SANTA ANA (CNS) - The Orange County Health Care Agency is reporting 26 COVID-19 fatalities and 1,292 new cases, along with an uptick in hospitalizations, prompting hospitals to brace for a surge of patients.

Nine of the fatalities reported Thursday involved skilled nursing facility residents.

The number of hospitalized patients increased from 679 on Wednesday to 691, and the number of patients in intensive care rose from 234 to 236.

The county's coronavirus death toll is 402, and the cumulative number of cases rose to 21,517.

"Our community has paid a heavy price" in the battle against COVID- 19, Orange County Board of Supervisors Chairwoman Michelle Steel told reporters Thursday.

"We cannot become numb to these losses," she said of the death toll.

Steel added it was "heartbreaking" to see the economic struggles of business owners and residents during the pandemic.

Steel, who has in the past questioned face coverings and voted against the ordinance to require them in food industry businesses and pharmacies, encouraged residents to wear masks.

The county's recent rise in infections was expected as officials relaxed restrictions on economic activity, Orange County CEO Frank Kim said, while noting there has been a significant rise in infections in young adults.

"One of the interesting or concerning dynamics we've seen in the positivity rate over the last several weeks is we've seen this ride in new infections in the younger population, 17 to 24 and 24 to 34," Kim said.

Infections in those age groups has raced upward "dramatically faster" recently, Kim said.

They are not necessarily requiring hospitalization at the same rate as older groups, Kim said, "but, obviously, they have parents and uncles out in the community," who are also getting sick.

Dr. Clayton Chau, the Orange County Health Care Agency director and interim public health officer, said "these trends are very concerning. We can expect it to impact our health care system and get worse in the coming weeks."

The county's hospitals are "actively preparing" for a surge of patients, and it could mean less beds for patients without the virus, Chau said.

Chau implored seniors and residents with underlying health issues to "stay at home as much as possible."

Since the pandemic began, 1,284 of the county's infections were from skilled nursing facilities, 420 from the county's jails and 116 were transients.

Of those who died, 203 were from skilled nursing facilities, 14 from assisted living facilities and two were transients.

In the county's jails, 394 of the 420 infected since the pandemic began have recovered, but 26 are in medical isolation with symptoms and authorities are awaiting results of 110 tests.

County officials reported that they have performed 288,996 COVID-19 tests, with 9,452 documented recoveries.

The county's case and hospitalization rate has kept it on the state's watch list, which will continue to prevent the county from reopening inside dining at restaurants and bars, among other businesses that were closed to help tamp down the surge of infections.

The county's case rate rose from 237.9 Wednesday to 245, much higher than the state's preferred target of 25 per 100,000. The rate of testing positive for COVID-19 rose dipped from 14.9 percent to 14.3 percent, higher than the state threshold of 8 percent.

The county's intensive care unit beds available nudged up from 39.6 percent to 36.9 percent, better than the state standard of 20 percent.

The percent of ventilators available decreased from 65.8 percent Wednesday to 64.5 percent, much better than the state standard of 25 percent.

The change in the three-day average of increased hospitalized patients bumped up from 9.4 percent to 9.6 percent, just under the 10 percent state standard.

Steel Thursday sought to address criticism of the county's reporting of statistics.

"It is important to note this is not unique to Orange County, and, in fact, other counties across the state face similar issues" in reporting statistics that are provided by the state, Steel said.

Each day, county officials sift through data from the state to remove redundancies and then must sort the information to provide breakdowns of how the virus is affecting various demographic groups, Steel said.

"It takes time to go through these steps," she said.

Data continues to flow in during the day, "which can lead to further discrepancies," Steel said.