By CBSLA Staff

SANTA ANA (CBSLA) — As COVID-19 hospitalizations in Orange County reached a record high Thursday, hospitals were directed to implement surge plans and cancel elective surgeries in response to a “crisis” situation that could cause the emergency medical system to “collapse.”

On Thursday, the Orange County Health Care Agency reported an additional 51 people have been hospitalized with COVID-19 bringing the total number of hospitalizations to 1,025, a new record.

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The number of people in intensive care units rose from 239 on Wednesday to 257 Thursday, also a new record. The previous peak was 245 in mid-July.

“It’s a slow moving disaster,” said Dr. Jim Keany, the head of the ER at Mission Hospital. “It’s not something like a car crash where it all of a sudden happened. We saw this coming before Thanksgiving and here we are a couple of weeks later.”

Keany said in the last week, he has seen cases of COVID-19 double at his hospital.

“We have, at times, plenty of space, plenty of staff, and everything is going along normally,” he said. “But, during the peak times of the day, we are definitely seeing the system stretched.

“We’re seeing long wait times, even for ambulance patients. All of the county is seeing times where we have to go on what’s called ‘diversion’ where emergency departments are diverting ambulances to the next emergency department because we just happen to be in a situation where we can’t take one more critical patient,” he said.

Late Wednesday night, the Orange County Health Care Agency sent a letter to hospitals, ambulance providers and 911 paramedic providers, saying the county’s health care system is “now in crisis” due to the surge in patients, with more hospitals requesting diversion of ambulances to other medical centers.

According to the letter, “This results in dangerous delays in initial patient assessments to ensure they don’t have an emergency medical condition. Hospitals are overwhelmed with admitted patients to both the floors and the ICUs. At the current rate of deterioration, the EMS system may collapse unless emergency directives are implemented now.”

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The letter urges hospitals to activate surge plans, establish alternate treatment areas in emergency departments to expand capacity, cancel all elective surgeries, apply for state waivers in support of surge plans and establish emergency operations centers.

“To those facilities that have activated these initiatives, all healthcare partners and the citizens of Orange County are grateful,” Schultz wrote. “To those who have chosen not to take this painful but necessary actions, there is still time, but you must act now.”

The letter was currently a recommendation, but could precede an order from Dr. Clayton Chau, the county’s chief health officer and director of the Health Care Agency, Orange County Supervisor Lisa Bartlett said.

UCI epidemeologist Andrew Noymer said the intense recommendation is a sign that the situation is worsening.

“We’re breaking new ground,” he said. “I haven’t seen a warning this stark…what concerns me the most is the acceleration. We’ve set hospitalization records every day for the last five days, and I expect that today’s records will be broken tomorrow.”

The Orange County Health Care Agency also reported 1,521 new coronavirus diagnoses on Thursday and seven additional fatalities.

The new numbers brought the county’s total caseload to 94,647 and the death toll to 1,640 since the pandemic begam.

Of the deaths, one was said to be a resident in a skilled nursing facility.

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(© Copyright 2020 CBS Broadcasting Inc. All Rights Reserved. City News Service contributed to this report.)