SANTA ANA (CNS) — Orange County's COVID-19 infections and hospitalizations may be trending down, but officials are concerned that the upcoming holiday season, starting with Halloween, will spur another winter surge, a deputy health officer with the Orange County Health Care Agency told reporters Friday.

Dr. Regina Chinsio-Kwong, deputy county health officer, encouraged parents to get their children vaccinated for the upcoming flu season. She noted it takes two weeks to develop full immunity after the shot, so if they get it now it will be in time for Halloween festivities.

"The flu is right around the corner," Chinsio-Kwong said.  "Some are asking can you get the flu and COVID at the same time and the answer is yes."

So it's important for adults to get their flu shots too, Chinsio-Kwong said.

Chinsio-Kwong said it was "technically safe to go trick-or-treating, especially if it's outdoors," but everyone should be mindful of continuing efforts to avoid infection such as social distancing, good hand hygiene and wearing a mask.

"Kids love to eat candy and so do I, but it means removing your mask," Chinsio-Kwong said. "This should be a fun and exciting time and it should be safe, but use some caution if you're indoors."

Chinsio-Kwong suggested Halloween and Dia de los Muertos festivities could be used as an excuse to decorate masks

The county on Friday reported that hospitalizations remained relatively stable.

Hospitalizations increased from 220 on Thursday to 223, with the number of intensive care patients declining 54 to 47, health officials said.

The county has 25.6% of its ICU beds available and 68% of its ventilators, according to the Orange County Health Care Agency.

The county also logged a dozen more fatalities with 10 of them occurring in September, one in August and the first one reported for October. 

The county also reported 260 new infections, raising the cumulative total to 299,594.

The overall death toll is 5,475.

The death toll in  September has climbed to 109. The death toll in August was 158.

The death toll for July is 26, 19 for June, 26 for May, 46 for April, 199 for March, 615 for February, 1,581 for January — the deadliest month of the pandemic — and 976 for December, the next deadliest.

Chinsio-Kwong said the vast majority of September's fatalities were unvaccinated. The victims who died from the coronavirus are also trending younger than previous surges, she added.

In September, 45% of those who died were younger than 65, she said. And 97% were unvaccinated, she added.

"I don't want us to repeat what happened this summer because so much could have been prevented if we'd been a little more cautious," Chinsio-Kwong said. "Until we can get more of our younger folks vaccinated we need to take precautions."

Chinsio-Kwong said everyone wants to gather with family and friends over the holidays, but she advised caution. Wearing a mask indoors "needs to be our new normal to get through this winter season, to allow us to have the ability to be together with our loved ones this season. If we're not careful and find ourselves in another surge I think that will be damaging for us."

As of Oct. 2, the county's new case rate per 100,000 people was 3.1 among fully vaccinated residents and 16.1 for the unvaccinated.

The number of fully vaccinated residents in Orange County increased from 2,115,536 on Sept. 30 to 2,135,325 on Thursday. 

That number includes an increase from 1,976,227 to 1,994,678 of residents who have received the two-dose regimen of vaccines from Pfizer or Moderna. The number of residents receiving the one-dose Johnson & Johnson vaccine increased from 139,309 to 140,647.

There are 197,201 residents who have received one dose of the Pfizer or Moderna vaccines.

The top providers of vaccines are the Orange County Health Care Agency at 26.50%, CVS at 18.30%, Walgreens at 6.10%, Kaiser Permanente at 5.50%, UC Irvine Health at 2.80%; Walmart at 1.90%, Safeway, Vons and Pavilions at 1.20%; Families Together of Orange County at 1.10%, and multiple others below 1%.

The county's weekly case rate per 100,000 residents improved from 9.7 to 8, while the positivity rate fell from 3.4% to 2.9%, according to data released Tuesday. The county's Health Equity Quartile positivity rate — which measures progress in low-income communities — dropped from 3.8% to 3.1%.