The wave of cases that made Los Angeles the center of California’s coronavirus surge is now crashing on nearby suburban counties.

Over the last week, San Bernardino, Riverside and Orange counties have all surpassed Los Angeles county in per-capita case rates, the Los Angeles Times reported.

By Wednesday, the three southern California counties respectively reported case rates of 408, 391 and 399 cases per 100,000 residents – all topping Los Angeles county’s rate of 372 infections per 100,000 residents.

Meantime, cases in Los Angeles county continue to surge, setting a one-day record on Thursday with more than 4,200 new cases, according to California public health data.

Officials in the three suburban counties made decisions to lift mask orders while Los Angeles kept its own in place.

The surge in LA’s neighboring counties comes as new cases continue to climb statewide, hitting their highest numbers since the pandemic began. On Friday, the governor, Gavin Newsom, announced strict new criteria for reopening schools – a move that means most students in the state are unlikely to return to classrooms in the fall.

Related: California hits record 11,000 daily cases amid coronavirus surge

The surges reveal the shortcomings of California’s approach to giving localities relative discretion on how to proceed with plans to reopen the economy, undercutting a uniform response and making it more difficult to contain outbreaks in one county.

It also highlights how a region’s politics can influence responses to a public health crisis, a division illustrated by Donald Trump’s own resistance to masks and his insistence that schools open for in-person instruction in the fall.

Before Newsom’s order, school officials in Orange county, which has emerged as a cradle of organized resistance to mandatory mask orders, recommended schools return to in-person instruction in the fall – without masks – even as the state’s two largest school districts, in Los Angeles and San Diego, said they would begin the school year online.

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While expert opinion is unanimous that wearing masks can slow the spread of the virus, some localities and individuals remain defiant. A mask order was issued by Orange county’s former public health officer, but she resigned after receiving a death threat and her replacement rescinded the order.

In Imperial county, which neighbors Riverside to the south, medical professionals face a barrage of coronavirus cases that has stretched hospital resources thin.

Between 15 and 17 patients each day are airlifted out of the county to outside hospitals that can provide higher levels of care, the CEO for El Centro regional medical center told the Guardian.

California has recorded more than 356,000 coronavirus cases – at an average rate of 8,500 per day – and has attributed 7,345 deaths to the virus.


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