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County teeters on purple tier amid coronavirus hospitalization rise and case increases

1,010 coronavirus cases were reported by the county in two days. With increasing case rates and hospitalizations, anticipation increases over tighter restrictions.

SAN DIEGO COUNTY, Calif. — San Diego County public health officials reported 480 new COVID-19 infections and three new deaths related to the illness today, raising the region's total to 59,116 cases and 907 deaths as the county continues to await news Tuesday on whether it will sink into the dreaded purple tier of the state's four-tiered COVID-19 reopening plan.

Two men and one woman died between Nov. 3 and Nov. 4. Their ages ranged from early 70s to early 90s. All had underlying medical conditions.

State officials reported Wednesday that San Diego County had an unadjusted new daily coronavirus case rate of 8.7 per 100,000. The adjusted case rate had dropped to 7.4 per 100,000, above the baseline of 7, qualifying the state for the purple, or most restrictive tier of the reopening plan. Last week's unadjusted case rate was 7.8 per 100,000.

According to the reopening plan, a county has to report data exceeding a more restrictive tier's guidelines for two consecutive weeks before being moved to that more restrictive tier. A county then has to be in that tier for a minimum of three weeks before it may move to a less restrictive tier.

San Diego County has been in the red tier for months, skirting but ultimately avoiding the purple tier, which would necessitate the closure of almost all indoor operations of nonessential businesses. Recent trends have shown a slow but steady increase in infection numbers.

If the county cannot drop its adjusted daily case rate below 7 per 100,000, indoor operations in locations such as restaurants, museums, places of worship, breweries and retail businesses will have to either close entirely, move to outdoor operations only or modify in other ways.

In recent weeks, the region had an unadjusted rate well above the purple tier guidelines, but a significant effort to increase the volume of tests had allowed for an adjustment to bring it back to the red, or substantial, tier.

Dr. Wilma Wooten, the county's public health officer, said retail operations, including indoor shopping centers, will be limited to 25% of building capacity, down from the current 50%. Schools, unless they have already restarted in-person learning, will be restricted to distance learning. K-12 schools already in session can continue, Wooten said.

"Cases are increasing in the region and it is vital that we take this virus seriously and recommit ourselves to the strategies that are proven to work," she said Thursday. "Wear a face covering when you go out in public, stay six feet away from others and avoid crowds and large gatherings."

The county's testing positivity rate actually improved, declining 0.3% from last week to reach 3.2%, but remains high enough for this metric to remain in the orange tier.

The state's health equity metric, which looks at the testing positivity for areas with the least healthy conditions, increased from 5.1% to 5.3% and entered the red tier. This metric does not move counties backward to more restrictive tiers but is required to advance.

The state data reflect the previous week's case data to determine where counties stand. The next update will be Tuesday.

Of the 13,079 tests reported Friday, 4% returned positive, raising the 14-day rolling average of positive tests to 3.2%.

Of the total number of cases in the county, 4,014 -- or 6.8% -- have required hospitalization and 924 patients -- or 1.6% of all cases -- had to be admitted to an intensive care unit.

Five new community outbreaks were also confirmed Friday, two in restaurant settings, one in a restaurant/bar setting, one in a hair/barbershop/nail salon setting and one in a business. Over the previous seven days, 27 community outbreaks were confirmed. A community outbreak is defined as three or more COVID-19 cases in a setting and in people of different households over the past 14 days. 

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