San Diego County public health officials have announced 385 new COVID-19 infections and nine deaths, raising the total number of cases to 24,520 and the number of fatalities to 487.
Tuesday's cases marked the fewest since July 7, when 264 cases were reported, and just the third time in July that fewer than 400 cases were announced.
Of the nine deaths, five were men and four were women. They ranged in age from 66 to 97 and died between July 10 and 19. All but one had underlying medical conditions.
According to Dr. Wilma Wooten, the county's public health officer, 95% of the 487 deaths in the county had underlying medical conditions.
A total of 9,030 tests were reported Tuesday, and 4% returned positive. The county's 14-day rolling average of positive tests is now 5.8%. The state's target is below 8%.
One new community outbreak was identified Tuesday, bringing the total in the past seven days to 14. The number of community outbreaks — defined as three or more COVID-19 cases in a setting and in people of different households — remains double the state threshold of seven or more in seven days.
A total of 108 community outbreaks have been reported since the pandemic began, with 33 in June and 48 so far this month.
Of the total positive cases, 2,237 — or 9.1% — have been hospitalized and 578 — or 2.4% — have been admitted to an intensive care unit. As of Monday, 482 people with COVID-19 were hospitalized, 158 of them in intensive care units.
From July 13-19, the county also reported the most hospitalizations, 163, and the most deaths, 56, in any one-week span since COVID-19 began spreading in the United States in March.
Board of Supervisors Chairman Greg Cox said Monday he understands the frustration with wearing masks, social distancing and other precautions aimed at keeping the virus from spreading, "but refusing to take these steps is just going to prolong" the pandemic.
Wooten had a similar message.
"We implore you to not wait for someone you care about to lose the fight against COVID-19 before you take action," she said Monday. Wooten said the massive spike in cases began to occur after bars, hotels and gyms reopened June 12.
The percentage of San Diegans testing positive dropped from 157.2 per every 100,000 people on Sunday to 149.2 on Tuesday, but remains well above the state's criterion of 100 per 100,000.
The last metric the county has failed to maintain is the percentage of cases that have been handled by a contact investigator within 24 hours of being reported. There are more than 500 investigators employed by the county, and although 98% of all cases had been investigated in that time frame as recently as June 25, that rate had dropped to 10% as of Tuesday. The county metric is to reach 71% of new cases in a day's span.
Wooten said that in response, the county is attempting to hire more contact investigators, with 97 set to come on board Friday and another 212 in the hiring process.
The number of cases continues to rise in people between the ages of 20 and 49 and particularly in people in their 20s, prompting the county to aim efforts at educating younger people.
Residents in their 20s account for 25.1% of the county's cases, the highest percentage of any age group, according to county data. The next highest group are residents in their 30s, representing 19.1% of cases.
"While it's true that the mortality for younger people is lower, it's also true that the rate is not zero," said Dr. Scott Eisman, a pulmonologist at Scripps Memorial Hospital Encinitas. "The complications from this illness are far greater, much longer lasting and far more serious than the flu."
Eisman also said heart attacks, strokes and serious blood clots are increasing among younger people confirmed to have COVID-19.
