The Coachella Valley leads Riverside County with the highest numbers of new COVID-19 cases and hospitalized patients reported in the past week, a trend that has persisted throughout the pandemic but is causing new worry as the holidays approach.

These recent upticks have largely been attributed to a combination of spread through farms and packing plants in the eastern part of the region, as well as an increase in family and friend gatherings. Coupled with flu season, officials expect to see even more pressure placed on the local health care system.

The number of COVID-19 patients in Coachella Valley hospitals has “changed dramatically over the past week,” said Eisenhower Health COO Martin Massiello. The Rancho Mirage hospital has seen a 383% increase in COVID-19 patients since the start of the month; the 29 patients undergoing treatment there are half of the total across all hospitals in the valley.

Officials say the outbreaks in District 4, which encompasses the Coachella Valley, are likely caused by a constellation of factors, including a large aging population, a high number of medically vulnerable individuals, and a high number of Latino essential workers with underlying conditions, such as heart disease and diabetes.

The highest rate of COVID-19 cases in the Coachella Valley based on population have been centered in the cities of Indio and Coachella, as well as the unincorporated communities of Thermal, Oasis and Mecca.

County officials and myriad local organizations are working together to provide support to the agricultural community, especially as workers return to the Coachella Valley to plant vegetables and harvest dates and citrus.

Officials are urging all residents to continue to wear masks, physically distance, and not spend time with people outside of their own household.

“Please take this new trend (of cases) seriously,” Massiello added. “Be as fastidious as you can be in keeping yourself, your families and our patients as safe as possible.”

Coachella Valley has most new cases 

Under California’s tiered reopening framework, upticks in cases can undo weeks of progress. Riverside County recently backtracked to the most strict tier of the state’s four-tiered, color coded system after losing ground on key metrics.

But the blame cannot be placed solely on the Coachella Valley. All of the county’s districts are reporting COVID-19 data that would independently place them in the purple tier, the strictest level of California’s pandemic restrictions.

District 4 reported 17 new COVID-19 cases per day between Nov. 2 and Nov. 8, according to an analysis by The Desert Sun.

It’s consistently had the highest rate when compared to all Riverside County districts — which have comparable population sizes — since the beginning of the pandemic.

District 5, which is just west of District 4 and includes Beaumont, Moreno Valley and Perris, trailed closely at 16 new COVID-19 cases per day. District 3, which includes the cities of Hemet, Murrieta, San Jacinto and Temecula, reported the lowest at 8.

All county districts are reporting new daily COVID-19 numbers that the state considers to be cause for stringent COVID-19 closures.

However, most districts are reporting a positivity rate that falls into the next, less strict red tier bracket. A positivity rate is the number of people who test positive among all the COVID-19 tests administered in a given week.

Counties, though, are placed in tiers based on their worst-performing metric.

District 4 had the second-lowest positivity rate in the county at 6.3%. District 3 reported the lowest at 5% while District 1, which includes most of the city of Riverside as well as the cities of Wildomar, Lake Elsinore and Canyon Lake, reported the highest at 8.6%.

If a county conducts more tests, its positivity rate is likely to decrease because more of the general population will be getting tested, not just essential workers and those with symptoms who are more likely to have the virus.

A lower positivity rate typically means that a community is safer from the spread of the virus because tests are, proportionately, finding fewer cases. However, the state’s current reopening guidelines incentivize counties to conduct an ever-growing number of tests each day. This has led counties, including Riverside, to ask all residents to get tested. Some experts, however, question whether this system truly keeps communities safer or forces them to aim for data points that allow for quicker reopening.

Overall, Riverside County, which has the second-highest number of cases in the state after neighboring Los Angeles County, reported a positivity rate of 6.7% and 13.3 new COVID-19 cases per day per 100,000 people, as of Tuesday. The state adjusted the county’s case rate up to 14 per 100,000. Under the tier system, the state health department adjusts counties’ case rates based on whether they’re conducting more than or fewer than the state’s average number of tests.

To move to the red tier, which would allow for movie theaters, gyms and indoor dining to reopen, the county would need to show two consistent weeks of documenting between four and seven new COVID-19 cases per day per 100,000 residents and report a positivity rate between 5% and 8%.

While Riverside County has maintained a positivity rate within the red tier, the county’s rate of new daily cases continues to keep it in the strictest tier assignment.

Overall, Riverside County Health Officer Cameron Kaiser attributed the rise in cases to an increase in private family and friend gatherings. He noted some new cases were related to Halloween gatherings and he cautioned against combining households during the upcoming holidays, especially since gatherings are more likely to be indoors, where there is a higher chance at spreading the virus now that the weather is colder.

