COUNTY NOTES SIGNS OF PROGRESS IN FIGHT

■ Social-distancing measures appear to be flattening the curve ■ Officials report 5 new fatalities, bringing local death toll to 36 ■ Even New York sees encouraging indicators amid difficult week ■ Britain approaching peaks of losses suffered in Italy

There may be some encouraging signs in the countywide fight against the coronavirus, but don’t bring out the surfboards or make restaurant reservations just yet.

After weeks of warning that April would be a tough month, county officials on Wednesday said there were signs that social-distancing orders may be working, and a new treatment involving plasma donations could be on the horizon.

But as the death count rose to 36, including five new fatalities reported Wednesday, officials also cautioned that the restrictions on public gatherings and other orders will last through the end of the month, and lifting those directives will be a slow and gradual process.

San Diego County Supervisor Nathan Fletcher stressed that any signs of progress should not be interpreted as an opportunity to ease up on the efforts that may have helped stop the spread of COVID-19.

“Our message today is very clear,” he said at the daily press briefing from the County Operations Center in Kearny Mesa. “It is to stay

the course.”

On Tuesday, the county reported that the new number of positive cases was 50, the lowest number of new cases since March 28. The number of new cases on Wednesday wasn’t significantly higher, with the county reporting another 76 people testing positive for the coronavirus.

Studies have shown that the number of new cases has doubled every three days in communities with few social-distancing rules, which could be encouraging for San Diego County, where health officials have said the doubling rate has hovered around five days.

Dr. Nick Yphantides, San Diego County’s chief medical officer, said this was the first week where the doubling rate has slowed, which he said was embraced as an encouraging sign, but with some caution.

There also is some encouraging news about treatment of the coronavirus.

The San Diego Blood Bank put out a call for plasma donations from former COVID patients who have recovered after illness. The effort is part of a nationwide effort to treat severely ill patients by infusing the part of their blood that carries antibodies from novel coronavirus infection.

These antibodies, which give a person immunity to viruses that the immune system is able to fight off, can theoretically stimulate the immune systems of those who are struggling to win the fight on their own.

The possible efficacy in COVID patients got a major boost after a study appeared in the Journal of the American Medical Association that showed that five critically ill COVID patients in China, all suffering from severe breathing problems caused by the disease, recovered after receiving plasma infusions from patients who had gotten well.

“The important thing was that there were no adverse effects, and all five did recover,” said Dr. Mark Edmunds, the blood bank’s medical director. “The study in JAMA was uncontrolled, and it was a small number of patients, so we can’t say for sure if it was the plasma or something else, but there definitely has been a lot more interest from (critical-care doctors) since that study appeared.”

The physician said the response in San Diego was quick on Wednesday. By day’s end, about 100 people from throughout the region had filled out an online form, indicating their willingness to donate plasma.

So far, though, just two of that first group have met stringent requirements to donate.

Patients must have received a positive COVID test in order to donate and at least 28 days must have passed since their last symptom or they must have received a second negative test between 14 and 28 days after their last symptom.

Wednesday also was the first time county officials have mentioned what life may look like after the outbreak subsides and life begins to return to normal.

But Fletcher again was cautious about celebrating too early, and said there were lessons to learn from how jurisdictions had handled the 1918 flu epidemic, which county officials have been studying.

Some jurisdictions did not put in public orders restricting contact early enough and paid a price, he said, while others made the mistake of lifting restrictions too soon, which led to a second infectious wave.

“In San Diego, we didn’t make the first mistake,” he said. “And we won’t make the second mistake, either.”

Fletcher would not venture when restrictions on businesses, schools and public outings would be lifted, but did predict it would be a gradual process.

“Our ability to get out of the current posture is based on our ability to fully commit to that current posture right now,” Fletcher said.

In the San Diego news briefing on Wednesday, county public health officer Dr. Wilma Wooten announced a racial breakdown of people who had died of COVID-19 in the county for the first time.

That breakdown followed news reports that black Americans had a disproportionately high fatality rate from the virus in some areas of the country.

Racial data was available for only 27 of the 36 local deaths in the county, limiting the ability to indicate any trends. Wooten said no black Americans were known to have died from the virus in the county, while 15 white people, 10 Hispanic or Latino people and two Asian Americans had died.

The number of county residents who have tested positive for the coronavirus is almost 1,500. The new cases include a Harbor Police officer, a Port of San Diego official said Wednesday.

The officer has not worked since March 20 and began feeling ill after that date, port spokeswoman Brianne Page said.

“Upon notification of the positive test, the Port promptly investigated and determined the officer has not been in contact with any other Port employees or Port facilities since that time,” Page said.

Besides orders to close businesses and restricting outings, the county is taking steps to curb the spread of the virus among people who are incarcerated.

As part of that effort, inmates are being shifted out of a Mountain View workfurlough program.

The number of county inmates held at the privately owned facility was expected to fall to 34 on Wednesday, with 11 people released after being fitted with Gps/ankle monitors on Tuesday and an additional seven slated to go on home detention on Wednesday.

County spokeswoman Alex Saint said the county began releasing inmates on March 27 who had 30 days or less left on their sentences after a judge signed a court order. Probation officials, working with the District Attorney’s Office and Public Defender’s Office, also were able to establish a temporary home-detention program that allowed more inmates to be released.

The outbreak also has affected health care workers who do elective procedures.

In Escondido, Palomar Health announced it has furloughed about 200 workers for 21 days as COVID-19 continues to significantly reduce the number of nonemergency medical procedures being performed throughout the region.

Diane Hansen, Palomar’s chief executive, confirmed the move Wednesday and said it largely involves employees who work in outpatient and surgical departments that have been hardest hit by a public health order that has shut down elective work since mid-march.

The executive said Palomar will assist furloughed employees to apply for temporary unemployment benefits and will also allow use of vacation time to make up for lost wages.

County orders to combat the coronavirus outbreak also may be having a positive impact on curbing the flu.

A weekly flu report released Wednesday showed a precipitous drop in the total number of cases reported to the public health department for the second week in a row.

Last week, only 21 confirmed flu cases were reported, compared to 331 for the same week last year. The prior three-year average was 222 cases. Rady Children’s Hospital also reported last week that they started seeing so many fewer young patients with severe respiratory illnesses that the facility had to shut down part of its intensive care unit due to lack of patients.

The significant reduction in flu cases, coupled with a similarly-sudden drop in the number of kids experiencing severe viral illnesses, suggests that the broad-based social-distancing campaign is working to reduce transmission of all viruses.

Public health officials said last week that they wanted to see at least two weeks in a row before forming a firm opinion on the trend, but Wooten said Wednesday that she’s now convinced.

Fletcher also announced on Wednesday an amendment to a public health order that had restricted public gatherings to 10 or fewer people. The order now prohibits gatherings of any size, and Fletcher acknowledged the change was a technicality, since the county already ordered people to remain at home except for essential trips or for work that has been deemed essential.

Staff writers David Hernandez and Karen Kucher contributed to this article.

gary.warth@sduniontribune.com paul.sisson@sduniontribune.com