SANTA ANA, Calif. (CNS) — Orange County's COVID-19 hospitalizations remained stable again Friday, prompting one epidemiologist to speculate the county may have reached its peak in this latest delta variant-fueled surge.

The Orange County Health Care Agency reported that hospitalizations due to the virus increased from 497 Thursday to 498 on Friday, while the number of patients in intensive care units dipped from 126 to 120.

Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention, said that with hospitalizations holding steady since Wednesday, it could mean the county has seen the worst of this latest surge.

"We may have found the peak of this wave," Noymer told City News Service. "It remains to be seen if that's the case, but we're heading in the right direction. Still, it's too early to call."

The percentage of positive cases "was a bit up again today, but that's a volatile  number," Noymer said.

"Ultimately, hospitalizations are the key metric," Noymer said. "I'm pleased to see that it looks like we may be finding a top to hospital numbers ... It will be interesting to see what happens Monday."

Orange County Supervisor Lisa Bartlett said during a surge, it is not uncommon for the number of patients to rise and fall and level off.

"It's important to see how long people are in the hospital," Bartlett said. "Are they there for three months or three days?"

Bartlett also noted, "We have plenty of capacity, plenty of ventilators. Our health care system is in great shape right now even with the spikes in COVID, so Orange County is faring well at the moment."

Officials in every county are eyeing positivity rates since it has been estimated about 18% of the infected are ending up in hospitals, said Bartlett, the immediate past president of the California State Association of Counties.

Many factors are involved in a doctor's decision to move a patient to intensive care, Noymer said. It doesn't mean the patients in ICU are in critical condition or fighting for their lives.

"What constitutes an ICU bed is kind of a judgment call inside the hospital," Noymer said. "If the overall hospitalization hasn't changed, then that's good because it means the severity of the county level hasn't changed and hopefully will be going down soon."

Orange County CEO Frank Kim told City News Service the trend has been that at least 20% of those hospitalized will end up in intensive care. Officials believe they will "have more clarity in the next two weeks," Kim said Thursday.

If hospitalizations level off, then the surge will recede, but if they keep increasing, then "it's something more difficult to manage," he said.

On Friday afternoon, Kim told CNS that he has been cautioned against jumping to conclusions about the most recent data.

"My staff continues to caution me to wait at least another week and a half before drawing conclusions," he said.

Overall, the county's hospitals have enough staff and beds to handle this summer surge, Kim said.

County officials have done modeling based on past waves that shows they last about six weeks, Orange County Board Vice Chairman Doug Chaffee said.

"And we're at the end of four weeks," Chaffee said. "That means by September, if we're following the same pattern, we'll see some relief, but Delta is different from other stuff."

Officials are concerned about morale among medical workers, Chaffee said.

"There's a lot of resentment among hospital staff who have to treat someone who had a chance to get vaccinated but didn't," he said.

The supervisor said he has encountered vaccine-resistant residents who usually cite oft-debunked myths about the vaccines. One woman told him she believed an erroneous claim that there is "heavy metal" in the vaccines and another resident insisted the flu claims more lives, which also isn't true, Chaffee said.

Dr. Colleen Cunningham, the chief pediatrician at Children's Hospital of Orange County, said the facility has admitted about 600 children for COVID- 19 since the start of the pandemic.

"Earlier this summer, there were many days we didn't have a single child (with coronavirus at CHOC," Cunningham said at a media briefing organized by Orange County Supervisor Katrina Foley.

"It was starting to feel like the worst was over. ... Since early July, we started seeing a steady increase in children with COVID," the physician said.

As of Thursday, there were 10 COVID-19 patients at CHOC, with half in intensive care — all of them unvaccinated, Cunningham said.

"They are seriously ill," she said. "These are not kids with a runny nose."

Cunningham acknowledged that children are less likely to experience serious illness from COVID-19, "but they are not immune and some can get seriously ill."

Many children experience mild symptoms to COVID-19 initially, but later end up at a hospital because they've developed pneumonia or Multisystem Inflammatory Syndrome, which can cause damage to the heart and other organs, Cunningham said. CHOC has treated 77 patients for MIS-C stemming from COVID-19, she said.

Some of the hospital's patients have developed long-hauler symptoms of COVID-19, she said.

Cunningham advocated more masking and social distancing in an attempt to help curb the spread of the virus.

"Children will wear masks if adults encourage them to wear them. It's not to just prevent infection of the person wearing a mask," she said, adding the masks also prevent transmission of the virus. Children can experience such mild symptoms from COVID-19 that they might shed the virus without knowing, she said.

"We must do all we can to keep children safe," Cunningham said.

Noymer underscored that previously infected residents should understand they can get the coronavirus again. The delta variant, he said, is "much more contagious and people can get infected twice."

The last time Orange County had this many COVID-19 patients in intensive care was the end of February. The last time hospitalizations were this was high was Feb. 25.

The summer peak last year was 722 hospitalized patients, Noymer said.

Hospitalizations are the most important metric public health experts are watching, 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.

On Friday, the county reported 933 new infections, raising the cumulative caseload to 273,847 since the start of the pandemic.

Two additional deaths were logged, with one happening Aug. 2 and the other Aug. 3, raising the death toll for this month to three.

The death toll for July is 13; 16 for June; 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 county's cumulative death toll is 5,156.

Experts expect fewer deaths because the demographic of patients is skewing younger than the winter surge. Now, there are vaccines available to every age group over the age of 12, and the vast majority of the county's seniors — the most vulnerable to COVID-19 — are vaccinated.

The county on Thursday updated its vaccination numbers. The county has 1,941,560 fully vaccinated residents out of a population of about 3.2 million, including 127,665 who have received the one-dose Johnson & Johnson shot.

The number of residents who have received at least one shot of the two- dose vaccines from Pfizer and Moderna totals 232,057, and a majority of them will get their second shot, experts say.

The case rate for fully vaccinated residents is significantly lower than the case rate for not fully vaccinated residents, according to the Orange County Health Care Agency. According to the update on Thursday, the seven-day case rate is 7.4 per 100,000 for fully vaccinated, but 40.1 for those not fully vaccinated.

The county reported 12,341 tests on Friday, raising the cumulative total to 4,466,241. The higher demand for COVID-19 testing might be driven by requirements from the state and employers, Kim said.

As of Friday, the county had 22% of its ICU beds and 70% of its ventilators available.