SANTA ANA, Calif. (CNS) — Orange County reported 156 new cases of COVID-19 and 26 additional deaths Wednesday, bringing the county's totals to 52,538 cases and 1,176 fatalities.

Wednesday's grim statistics for coronavirus fatalities follows Tuesday's report of 22 deaths, and makes 49 COVID-19 deaths since Sunday.

The deaths were spread out over the past few weeks, according to the Orange County Health Care Agency. The lag in reporting is common since the data come from multiple sources, officials say. The last double-digit day of fatalities occurred August 27 when a dozen people died.

Six of the latest deaths were skilled nursing facility residents and two lived in assisted living facilities. Since the pandemic began, 431 of the fatalities were skilled nursing facility residents and 81 lived in assisted living facilities.

Four of the fatalities since the pandemic began were transients, up from one reported Tuesday.

"Even though the disease transmission is much lower in our communities, today the risk is still the same for those individuals with underlying health conditions," Orange County CEO Frank Kim said. "We know people are interacting and we have to be very careful with people who are older or who have underlying health conditions. The risk hasn't changed."

Officials are concerned that as more businesses reopen, residents might let down their guard and be less vigilant about following social distancing guidelines, Kim said.

"We're all going through it as an entire country. As we reopen more you'll continue to see a disproportionate number of people who pass away," Kim said. "Just because your risk of infection is lower because there's less transmission in the community doesn't mean that the actual risk of contracting COVID-19 has diminished, especially for those who are older and have underlying conditions."

Orange County officials say COVID-19 numbers are improving enough to move it up a level to the orange tier within a week if trends continue. The overall positivity rate went from 3.9 percent to 3.1 percent, and the daily case count per 100,000 people dropped from 4.7 to 3.6.

"I expect we will go to the orange tier next Tuesday," Supervisor Lisa Bartlett said. "That's another huge milestone relative to getting the upper hand on coronavirus in Orange County."

The county has to remain within that range for another week, then it can move up from the red to the orange tier.

"It's a big week," Kim said. "If we miss it this week you have to wait another seven days."

Considering the average incubation period of two weeks, if Labor Day gatherings were going to have an effect, county officials would be seeing it by now, Kim said.

Moving up to the orange tier means retail businesses could operate at full capacity, instead of 50 percent in the current red tier. Shopping malls also could operate at full capacity, but with closed common areas and reduced food courts just as in the red tier.

The orange tier boosts capacity for churches, restaurants, movies, museums, zoos and aquariums from 25 percent capacity to half capacity. Gyms and fitness centers could boost capacity from 10 percent to 25 percent and reopen pools.

The orange tier also allows family entertainment centers like bowling alleys and wall climbing to open indoors to 25 percent capacity.

Orange County's schools are already eligible to reopen for indoor, personal instruction, but not all of them will reopen right away. Schools in Fountain Valley reopened on Tuesday.

It is up to school districts to decide and many are offering "hybrid models" of some in-person instruction and some online-only instruction, Kim said. Some school districts will allow parents to continue with distance learning only.

If there is a breakout at any of the schools, they would have to close for two weeks and have no more COVID-19 cases before reopening, said Dr. Clayton Chau, the county's Health Care Agency director and chief health officer.

Last week, the county reported 34 fatalities, down from 42 the week prior.

Hospitalizations in the county inched up from 170 on Tuesday to 175 on Wednesday, with the number of patients in intensive care declining from 55 to 51.

The OCHCA reported that 810,908 COVID-19 tests have been conducted, including 5,716 reported Wednesday. There have been 47,367 documented recoveries.

Officials are not concerned they will not be doing enough testing to help vault the county into the orange tier, Kim said. The county has promoted testing among retail and food industry workers and among educators, Kim said.

A week ago the county had 157.7 per 100,000 residents testing on average and as of Wednesday that number was up to 214 per 100,000, Kim said.

"That's a pretty big jump," he said.

Since the pandemic began, 359 of those infected who died were 85 years or older, 251 were 75-84, 240 were 65-74, 169 were 55-64, 103 were 45-54, 32 were 35-44, 17 were 25-34, four were 18-24 and only one was a child.

The county has 65 percent of its ventilators available and 35 percent of its intensive care unit beds. The change in three-day average hospitalized patients is -8.7 percent.

To move up from the second-most restrictive red tier to the orange tier in the state's four-tier monitoring system, the county must have a daily new case rate per 100,000 of 1 to 3.9 and a positivity rate of 2 to 4.9 percent.