New outbreaks at long-term care facilities and other workplaces caused a spike in new daily COVID-19 cases in Spokane County on Friday.

County Health Officer Dr. Bob Lutz confirmed 57 new cases, nearly double the highest previously reported number of daily cases.

Spokane County now has 707 confirmed cases of COVID-19 and 35 deaths from the disease, including one new death announced Friday of a man in his 50s.

Of all the deaths in Spokane County, four patients have been in their 50s. The rest have been older.

The spike is due to new outbreaks and increased testing, Lutz said.

He said outbreaks are at long-term care facilities, adult family homes and at least two new workplaces. An outbreak at the Philadelphia Macaroni Co. was behind a previous surge in cases in Spokane that emerged two weeks ago and that contributed to the county’s previous daily high of 30 new cases on May 29.

In long-term care facilities, two confirmed cases of COVID-19 qualify as an outbreak.

The new outbreaks indicate that COVID-19 can easily spread in group settings. Lutz noted that despite the high case count, he is still not seeing big community spread of the virus, meaning most confirmed cases can be connected to an outbreak or contact with another confirmed case.

“It speaks to the fact that you can do as much as you possibly can with respect to all the infection prevention strategies, and yet it doesn’t take much to have one little slip-up,” Lutz said. “One little slip-up in a population that is susceptible can cause an outbreak.”

Lutz said that health care providers conducted 3,900 tests in the last two weeks, compared to 2,300 tests collected the two weeks before that.

The Spokane Regional Health District is requesting help from the state Department of Health to quickly contact all confirmed cases, asking them to isolate themselves, and then collect information about their close contacts.

Lutz expects the health district will need support from the state for contact tracing, at least through the weekend.

Since Spokane County moved into Phase 2 during Memorial Day Weekend, case counts have spiked and climbed at higher rates than they had previously. Lutz said the increase in cases also reflects increased testing.

“As we do more testing, we will find more cases,” Lutz said. “And as we do focused testing, we’ll find more clusters.”

Of residents tested in the county, 3.7% have tested positive, Lutz said.

Lutz said hospitalizations have continued to stay steady in the last few weeks. Eight people are hospitalized due to COVID-19, as has been the case since May 22.

It is difficult to know initially how severe a new case will be, as it takes up to a week or 10 days after a person starts experiencing symptoms before doctors can gauge their severity.

“There’s no doubt I’ll see more hospitalizations,” Lutz said.

He noted, though, that the county has had a very stable and encouraging hospitalization rate so far, even with more than 200 cases reported in the past two weeks.

Both Providence and MultiCare officials assured the community in a news conference Friday that they have adequate capacity and personal protective equipment to adequately welcome patients back for surgeries as well as potentially treat a surge of COVID-19 patients, if the need arises.

“We have excess capacity and have been able to stock enough PPE that should we have a spike that rivals the one we saw in the Puget Sound, we’ll be able to handle that,” Greg Repetti, president of MultiCare hospitals in the Inland Northwest, told reporters Friday.

On Friday, Lutz rescinded his order that prohibited play structures and jungle gyms from being used, allowing community members to access them again.

He encouraged people to continue to follow social distancing guidelines, not to gather in groups of more than five people and to be aware that restrooms at parks may remain closed.

With protests planned for the weekend, Lutz said they are risky in the midst of the COVID-19 pandemic, due to the large gatherings of people where social distancing can be difficult. Additionally, shouting without face coverings in close proximity can put people at risk. Lutz said people have lots of ways other than protesting that they can be “focusing on the issue at hand.”

For those participating in protests, Lutz encouraged face coverings.

“I think people’s voices want to be heard and need to be heard and in doing so, if you’re out there do it safely,” Lutz said. “And do it safely with face coverings and try to physically distance.”

On Friday state Secretary of Health John Wiesman approved 14 counties to advance to a next phase statewide, including seven counties that can move to Phase 3. Columbia, Garfield, Lincoln, Ferry, Stevens, Pend Oreille and Wahkiakum counties can advance to Phase 3. King County was approved for a modified version of Phase 1.

Clark, Okanogan, Pierce, Skagit, Snohomish and Whatcom counties were approved to advance to Phase 2.