Preparing workers in eastern valley

Amid outbreaks among agriculture workers, Saruwatari said county health officials toured eastern Coachella Valley produce packing houses and fields on Nov. 6 to observe safety procedures that operators had in place for their workers.

Saruwatari said the county plans to conduct weekly check-ins with the area’s agricultural community to track COVID-19 cases and intervene when necessary.

More than 4,300 farmworkers and day laborers had contracted COVID-19 as of Oct. 29, according to county data, but the exact number of outbreaks linked to farmworking is unclear due to lack of data from contact tracers.

While growers say they have always prioritized food safety practices, they’ve taken additional steps to keep their crews safe during the pandemic, including erecting plastic barriers at work sites and break rooms when possible; providing people with face masks and shields when such barriers weren’t possible; and staggering shifts and lunch breaks.

“We had good conversations with growers and are working with them to address the needs of that population since they are at high-risk,” Saruwatari said. “It was encouraging and the growers were receptive to have this partnership.”

Dr. Conrado Barzaga, CEO of Desert Healthcare District and Foundation, also joined the agricultural tour. He said the protective measures that growers and packinghouse owners have implemented are “very good.” He said he is more concerned about other places workers might get infected, including while carpooling to and from work and in crowded homes.

“We have no concerns about all the protections that they are offering the employees,” he said. “But the employees are attached to a family, attached to a community, and that community as a whole is at risk.”

The organization is gearing up to address that risk. It is in preliminary talks with the growers and the Catholic diocese about providing testing in the fields and at packinghouses and churches.

Citing concerns that virus-related information is often disseminated using technical language, with few graphics or photos, the organization is also interested in enlisting community health workers who can go door-to-door, in apartment complexes and mobile home parks, to share information in a culturally appropriate manner, according to Alejandro Espinoza, the Healthcare District and Foundation’s outreach director.

Additionally, the state, county and the nonprofit organization TODEC are collaborating to provide some support and financial relief to infected farmworkers. A state initiative, called Housing for the Harvest, offers temporary housing for people who test positive for COVID-19, work in the fields or food processing, and need to isolate. The county’s version of the program builds upon that effort by also providing people with grocery delivery, a dedicated case worker who calls and provides daily wellness checks and, critically, a $2,000 check to ensure they can isolate and fully recover at home without facing financial fallout from lost wages.

The local program launched in mid-September and is funded through the end of the year. It’s expected to serve about 250 people; about 70 people had received assistance through the program as of Oct. 27.

Hospital official urges caution

The high number of new daily reported COVID-19 cases in District 4 is concerning to Coachella Valley health officials because it directly impacts demand on hospital capacity as flu patients pop up as well.

On Nov. 1, Eisenhower Health had just six COVID-19 patients, one of whom was a critical case in the intensive care unit.

As of Monday, the hospital reported 29 COVID-19 patients, with six of those in the ICU. Of those six, three were serious enough to need ventilators.

Across the valley’s three hospitals, which also include Desert Regional Medical Center in Palm Springs and JFK Memorial Hospital in Indio, there are a total of 60 COVID-19 patients — the highest in the county — according to Riverside County’s most recent tally on Nov. 8.

While the number of COVID-19 patients at Desert Regional and JFK has been stable since the beginning of October, the hospitals experienced an increase from a week ago, said Krista Deans, spokeswoman for the hospitals.

“This shows how quickly the numbers can change,” she said.

While the overall increase is concerning, it is still less than half of the number of COVID-19 patients that District 4 hospitals were caring for at the height of this summer’s surge in cases. At the end of July, Coachella Valley hospitals had more than 130 COVID-19 patients at one time.

A small tick upward — similar to what is being reporting now — preceded the surge that overwhelmed hospitals.

However, Gov. Gavin Newsom reported this week that COVID-19 patients accounted for just 4% of total hospital capacity throughout the state. He said hospitals are more prepared this time to handle an influx of cases as they have learned from prior upticks and expanded their resource capacity.

“We anticipate that this trend will continue through the next few months due to family gatherings during the holidays and because snowbirds will be arriving in the valley from all over the U.S., where cases are surging,” Massiello said.

Desert Sun reporter Nicole Hayden covers health in the Coachella Valley. She can be reached at Nicole.Hayden@desertsun.com or (760) 778-4623. Follow her on Twitter @Nicole_A_Hayden.