Staff photo by Troy Stolt / Clinician Amy Farlett at a pop-up coronavirus test site at the New Hope Baptist Church by Cempa Community care on Wednesday, May 27, 2020 in Chattanooga, Tenn.

The Hamilton County Health Department reported the highest single-day number of hospitalizations and people in the intensive care unit related to COVID-19 on Tuesday, signaling a worsening outbreak and further spread of the virus a day after officials said the virus is stretching the agency thin.

As of Tuesday, there were 46 people hospitalized locally and 18 people in the ICU with the coronavirus, higher than at any other point in the pandemic and breaking the previous single-day highs of 37 and 17, respectively. The previous single-day high for hospitalizations occurred on June 6.

On Monday, Becky Barnes, Hamilton County Health Department administrator, said the virus is spreading across all ZIP codes, workers, living situations and demographics — indicating that community spread is occurring, as well as spread from reopening businesses.

As of last month, officials were saying much of the spread was occurring among multigenerational families and essential workers — or those who worked throughout the pandemic, and therefore were not directly affected by the recent easing of restrictions allowing the economy to reopen.

Officials have said that it's important to follow data trends over time rather than focus on single-day jumps. However, Tuesday's growth in hospitalizations continues a trend that began May 30. Since then, Hamilton County hospitals have cared for more than 30 patients with COVID-19 every day.

Hamilton County Mayor Jim Coppinger has said multiple times that hospitalization data is a key metric he follows to indicate whether stricter social distancing measures should be reinstated. That's because most people with COVID-19 don't require hospitalization, so increased testing can result in an increased overall case count. But increases in coronavirus patients in hospitals signals growing severity of the outbreak because it can happen regardless of testing trends.

During a news conference on Monday, Barnes said the health department is the busiest it's been since the pandemic began, pulling staff from other departments and adding new staff almost daily in order to keep up with the demands of the pandemic.

However, local health officials said Tuesday that while the high number of hospitalizations is concerning, it is not expected to overwhelm the local health systems.

"The hospitals are seeing a slight uptick in COVID patients, but it's not anything they're not prepared to handle," said Rae Bond, CEO of the Chattanooga-Hamilton County Medical Society, following a meeting of the local COVID-19 task force.

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Staff photo by C.B. Schmelter / Mayor Jim Coppinger answers questions during a news conference announcing a confirmed case of COVID-19 in Hamilton County at the McDaniel Building on Friday, March 13, 2020 in Chattanooga, Tenn.

Barnes said on Monday that although the department tracks overall local hospitalizations, the agency doesn't know the details of individual cases. At least some of the patients could be from other counties, since Chattanooga is a regional hub for medical care.

The health department announced 70 new people infected with the virus on Tuesday, bringing the county total to 1,556. The department reported 608 of the 1,556 people with the virus have recovered.

In May, Hamilton County officials said the growing number of local COVID-19 cases was due largely to an increase in testing and the virus spreading among essential workers. While it's true that the county ramped up testing efforts significantly, determining how many new cases were a result of more testing is a challenge, because the health department doesn't regularly update its testing data.

On Monday, Barnes provided a snapshot of COVID-19 testing in Hamilton County, saying the county had completed a total of 2,845 tests for the week June 1 to 7.

"There are many more tests being conducted in our community through our community partners," Barnes said. "We get testing from other areas, we get testing from Georgia and Alabama if our citizens are tested there — it's a fluctuating number."

Based on Monday's update, a total of 23,057 tests had been conducted in the county since the beginning of the pandemic, for a 6.4% positivity rate.

The federal government and World Health Organization recommend testing enough that a population's percent of positive cases is below 10%, indicating a larger sample size beyond testing just the sickest patients. Tuesday's update did not include new testing data, therefore a more recent positivity rate could not be calculated.

In the coming days and weeks, Hamilton County could see even more positive cases as a result of probable spread that took place during recent gatherings to protest the killing of George Floyd by a Minneapolis police officer. Health officials have urged anyone who attended the demonstrations to be tested for COVID-19.

With the data released Tuesday, the department reported 67 new infections among Hispanic residents, many of whom are particularly vulnerable due to densely populated living and working conditions, officials have said in the past.

The local ZIP codes hardest hit by the virus also coincide with areas of poor health, poverty and high rates of chronic disease, which make a person more susceptible to serious COVID-19 illness and death. The 37407 ZIP code, which represents Clifton Hills, ranks 598th out of Tennessee's 600 ZIP codes for health outcomes, according to ExploreTNhealth, a website created in partnership between the Tennessee Hospital Association and its data partner, the Hospital Industry Data Institute.

Case growth in certain demographics and ZIP codes can largely be attributed to community testing events focused on vulnerable populations.

However, the complete picture of racial or ethnic disparities in COVID-19 infections in the county remains unknown with more than a quarter of all cases, 397 of 1,556, still not assigned to a race.

Hamilton County's last reported death was June 4, part of a 10-day stretch during which the county experienced five deaths. Total deaths related to coronavirus in the county is 19.

Contact Elizabeth Fite at Contact Wyatt Massey at or 423-757-6249. Follow him on Twitter @news4mass.