Novel coronavirus
An electron microscope image of the new strain of coronavirus. Courtesy of NIAID-RML

San Diego County health officials on Tuesday reported 109 new COVID-19 cases and 15 additional deaths — the largest daily toll to date.

The new numbers bring the countywide totals to 2,434 cases and 87 fatalities.

“Today we are reporting, unfortunately, the single highest number of deaths since the start of the COVID crisis,” Supervisor Nathan Fletcher said at the county’s daily briefing. “We’re also reporting 109 new positive cases, which is our highest daily total reported in more than two weeks.”

He said planning for reopening the local economy will be based on longer-term trends, “but today’s numbers are a sobering reminder that we must remain vigilant, that we are not out of this yet.”

Dr. Wilma Wooten, the county’s public health officer, said the latest victims of COVID-19 were six women aged from their late 60s to early 90s, and nine men in their early 40s to late 80s. All but one had underlying medical conditions.

The mortality rate of those tested positive for coronavirus in San Diego County now stands at 3.6%.

“We’re not out of danger yet,” said Board of Supervisors Chairman Greg Cox.

The number of San Diegans who have been hospitalized due to coronavirus complications increased to 592 Tuesday, with 199 in intensive care units — 30 and 10 more, respectively, than Monday. According to county data, there have been 1,367 documented COVID-19 recoveries.

Despite the increases in positive cases and deaths, the county is preparing for a path to reopen some outdoor spaces sooner rather than later. Cox said the county was working in conjunction with municipalities throughout the region to create plans for parks, beaches, golf courses and other public outdoor spaces to open — with some catches.

Any plan to reopen — being considered only after the April “month of action” has ended — includes gradual phases of openings including social distancing, facial coverings and a maintained ban on groups outside of the same household.

Fletcher warned that opening the county’s public spaces up with no restrictions too soon would cause a second spike of cases and deaths — and that’s only if the county has reached the peak of cases and deaths, which he said is not clear.

“When we reopen, it will not be a political decision and it will not be an emotional decision,” Fletcher said.

Wooten said the county would measure five metrics when weighing listing public health orders.

Those metrics, designed by the federal government, are:

  • A downward trend in influenza-like illnesses
  • A downward trend in COVID-like illnesses.
  • A downward trend in percentage of total tests turning up positive for COVID-19.
  • Treating patients with a normal level of staff and resources and not using emergency resources.
  • And robust testing in place for at-risk health care workers.

The proportion of positive test cases has been on a downward trend for the past two weeks, Wooten said, as have the number of influenza-like illnesses — with 3% of emergency department visits fitting that category, down from 10% in mid-March.

However, the trend of COVID-like illnesses has either plateaued or is increasing slightly, at a little more than 3.5% of emergency room visits.

Currently, the region’s hospitals are about 68% full, Wooten said, only about 7% of which involve either COVID-19 positive or under investigation cases.

Of all positive coronavirus cases, 24.3% of the patients have been hospitalized and 8.2% sent to intensive care, for a 3.6 mortality rate. Those statistics track fairly closely to percentages seen around the country and the world.

Of the deaths, 56% have been white, 30% Latino, 11% Asian and around 1% each for black, Pacific Islander and patients of multiple races.

Businesses should begin planning now on how to reopen and maintain public health orders, Fletcher said, so they will not be caught unprepared if there is an opportunity to reopen in May.

The San Diego Economic Recovery Advisory Group met for the first time on Monday to develop a framework for a phased re-opening of San Diego County’s economy once the threat of COVID-19 has been tamed.

The group, which was announced Friday, consists of local “civic and business leaders” representing a variety of industries that can advise how best to safely reopen for business, and how to have the local economy thrive in a business environment so widely impacted by COVID-19.

Updated at 4:50 p.m. April 21, 2020

— City News Service contributed to this report.

Chris Jennewein is founder and senior editor of Times of San Diego.