SANTA ANA, Calif. (CNS) — Orange County's COVID-19 hospitalizations dipped by more than 20 Wednesday, while the Orange County Health Care Agency reported four more deaths that occurred this month due to the virus.

The number of COVID-positive patients in Orange County hospitals was 534 as of Wednesday, down from 556 on Tuesday, while the number intensive care unit patients with the virus dropped from 150 to 149.

The county has 22.2% of its ICU beds available and 68% of its ventilators, according to OCHCA figures.

"The hospitalization numbers look great," Andrew Noymer, an epidemiologist and UC Irvine professor of population health and disease prevention, told City News Service. "The percent positivity is good. I don't want to say it's great, but certainly moving in the right direction. Overall, the numbers look good. I'm somewhat surprised given school has started, but as I've said a million times before, we often get surprised by these things."

According to weekly numbers released on Tuesdays, the county's average daily case rate per 100,000 residents dropped from 22.2 last week to 18.6, while the testing positivity rate fell from 8% to 6.8%.

The county's Health Equity Quartile rate, which measures the impact of the pandemic on disadvantaged communities, dropped from 8.4% to 7.3%.

It has been difficult for epidemiologists at this point to predict the next waves, according to Noymer. He was concerned that the summer surge might exceed last summer's wave, but the peak hospital rate was in mid-July, when 722 patients were infected with COVID-19.

"It seems unlikely we'll grow 200 more beds," he said. "I'm certainly pleased to see that."

Dr. Regina Chinsio-Kwong, deputy health officer for the Orange County Health Care Agency, told reporters Tuesday that with college students returning to classes, there could be another surge in cases ahead.

"I'm assuming we'll see a rise after Sept. 6," Chinsio-Kwong said.

Noymer said it is important to keep schools open as much as possible.

"I worry about schools mostly from the point of view on the effect it will have on the community," he said. "If we can open schools and don't increase that hospital number, that is like cartwheels and somersaults."

Noymer added that reopening school was a "risk, but what if we closed this year and next year's variant is worse and we have to close schools again? I was in favor of closing schools last year, but we don't want to talk about closing schools three years in a row. We'd have a generation 30 years from now not adjusted for life."

The OCHCA reported 646 new COVID-19 cases and four additional deaths Wednesday, bringing the county's cumulative totals to 285,453 cases and 5,229 fatalities.

Health experts note that many of the infections being logged recently are due to an increase in testing, with many businesses and schools requiring routine screenings.

Orange County's coronavirus death toll for August continues to rise. All four of the fatalities logged Wednesday occurred this month, raising the month's death toll to 52.

One of the fatalities was in the 35-to-44 age range and one was 55 to 64, which follows the trend of deaths and patients trending to younger age groups.

The death toll for August stands in contrast with July's 17. It is the first time since the winter surge that there has been a month-to-month increase in fatalities.

The death toll for June was 15, with 23 fatalities in May, 44 in April, 199 in March, 615 in February, 1,574 in January — the deadliest month of the pandemic — and 971 in December, the next-deadliest.

Deaths are the final lagging indicator, experts say, so it reflects the ultimate toll from this summer's surge.

Vaccinations have steeply driven down the death toll each month since records were set in December and January, but it now appears they are trending back upward due to the more contagious delta variant of the virus.

Chinsio-Kwong said vaccinations are back on the rise in the county, with about 11,000 shots dispensed in one day recently.

Orange County Supervisor Katrina Foley, who hosted the media call with Chinsio-Kwong on Tuesday, asked the doctor about a recent study making the rounds that indicates natural immunity is stronger than the protection vaccines offer.

Chinsio-Kwong said data indicates that people who were previously infected with COVID-19 were two times more likely to get infected by the delta variant than those who were fully vaccinated.

"It's still in everybody's best interests to get the vaccine," Chinsio-Kwong said. "I don't think you want to play Russian roulette with COVID-19."

Chinsio-Kwong said: "If you've had COVID and you're fully vaccinated, you're probably more protected than if you're just fully vaccinated ... It's to everybody's benefit to not get COVID again or to not get it at all, and since we have three successful vaccines, just get a shot."

Noymer told CNS the data on the natural immunity versus vaccination is still up for debate.

"I've seen studies that say natural infection is superior to vaccination and I've seen studies that say it is inferior to vaccination," Noymer said. "There's still a lot we don't know. I think a lot of these studies were done in good faith. It's a new science and the numbers are still bouncing around."

With Labor Day weekend upcoming, Chinsio-Kwong recommended avoiding any long-distance traveling that requires a plane ride.

"Travel is not a good idea at this point," she said. "When you get to the airport you're exposed to a whole lot of people."

Chinsio-Kwong said "your immune system takes a hit" because sleep gets disrupted during a trip, as well.

As for get-togethers over the holiday weekend, Chinsio-Kwong recommended against gathering with large crowds indoors.

"The last place you want to be is in an indoor room with no ventilation," Chinsio-Kwong said. "Even if there's only one person with an infection and they move their mask to drink or to eat or to shout ... all those respiratory droplets linger in the air and the longer you stay in that room, the odds increase you'll be exposed."

Chinsio-Kwong recommended anyone who is unvaccinated make an appointment to get a shot.

"And take good care of yourself," she said. "Exercise is still important during this time period. Eating healthy foods is important."

Residents should also be mindful of reducing stress as that can weaken the immune system, as well, she said.

"We know how important socialization is," she said. "It really helps with mental health so it's really good to socialize."