SAN DIEGO COUNTY, California — San Diego County public health officials reported 291 new COVID-19 infections and six deaths from the illness Thursday, raising the county's totals to 49,446 cases of the coronavirus and 819 deaths, while a new daily record for community outbreaks was set.
A total of 19 community outbreaks were reported Thursday, six in restaurant/bar settings, six in business settings, two in grocery settings, two in restaurants, one in a food processing setting, one in a residence and another in a hair salon/barbershop setting.
In the past seven days, 32 community outbreaks were confirmed, well above the trigger of seven or more in a week's time. A community setting outbreak is defined as three or more COVID-19 cases in a setting and in people of different households over the past 14 days.
Four women and two men died between Sept. 4 and Oct. 7, and their ages ranged from late 40s to mid-70s. All had underlying medical conditions.
Of the 10,915 tests reported Thursday, 3% returned positive, bringing the 14-day rolling average percentage of positive cases to 3%. The seven-day daily average of tests was 9,150.
Of the total number of cases in the county, 3,646 -- or 7.4% -- have required hospitalization and 849 -- or 1.7% of all cases -- had to be admitted to an intensive care unit.
On Tuesday, the county found out it will remain in the second, or red, tier of the state's four-tier COVID-19 reopening plan for at least another week.
RELATED: San Diego County remains in red tier with 6.5 adjusted case rate
However, a new wrinkle in how the state looks at county data was announced Wednesday. A health equity metric will now be used to determine how quickly a county may advance through the reopening plan, San Diego Public Health Officer Dr. Wilma Wooten said.
A community can only be as well as its unhealthiest quartile, she said, and while counties with a large disparity between the least and most sick members of a community will not be punished for the disparity by sliding back into more restrictive tiers, such a disparity will stop counties from advancing to less-restrictive tiers.
According to the state guidelines, the health equity will measure socially determined health circumstances, such as a community's transportation, housing, access to health care and testing, access to healthy food and parks.
Neighborhoods are grouped and scored by census tracts on the Healthy Places Index, https://healthyplacesindex.org/. Some of the unhealthiest neighborhoods include Logan Heights, Valencia Park, downtown El Cajon and National City. According to county data, the county's health equity testing positivity percentage is 6.2 and is in the Red Tier.
The complicated metric will be explained further on Monday, Wooten said, when the state releases an official "playbook" of how it is calculated and what it means to communities throughout the state as they attempt to reopen.
The county's state-calculated, adjusted case rate is 6.5 new daily infections per 100,000 people, down from last week's 6.7. The unadjusted case rate is down to 7 from last week's 7.2. Because San Diego County testing levels were above the state median testing volume, the county's adjustment level was decreased.
On the last two Tuesdays, the county narrowly avoided being pushed back into the purple tier, the most strict in the state's reopening plan. The state-set threshold of case rate to avoid the purple tier is below 7 per 100,000 people. To move into the less-restrictive orange tier, a county must have a rate below 3.9 per 100,000 people.