The number of people in San Diego County with probable COVID-19 cases grew from one to seven Thursday, as county officials announced they will follow the state’s lead and ban all gatherings of 250 or more people.

Most of the new cases announced at a news conference had recently traveled to one location or another, but Dr. Wilma Wooten, the county’s public health officer, said that one, a man in his 50s, thus far has shared no recent history of movement outside the region.

Though the investigation is still ongoing, Wooten said she and her fellow public health leaders are acting under the assumption that the novel coronavirus situation has fundamentally changed in San Diego: This is no longer a travel-related risk to the community.

Local transmission is here.


Though seven cases is not a lot compared to many places — King County in Washington State leads the nation with 270 confirmed infections and 27 deaths — the advent of local transmission is a significant turning point. It means that the days of trying to contain the risk to the community within the population that has recently traveled are likely over.

The goal now, officials said, is to keep the number of new infections from occurring so quickly that they overwhelm local medical resources, especially the combined hospital capacity to offer the sickest patients the advanced life support needed to keep them breathing when infections enter the lungs, often causing pneumonia or severe respiratory distress.

With local transmission now appearing to be a fact, Wooten said, no one should expect this threat to blow over.

“We will have more cases and, yes, we will have deaths,” Wooten said.


And that includes what’s going on at Marine Corps Air Station Miramar where two additional flights that arrived Thursday brought the number of evacuees from the Grand Princess cruise ship to approximately 480.

On Thursday, a broad group of local leaders, representing the county and all 18 of its cities, showed their unity, gathering before cameras to make it clear that they’re ready for the fight, universally supporting new guidance from the California Department of Public Health that calls for all large gatherings of 250 or more people to be canceled.

“The simple fact is, this virus is highly contagious, it is spreading through San Diego County, and we need everyone to take action to limit that spread,” county Supervisor Nathan Fletcher said.

Smaller gatherings should also be canceled if they’re “held in venues that do not allow social distancing of six feet per person.”


There was, however, still a significant unresolved issue.

Like most public health officials in her position, Wooten did not proactively close local K-12 schools. While the available medical evidence so far suggests that school-age kids don’t get very sick when they do pick up novel coronavirus infections, they can still serve as vectors, potentially increasing the risk for grandparents, those with compromised immune systems who are most in need of protection as the outbreak breaks out.

The upshot: While local elementary, middle and high school students will still congregate in classrooms where desks are often wedged in as closely as possible, they will have to move at least six feet apart if, say, they wanted to go to church on the weekend.

Dr. Nick Yphantides, the county’s chief medical officer, said after Thursday’s news conference that the public health department has been monitoring the situation in local schools but does not yet believe a shut down is warranted.


“There is not current evidence or direction that social distancing of that nature is required in a school-based environment at this point,” Yphantides said.

Officials have said for several weeks now that they would handle possible school closures on a case-by-case basis, likely acting when a confirmed case pops up in a school or if there is solid evidence of widespread community transmission.

In addition to the single suspected example of such transmission mentioned Thursday, the county provided additional information on four others.

They include a woman in her 70s who traveled on the Diamond Princess cruise ship, a male in his 50s and a male in his 40s, both of whom apparently traveled to Colorado; another woman in her 70s who arrived at Miramar on a quarantine flight two days ago after disembarking the Grand Princess cruise ship.


Scripps Health, which admitted the region’s first presumptive positive COVID-19 case on Saturday, said in a short statement Thursday that it admitted another patient with a positive test at Scripps Memorial Hospital Encinitas on Wednesday. The rest of the hospital, Scripps said, is unaffected and safe for patients.

In an additional case, the Marine Corps said that a non-commissioned officer tested positive for COVID-19 at Miramar Wednesday.

The affected Marine recently returned from leave in Washington state and did not contract the illness from Grand Princess cruise evacuees who are quarantined on the base, the official said. The Marine felt sick and went to a base clinic Wednesday where he tested positive.

The Marine is in isolation at his off-base residence, a military official with knowledge of the case, but who was not authorized to comment publicly, said. His status is officially “presumptive positive” until confirmed by the Centers for Disease Control and Prevention.


Another Marine, who traveled to Washington with the man who tested positive, is currently in isolation to receive testing, Tuthill said.

The county’s ban on gatherings of more than 250 people is in effect through March, and a hotline is available for information on cancellations at (858) 571-8888.

Officials said people in high-risk groups — those over 65 or with chronic health problems — should avoid travel, limit interactions to groups of 10 or fewer people, and use “social distancing” practices by keeping six feet away from others.

Faulconer said he declared a state of emergency for the City of San Diego, similar to those already adopted by the county and state. That designation will help the city mobilize quickly to respond to the virus, and seek state or federal compensation for costs involved. He added that city and county officials are paying close attention to the homeless, as they consider individuals most at risk of infection.


“We’re also operating on high alert when it comes to our most vulnerable population of those that are homeless,” he said. “We want to make sure that those that are living on our streets, those that are living in our... shelters, to make sure that this virus does not take hold in that population.”

Officials said their goal is to “flatten the epidemiological curve” of the disease - or reduce the rate of spread - in order to ensure that medical facilities are not overwhelmed by new cases, and remain able to care for severely ill patients.

The goal, Fletcher said, is to “slow down infection, rates of new cases, not only to protect public health, but protect our public health system.”

Places of worship are likely to be among the hardest hit by the new limits on gatherings.


Many said Thursday that they are taking steps to keep their faith communities together, even if they may not be able to physically share the same spaces.

First United Methodist was among several churches that canceled live services, instead urging believers to watch a live-streamed presentation on the church’s web site.

The minister, choir and organist will perform their normal functions, but inside an empty sanctuary.

“We’ll probably try to work something in, to make this more of a two-way experience,” said Holly Watt, First United Methodist’s director of communications. “We’ll be asking for feedback from the people who have been watching.”


Officials said the county has a total of 4,200 hospital beds, including some with specialized equipment for treating patients in respiratory distress and other severe symptoms. Fletcher said the county has also secured 90 hotel rooms for use in isolating infected patients, and said people who do not need urgent health care should not go to the hospital. He also said the county set up 114 public hand-washing stations, to encourage the preventative practice, and is adding more at transit stations.

Wooten said the county has the capacity to test about 1,200 individuals, and so far has received about 300 specimens. She said commercial labs and local hospitals will also begin helping with testing shortly.

Not everyone who is ill will be tested, and the county’s priority will be testing patients with more severe symptoms, Wooten said.

“If people are stable, and have symptoms similar to a cold, we will ask them to stay home,” she said.


Yphantides said the county is working on new testing options that could increase the capacity for testing, while keeping infected patients away from other people in health care centers. That could include home testing, drive-up testing systems, or other test locations.

“I would call that the Uberization of (COVID-19) testing,” he said.

San Diego Unified School District Superintendent Cindy Marten declined to say whether schools are considering closing, but said that districts remain in contact with county health officials, and the San Diego County Office of Education, regarding the outbreak.

Officials said that city, county, state and medical officials are in constant communication about the outbreak, and updating plans based on a situation that changes hourly.


“We can control how we respond to this challenge,” Faulconer said. “I want all San Diegans to respond to one simple thing: will will respond based on the facts.”

Union-Tribune staff writer Peter Rowe contributed to this report.