The county and city on Tuesday both reported their highest number of deaths from COVID-19 since September, with Los Angeles County reporting 51 deaths and Long Beach reporting four.

The caseloads for both agencies also continued to swell quickly upward, though not as high as the past few days, which have averaged more than 4,500 cases. On Tuesday Los Angeles County reported 3,692 cases, and Long Beach reported 296—though some of that was due to reporting lags at the state level, the city said.

Since March, 374,134 cases of COVID-19 have been confirmed in Los Angeles County, 15,522 of those in Long Beach. The total deaths for Los Angeles County is 7,497, with 274 of those in Long Beach.

With an increase in COVID-19 testing, Long Beach also reported a 5.8% seven-day positivity rate—a jump from a 4.2% seven-day positivity rate announced last week.

The increase in cases locally comes as the county reported a staggering 6,124 new cases on Monday, which pushed health officials to consider stricter measures meant to control the surging coronavirus, such as closing down dine-in service at restaurants. The new health mandate will go into effect Wednesday night at 10.

Pasadena and Long Beach are the only two cities in the county that have their own public health departments. Pasadena announced on Monday that it would not follow the county’s public health orders, while Long Beach has opted to follow the county’s lead.

The number of patients hospitalized as a result of COVID-19 has steeply increased, local officials said. Los Angeles County Public Health Director Barbara Ferrer told county supervisors during a press conference Tuesday that while she was aware of the frustration business owners felt under the new restrictions, it was the growing number of hospitalizations that guided the health order decision.

The county on Tuesday reported 1,575 people were hospitalized.

“We don’t want to wait until case numbers in hospitals increase,” Ferrer said. Hospitalizations numbers today are reflective of infections that took place about two weeks ago, health officials said, adding that the more than 6,000 cases recorded countywide yesterday have not yet affected current hospitalization numbers.

The impending restrictions has been met with strong opposition from restaurants and business owners who feel they are the easy target to close down, and argue they have followed every health order from the start of the pandemic.

The Long Beach Restaurant Association, composed of local business owners, recently organized to oppose the new health order and will host a meeting with local health officials Wednesday to develop alternative guidelines to tackle the surge in COVID-19 infections.