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Marin has recorded the highest number of coronavirus cases of any Bay Area county relative to its population, according to new public health data.

That does not include cases at San Quentin State Prison, where more than a third of the inmates have tested positive for the virus.

Cases in Marin climbed by 52 on Thursday, bringing the cumulative total to 1,311. The county also reported that a man in his 40s diagnosed with coronavirus died this week, marking the 19th coronavirus-related death in Marin. The man was the first person under the age of 50 to die with a coronavirus diagnosis in the county.

According to public health data compiled Wednesday by the Bay Area News Group, Marin had 482 cumulative coronavirus cases per 100,000 residents — the highest in the region. The data include the 918 Marin residents who have recovered from the virus.

San Mateo County had the second-highest cumulative case rate in the Bay Area, with 425 cases per 100,000 residents. San Francisco followed with 399 cases per 100,000 residents.

Health officials said Marin also has one of the highest rates of coronavirus testing in the Bay Area, which is playing a role in the county’s relatively high case rate.

Cases and deaths at San Quentin are not counted in the tally of Marin’s cases, according to the county’s public health officer, Dr. Matt Willis. The California Department of Corrections and Rehabilitation reported Thursday that 1,375 inmates and 114 staff members at the prison have tested positive for the virus.

The Marin County coroner and state Office of the Inspector General continue to investigate last week’s death of 71-year-old death row inmate Richard E. Stitely, who was found unresponsive in his single-occupant cell.

Stitely tested positive for COVID-19, according to the coroner’s office. If COVID-19 is determined to be the cause of death, Stitely, who had been on California’s death row since 1992 for a rape and murder conviction, would be the first coronavirus death at the prison.

On Wednesday, a second death row inmate was found dead in his single cell. Joseph S. Cordova, convicted of rape and murder and on death row since 2007, was discovered unresponsive around 4 p.m., according to a department of corrections statement. He showed no signs of trauma. The coroner is investigating cause of death and COVID-19 status.

The San Quentin outbreak is alarming public health officials and putting pressure on Marin’s hospitals, which were treating 28 coronavirus patients on Thursday, including 12 prisoners. According to Willis, “about 10 individuals are transferred from the prison daily for hospitalization.” Some of the inmates are transferred to hospitals outside the county.

“Observing this outbreak as it has accelerated over the past month from the margins has been one of the most challenging and frustrating experiences in my public heath career,” Willis said Wednesday in a video announcement.

The outbreak began after 120 inmates were transferred to San Quentin on June 1 from the California Institution of Men in Chino, Willis said. The transfer was aimed at reducing the population at the Chino prison due to a coronavirus outbreak there, but the majority of the men who were transferred to San Quentin hadn’t recently been tested for the virus, he said. The men were transferred to a unit with other San Quentin inmates before testing revealed that many of them had been infected, Willis said.

“Marin Public Health has no authority to influence the response onsite, outside of providing advice,” he said. “The small and very dedicated team of doctors and nurses at the prison are trying to keep up with rising numbers and are increasingly overwhelmed.”

The prison outbreak comes amid a surge in cases in Marin. The county set its record five times in June for the highest number of coronavirus cases reported in a day. The highest one-day increase yet was recorded June 25, when 54 cases were recorded.

Coronavirus outbreaks in workplaces are a driving force behind the spread of the virus in Marin, officials said. On Monday, the county allowed restaurants to resume indoor dining service, and allowed hair salons, barber shops and campgrounds to reopen.

But due to the rising number of coronavirus infections, Marin canceled its plan to reopen gyms, hotels, vacation rentals, nail salons, massage parlors and other businesses this week.

As health officials continued to loosen restrictions on businesses in June, the county also updated its stay-at-home order to allow residents to gather outdoors in “social bubbles” of up to 12 people.

With a holiday weekend approaching, Willis urged people to follow Marin’s public health guidelines for such gatherings, which include wearing masks and maintaining “social distancing.”

“Please do your part to stop preventable surges in cases from July 4 gatherings by staying in your protected smaller groups outside, covering you face and staying 6 feet apart,” he said.