Health Equity Measured by More Than COVID, Says OCHCA Director

October 10, 2020 Updated: October 11, 2020

Orange County Health Care Agency (OCHCA) Director Dr. Clayton Chau said the county’s health equity metric should be measured by more than just COVID-19 case rates, as it prepares to present its data to the state of California in the hope of elevating to the next, less restrictive tier on the state’s monitoring list.

Chau, who is also the county health officer, said Orange County officials have been creating a plan to address the issue ever since California started to release health equity data for each county on Oct. 6—but that the county can’t do it without help.

“I personally have spoken to philanthropists and foundations about what we’re doing in Orange County, because we know the county, from the public side, won’t be able to do it all on our own,”  Chau said at a press conference on Oct. 8.

Chau said the due date is now Oct. 15 for the equity plan that the county must present to the state.

The plan will be used—along with the county’s overall COVID-19 case rates—in the state’s Oct. 20 decision to determine whether the county will be allowed to move up from the red to the orange tier, allowing businesses to open to greater capacity and with fewer restrictions.

California’s health equity measurement is based on the test positivity rates in the county’s most disadvantaged neighborhoods. The state’s health equity guidelines require counties to submit a plan that defines each group that is disproportionately impacted by COVID-19, states the percentage of cases in those groups, and shows that the county will invest funding toward reducing disease transmission in those groups.

Chau said there are many different reasons why there are disparities in COVID-19 case rates in different populations, including chronic medical conditions, housing density, and transportation methods—and these things won’t disappear overnight.

“That existed before COVID-19,” he said. “This equity work is really tough. It was tough before the COVID, and it’s going to be even tougher during COVID.”

At the same time, Chau said the test positivity rate doesn’t give the whole picture regarding overall wellness in a community. Emotional and economic health are also important.

“In looking at equity, we have to look at the totality of it,” Chau said.

If officials focus only on “the health equity metric” and stop the economy from reopening, in the end, they might be hurting the very people they’re trying to help, he said.

“The individuals who get hurt the most are people who live in those areas who need to have a job, to work, to put food on the table and a roof over their head,” said Chau.

At a press conference on Oct. 5, Gov. Gavin Newsom defended the health equity metric and claimed it might help some counties open up their economies even faster.

“Our approach is about making sure that we are doing justice to our diverse communities and that we’re not just gaming a system to paint a much more rosy picture that may be for some but not all members of a community, particularly a specific county,” Newsom said.

Orange County CEO Frank Kim said that the county has been working on equity-related projects for some time.

He asked the state for more flexibility in addressing the county’s overall pandemic health situation and business reopening schedule.

“While we address the health equity, and if we’ve built out a good, responsible plan, and we’re making good, solid progress in achieving what we all want, which is a very low disease burden within all of our health ZIP codes and sectors, we should be given an opportunity to not only work within our community to further enhance those efforts, but we should also be given flexibility to understand how to limit the risk to the broader community, and then allow the county to make decisions on additional local reopening opportunities,” Kim said.

At the press conference, Chau also updated the public on preparations for the COVID-19 vaccine.

Orange County is one of nine counties that were chosen by California to be on the state’s COVID-19 vaccine task force, which will be identifying certain members of the population who are a greater priority for receiving the vaccine.

“We are expecting that the first round of vaccines … will be very small,” Chau said.

“The COVID-19 vaccine protocol from start to end will be very complicated. It’s not as simple as our regular seasonal flu vaccine because of the condition of storage, condition of distribution, condition of transportation, and provider readiness.”

California is also one of five states chosen by the U.S. government to receive the first round of vaccines, which is expected to be ready sometime between mid-winter and early spring.

The OCHCA reported on Oct. 10 that 10 more people had died from COVID-19 in Orange County, raising the death toll to 1,316, and confirmed 162 new cases of the disease, raising the total to 55,345.

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