SANTA ANA, Calif. (CNS) — Nearly 20 more COVID-19 patients have been admitted to Orange County's hospitals as the Delta variant-fueled surge raged on Wednesday.

"Today's numbers were up again for hospitalization," said Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention. "We're still climbing. It's been climbing every day since July 2."

The lowest point was June 25 when there were 49 hospitalized for COVID- 19 in Orange County.

Noymer noted the highest hospitalization point last summer was 722 in July during the first surge, but the key difference is there were no vaccines then.

Hospitalizations increased from 549 on Tuesday to 568, with the number of intensive care unit patients dropping from 126 to 125.

Experts say hospitalizations are a more important statistic than case numbers because any surge can be exacerbated by an overburdened health care system, and case numbers are expected to rise as schools and businesses require more people to get tested.

The county also logged 1,213 new infections Wednesday, nearly double what was reported on Tuesday, bringing the total to 277,845 since the pandemic began. A big jump in infections can sometimes be attributed to a backlog in processing lab results, officials say.

Dr. Regina Chinsio-Kwong, deputy health officer for the Orange County Health Care Agency, cautioned against reading too much into the infection rate on a call with reporters organized by Supervisor Katrina Foley, who has been providing daily updates on the Delta surge.

"Unfortunately today it's high," Chinsio-Kwong said of the infections logged Wednesday.

When Foley asked her if contact tracing indicates where the infections are concentrated, Chinsio-Kwong said, "It's pretty much all over the place."

She added, "We see ebbs and flows. We have to wait and see if it's really a pattern or if it's just the database ebb and flow ... It takes weeks to see a trend. That's what we see on a national level."

Meanwhile, as expected, federal health officials Wednesday recommended that all vaccinated Americans who received Pfizer or Moderna vaccines get third shots eight months after they become fully vaccinated with the two-dose program. 

Officials said it is likely a second dose of the one-dose Johnson & Johnson vaccines may also be warranted.

"Pretty much what they're saying is hold off on J&J because that guidance will be coming in the very near future," Chinsio-Kwong said.

Officials are working on updating their online appointment systems such as the state's MyTurn app and Orange County's Othena to accommodate extra shots, Chinsio-Kwong added.

There will be no return to large-scale vaccination centers as it is expected that local pharmacies, primary care physicians and mobile vaccine pods can handle the demand, she said.

Administering those extra shots could begin the week of Sept. 20, according to a joint statement Wednesday from the Centers for Disease Control and the U.S. Department of Heath and Human Services.

The CDC and HHS said data "make very clear" that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination.

"Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout," the agencies said.

"For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability."

Noymer endorsed a new state requirement for vaccination proof to attend events of 1,000 or more people.

"Lollapalooza showed you can ask for proof at very large events and still have it come off," Noymer said.

Vaccine card counterfeiting may be an issue, Noymer said, adding, "I think people will find it easier to just to get a free jab."

Meanwhile, Santa Ana officials issued a requirement Wednesday for city employees to get inoculated against COVID-19 or face regular testing as the Delta variant fuels a surge that has hospitalizations continuing to climb.

Santa Ana City Manager Kristine Ridge announced she was requiring vaccination of all city employees to help better protect staff and the public they interact with.

"We were a very hard hit community," Santa Ana Mayor Vicente Sarmiento told City News Service. "We have over 800 deaths of people we can point to and we don't want any more, and we simply wanted to make sure we're as responsible as possible and this is at least a responsible first step."

Ridge said she will meet with the city's labor leaders on the requirement to discuss how it will be implemented. Sarmiento said it was a "courtesy" and anyone who cannot get vaccinated for a health or religious reason the option is open to submit to regular testing for the virus.

"I want this to be more a carrot than a stick and encourage people" to get vaccinated, Sarmiento said.

Noymer said the city's effort to get employees vaccinated is "great. I'm all for it."

Four more COVID-related fatalities were logged Wednesday, but three were in January and the other on Dec. 23. The county's cumulative death toll is 5,165. Fatalities have decreased because of the high vaccination rates of seniors who are most vulnerable to the virus, experts said.

There were 12 infected people in Orange County's jails as of Wednesday, down from 14 on Tuesday, but officials say they are all newly booked inmates.

Dr. Clayton Chau, the county's chief health officer and director of the OCHCA, said Tuesday that he thinks "we're pretty stable now" with infection rates.

"I am confident to say that we're probably reaching a peak now, a plateau," Chau said. "But we're keeping an eye on the hospitalizations."

The county has 21.7% of its ICU beds available, and 69% of its ventilators.

The county reported 11,213 tests Wednesday, raising the cumulative total to 4,522,326.

Of those eligible to get a shot, 75.4% of Orange County residents have received at least one dose, up from 73% last week, Chau said. Of the eligible residents, 67% are fully vaccinated now, up from 65% last week.

The county is also seeing an increase in interest for a third shot of the two-dose vaccines from Pfizer and Moderna that have already been authorized for immunocompromised people, Chau said.

That population includes organ transplant recipients and individuals undergoing therapies that suppress their immune system.