Editor's note:The Star is making this story free to readers due to public health concerns related to coronavirus. Please consider a digital subscription to The Star so we can continue doing this important work.

Update: Additional lab tests cast uncertainty on child's COVID-19 status. To read the story, go here.

An 8-year-old Ventura County child with an underlying health condition tested positive for COVID-19 in what appears to be the county's first case of community transmission, public health leaders said.

Officials say they don't know the exact cause of transmission but it appears the virus was passed from person to person in the community. Ventura County's four other coronavirus reports all involve people believed to have been exposed in travel — on a cruise ship, in Italy and in Egypt.

The child's positive test and three others in the county still need confirmation from the U.S. Centers for Disease Control and Prevention.

On Friday, public health officials said they were still gathering information about the child and the case was not being considered as community transmission.

That has changed, they said a day later, in part because public health workers have found no evidence of travel that would have significantly increased chances of exposure.

Update: Additional lab tests cast uncertainty on child's COVID-19 status. To read the story, go here.

"We already knew we had people walking around with this viral infection," said Ventura County Public Health Officer Dr. Robert Levin, labeling the case as likely community transmission. "It just confirms what we knew."

The investigation and efforts to track down contacts continues.

Public health leaders had pointed at the absence of such community spread as evidence the risk of acquiring the virus in the county was low. The last week brought reports of five cases, a countywide emergency health declaration and a call for social distancing that helped bring waves of school closures, event cancellations and businesses telling employees to work from home.

Now comes the report of apparent spread via community transmission.

"The only thing that changes is probably within the individual and that is the decision to take more seriously what we’ve been telling them," said Levin, referencing advice such as staying home when sick, staying six feet away from people when possible and washing hands often.

People wondering about being tested had been cautioned the chances of acquiring the virus are low unless they have traveled to high-risk places or been exposed to known or suspected cases of the virus.

Such actions still escalate the risk but people should contact their primary care doctor if experiencing fever, cough and shortness of breath to determine if they need testing, said Ashley Bautista, Ventura County public information officer.

"It's really up to the primary physicians," she said, noting that new shipments of test supplies and the emergence of commercial labs that can test for COVID-19 means there is no longer a shortage of test kits in the county.

The 8-year-old child, identified as a boy from Oxnard by a health system involved in his treatment, tested positive on Thursday. He is the first child among Ventura County's coronavirus cases.

Only four of the 247 coronavirus cases in California as of Friday involved children 17 or younger, according to the California Department of Public Health.

The child's underlying condition is believed to have increased vulnerability, said Bautista.

"The child is already very ill from something else," she said Friday. "We don't have details on that yet."

More coronavirus news:

On Saturday, Bautista confirmed the child attended Art Haycox Elementary School in Oxnard. Christine Walker, superintendent of the Hueneme Elementary School District, said the student had not been in school since Feb. 28 because of the underlying health condition.

Public health officials said that absence of more than two weeks is key because the incubation period for the coronavirus is believed to be a maximum of 14 days. They said the risk of exposure is low.

The child "was not in school during any of the time that he would have been contagious," Walker said, adding that public health has not requested any quarantines.

The school has nearly 1,000 students and is part of a kindergarten through eighth grade district with 8,000 students.

"We will work closely with public health in updating individuals and the community if there are any risks of exposure," Walker said in a message sent Saturday to staff and families in the district. "We​ recommend anyone​ who develops symptoms of a cough, fever or shortness of breath contact their healthcare provider."

Before learning of the positive test, the district had already announced its decision to close for a week starting Monday. Out of an "abundance of caution," the district will remain closed through spring break with students returning on April 20, Walker said.

The district's schools have been cleaned and disinfected daily following state guidelines regarding the coronavirus. Those efforts will be redoubled during the closure, Walker said.

Roberto Juarez, CEO of the Clinicas del Camino Real system, said the child who tested positive is an 8-year-old boy who had been treated in the health system and also at an area hospital. He said the boy is currently being cared for at Children's Hospital Los Angeles.

Bautista confirmed Saturday that the child had been admitted to St. John's Regional Medical Center in Oxnard and later transferred to a hospital outside of the county.

Children's Hospital Los Angeles officials on Friday said a child between the ages of 6 and 9 tested positive for coronavirus and was being cared for at the facility but offered no more identifying information. They also cited an underlying condition that "most likely made the child vulnerable."

"COVID-19 test was administered while the child was being treated at another hospital," officials said in a written statement. "(Children's Hospital) was notified that the patient was a suspected COVID-19 patient and took all necessary safety and infection control precautions during the emergency transport and admittance."

The child was in fair condition, hospital officials said Saturday.

Juarez said the 8-year-old boy was cared for several times at Clinicas, receiving treatment at two of the health system's Oxnard sites. He declined to name the sites.

Dr. Gagan Pawar, chief medical officer for Clinicas, said the coronavirus wasn't suspected because there was no travel history or known exposure that would suggest the condition.

Bautista said no quarantines of any health facilities have been ordered by public health. Pawar said 11 staff members at the two Oxnard sites, including several doctors, are being asked to monitor their health.

Juarez emphasized the Clinicas system would do whatever is necessary to protect the staff. Pawar said all of the system's facilities are cleaned and disinfected following federal standards regarding COVID-19.

At St. John's, all hospital personnel who had contact with the child are being monitored. "Less than a dozen" employees are in self-quarantine, said Megan Maloney, St. John's spokeswoman.

None have shown any symptoms, she said.

Juarez expressed deep frustration at what he called the lack of guidance given to Clinicas by Ventura County Public Health regarding possible quarantines. He said Clinicas officials called public health repeatedly and had trouble making contact, especially after business hours. He also expressed concern at the input that was given.

"This is critical timing. We need to be prepared," he said, questioning the public health department's readiness for COVID-19 and contending the agency didn't respond with any urgency. "We're trying to protect our employees and staff. None of that guidance is coming."

Bautista defended the county agency, asserting Clinicas had a direct line to public health. She said the county agency contacted the health system within one hour of receiving the child's positive test.

"Public health takes this very seriously," she said of the threat posed by the coronavirus, contending the agency is "responding really efficiently and effectively."

COVID-19: Coronavirus map shows COVID-19 cases in California, Nevada and beyond

Public health officials announced Thursday a county resident tested positive for COVID-19 after returning from a journey to Egypt.

Bautista said on Friday the resident's spouse, who also traveled from Egypt, tested positive for the virus, too. Both people are being home quarantined and had limited public contact, she said.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

SUPPORT LOCAL JOURNALISM: To see more stories like this, subscribe here.