San Diego County needs to reduce its daily new coronavirus cases by about half in order to come off the state’s watch list and allow businesses to return to indoor operations. A sustained surge in new infections over the last few weeks boosted the county’s case rate above the state’s threshold, resulting in governor-ordered rollback measures.
County officials had reported a declining number of new illnesses over the last few days but that brief trend changed Wednesday when they announced 587 more people had tested positive.
San Diego County Public Health Officer Dr. Wilma Wooten said daily case totals need to come down to 234 or fewer and stay there for two weeks. That will reduce the county’s current case rate of 154.8 per 100,000 to the goal of no more than 100 per 100,000.
“Changing this metric will depend on all of us doing our part, including individuals, all of our sector work sites and governments — again, we all have a role to play,” Wooten said.
Wooten said the county is partnering with cities on a compliance squad to better enforce public health orders at businesses. More details would be shared next week, she said.
The county also on Wednesday announced 18 additional people died. Their deaths occurred over a few weeks and all had underlying health conditions.
The daily update pushed the region’s totals to 25,107 cases and 505 deaths. Statewide on Wednesday, California’s total cases tallied more than any other U.S. state.
Supervisor Greg Cox said the county’s Safe Reopening Compliance Team will provide assistance to businesses and residents not following public health orders.
The group’s exact powers were not immediately clear.
"This is a carrot approach, not a stick," Cox said. "But we still have the stick and other tools to ensure compliance."
Supervisor Nathan Fletcher said the team would enable the county to step up enforcement on "egregious violations" — but the details on that enforcement were also unclear. Officials were also reaching out to the various cities and communities in the county to collaborate on solutions.
"This is out of an effort to keep our businesses open, not to close them," Fletcher said.
A total of 8,280 tests were reported Wednesday, and 7% returned positive. The county's seven-day rolling average of positive tests is now 6%. The state's target is below 8%.
Two new community outbreaks were identified Wednesday, bringing the total in the past seven days to 12. The number of community outbreaks — defined as three or more COVID-19 cases in a setting and in people of different households — remains higher than the state threshold of seven or more in seven days.
The new outbreaks were reported in a business and a health care setting.
As of Wednesday, 485 people with COVID-19 were hospitalized, 166 of them in intensive care units. Wooten said hospitalizations jumped since late June but there has been a slight improvement.
“We have some hope over the past several days; There appears to be a modest, a very modest decline in hospitalizations, but again, we will continue to monitor,” she said.
Of the county’s total positive cases, 2,279 — or 9.1% — have been hospitalized and 592 — or 2.4% — have been admitted to an intensive care unit.
From July 13 to July 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 U.S. in March.
"We implore you to not wait for someone you care about to lose the fight against COVID-19 before you take action," Wooten said Monday. She said the recent spike in cases began to occur after bars, hotels and gyms reopened June 12.
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 — 223 of which solely focus on new cases — 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 9% as of Wednesday.
Wooten said that in response, the county is attempting to hire more contact investigators, with at least 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," Dr. Scott Eisman, a pulmonologist at Scripps Memorial Hospital Encinitas, said at a county briefing last week. "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.
