State and Local Officials Frustrated by Inequities in COVID-19 Vaccine Distribution

Orange County is currently (as February 14) hospitalizing 790 COVID-19-positive patients; 257 of them are in Intensive Care Units (ICUs), a drop from over 400 ICU hospitalized patients just two weeks ago. St. Jude Medical Center will not confirm the number of COVID-19 patients currently being treated there, but a California government site shows a hospital corresponding with St. Jude’s location treating 97 COVID-19 positive patients at this time. Countywide, the availability of ICU beds has risen from a low of 70 on January 20 to 130 on February 12. Six months ago that number exceeded 400 available beds.

With a population of 142,824, Fullerton has recorded 10,750 known COVID-19 cases, a rate of over 75 per 1,000 residents, the 10th highest in the County. There have been 228 Fullerton residents who have died from it, or 1.6 per 1,000 residents—a rate exceeded only by four other cities in OC. Health professionals remain concerned about a possible rebound of infections and hospitalizations due to the ill-advised mixing of households at Super Bowl parties.

While testing is still a priority for the Orange County Healthcare Agency, much of their attention is focused on vaccinating as many individuals as possible in California’s Phase 1A categories, which include those age 65 and over, residents of long-term care facilities, and a wide range of healthcare workers. On Feb. 11 California updated the State’s Vaccine Allocation Guidelines to include the Phase 1B categories of Food and Agriculture Workers, Education and Childcare workers, and Emergency Service providers, but the guidelines are based on available supplies, which are too low at present to cover everyone in these sectors. The Orange County Health Care Agency (HCA) still shows the County vaccinating just Phase 1A individuals.

In a recent virtual “Breakfast Club” meeting hosted by Sharon Quirk-Silva, who represents the 65th District in the California State Assembly, HCA Director and County Health Officer Dr. Clayton Chau noted that there were over 200,000 healthcare workers of some sort in the County. He explained that when the State issued its new eligibility list he consulted the OC’s COVID-19 Vaccine Taskforce who decided to continue focusing all efforts for the following two weeks on seniors and heath care workers and evaluate their progress at the end of that period. OC’s Board of Supervisors approved the approach, although it meant not immediately expanding access in OC to the workers in the 1B category. Dr. Chau said the decision to remain focused on seniors was based on the statistics that showed that 72% of ICU beds were occupied by seniors in the recent COVID-19 wave and that 75% of those who died from it were over the age of 65. He said that ICU patients are evenly split between Whites, Latinos, and Asians, but did acknowledge that for patients under the age of 65, the majority who die are Latino.

Dr. Chau also reiterated his priority to address ethnic inequities in vaccination distribution. Overall, OC has administered more than 450,000 doses of either the Pfizer or Moderna vaccines, both of which require two doses to achieve maximum immunity. However, the County’s reliance on an online app and website called Othena, developed especially for the purpose of registering individuals for vaccine appointments, has resulted in Black and Latino populations receiving fewer vaccinations in proportion to their percentage of the population in the County. Latino populations in particular have suffered far higher amounts of infections and deaths from COVID-19 because many live in higher density housing with more people per household making infections more likely. They are also less likely, as a group, to be able to work from home, where they might avoid workplace transmissions of the virus. Additionally, language barriers also exist in some households, lessening the likelihood that they are aware of preventative health measures.

According to the HCA’s own data (https://coronavirus.egovoc.com/vaccines-administered-oc), Latinos make up only 11% of the total number of persons who have received at least one vaccine dose, while Whites make up 46%, Asians 26%, and Blacks 1%. Of those age 65 or older who make up 58% of those vaccinated so far, Whites represent over half at 57%, while Latinos drop to only 9%, Asians drop to 11%, and Blacks 1%.