The Orange County Grand Jury released a much anticipated report on May 11 detailing the results of their months-long investigation of Orange County’s pandemic preparedness and plan. The report had little, if anything good to say about Orange County officials’ preparedness prior to the declaration of the pandemic in 2020 or its response during the past year, acting on behalf of the County’s 3.2 million residents.

The investigation “revealed that while Orange County had emergency plans specific to a pandemic, these plans had known gaps that were not addressed in accordance with the state, national and international guidelines.” Unfilled “budgeted” positions within the HCA’s ranks and a failed strategy to add personnel during the emergency led to “execution problems and errors” during the pandemic, according to the report.

OCHCA’s Director Richard Sanchez left his position in late March 2020, a critical time in the early days of the agency’s response to the pandemic, to work for CalOptima, the County’s low-income and disability insurance system. The report did not address this particular vacancy, which was filled in the interim by a deputy who retired when the Board of Supervisors eventually hired the current director Dr. Clayton Chau. The Grand Jury did not comment specifically on Chau’s performance.

A list of the report’s principal findings included the failure of the County’s pandemic plan to “adequately address” guidelines provided on state, national, and international levels. The County’s Emergency Operations Plan classified a pandemic as “unlikely,” leading to the HCA being underprepared, the report concluded.

HCA did not manage to maintain a sufficient supply of Personal Protective Equipment (PPE), usually defined as medical grade disposable face masks/respirators, goggles, gloves, and other attire worn by doctors and nurses to avoid exposure to pathogens. HCA reportedly caused PPE “to be held past the manufacturer’s recommended product life.” Though not cited in the report, before the pandemic was declared, HCA staff auctioned off expired face masks  because their fasteners could potentially break. In the early days of the pandemic hospitals experienced critical shortages of masks for medical professionals, leading some to have to fashion makeshift substitutes or re-use the same pieces.

The report faulted HCA directly for failing to effectively use its resources to close existing gaps in specific plans addressing public health emergency and hospital preparedness, and for not allocating its budget “relative to the likelihood of pandemic planning and preparation.”

According to the report, “The Grand Jury also observed that the agency did not establish comprehensive community-based task forces that included official threshold language communities in Orange County. In addition, the County did not have enough resources (facilities, materials, and personnel) to enact key parts of the emergency plan such as handling urgent communications.”

HCA was found to have inadequate facilities in place for effective communication during the pandemic and no centrally-located media room. More crucially, the report found that the agency was unable to reach all residents with limited English language capabilities, a group said to comprise as much as 45% of the County’s population, which led to high infection rates and deaths in many central OC ZIP codes. Reaching these disproportionately affected areas with tests, and later, vaccinations, became a high priority for the agency as the virus spread rapidly through these communities. HCA eventually contracted with non-profits who were better able to contact these populations, but the report faults the agency even so, for not adopting recommendations by groups like Latino Health Access and other contracted organizations.

Not until September of last year did HCA have a “well-structured and coordinated mass vaccination plan” or a task force for the purpose, according to the report. By March 2021, residents with limited English language proficiency had received “only 18% of available vaccines,” resulting in a serious shortfall in their percent of the overall population vaccinated.

A chart illustrating that the OC Healthcare Agency’s budget increased as it failed to adequately prepare for the COVID-19 pandemic, as found in a report on the topic issued by the OC Grand Jury.