 1,796,967 fully vaccinated residents who received Pfizer or Moderna vaccines, which require two shots, and 125,729 who have received the one-dose Johnson & Johnson vaccine.

Dr. Carl Schultz, the EMS medical director for the Orange County Health Care Agency, issued a memo last week asking hospital executives to work together to improve patient drop-off times, which have escalated during this surge.

If not, the agency may have to issue an order preventing hospitals from diverting patients to other hospitals when they are busy.

The average patient drop-off times were climbing up to 44 minutes when the county's standard is 30 minutes at the most, Schultz said. The offload time, however, has dropped to about 32 minutes.

"We're not in a crisis right now," Schultz said.

Foley said she started having media briefings on the pandemic because the county has not been holding them at the board of supervisors meetings anymore.

"I felt like we need to sound the alarm," Foley said. "We need to let people know there is still something to be concerned about, so I started daily updates here as a replacement."

Foley on Tuesday plans to propose a break on fees for small businesses on health permits that would cost the county $25 million.