The Impact of COVID-19 in San Bernardino County

Looking back on 2020, it is clear that few people or sectors have remained untouched by the coronavirus pandemic. In the wake of the March 2020 stay-at-home order, which led to historic levels of unemployment and changes in how we work, San Bernardino County residents, employees, and service providers were tested in new ways and learned to adapt in extraordinary circumstances.

In this section of the 2020 Indicators Report, we analyze available 2020 or real-time data to create a snapshot of the impacts of the pandemic on each of the sectors covered in this report, including the economy, housing, education, wellness, and transportation. In addition, in the body of the report, on the section title pages, we capture stories of resilience and perseverance on the part of the many agencies working to help San Bernardino County emerge stronger than ever from this unique period in our collective history.


As of January 2021, COVID-19 case rates in San Bernardino County outpaced state and national rates, with Pacific Islander residents disproportionately affected.

  • While case rates were high, a lower proportion of San Bernardino County residents have died of COVID-19 than the state and nation.
    • The higher case rates may be traced to the fact that more San Bernardino County residents identify as essential workers than the statewide average and were less likely to work at home where they would be less exposed.
    • Anecdotal accounts suggest that the efforts of the collaborative Skilled Nursing Facility Outreach and Support Team may have contributed to reduced COVID-19 infection among this vulnerable population and, in the process, may have contributed to lower death rates.
  • As employment plummeted, caseload data show that residents turned to safety net programs, such as CalFresh, CalWORKs, and Medi-Cal, to help them weather the economic uncertainty.
  • One-in-10 residents reported having difficulty paying their rent or mortgage.
  • Further impacting families’ ability to work, over 700 childcare providers closed their doors at least for part of 2020 after the start of the pandemic and hundreds remain closed into 2021.
  • As schools moved online, child abuse and neglect reports declined sharply as children were no longer under observation by one of the main sources of child abuse and neglect referrals – teachers and school staff. Reports by health professionals were down, also.
  • Meanwhile, not all indicators were negative:
    • home sales remained robust throughout 2020, with higher prices and fewer days on the market for single-family home sales than the previous year,
    • freight moving through Ontario Airport grew, and
    • traffic congestion fell dramatically as fewer commuters filled the roadways at peak hours, which contributed to a temporary improvement in air quality.


To understand how COVID-19 has affected San Bernardino County, it is important to first look at the key drivers behind many of the impacts: COVID-19 case rates and levels of sheltering in place to reduce exposure.


In terms of absolute growth, several age groups are expected to decline in numbers between 2020 and 2045, including young children ages 0-5 (0.1% decline), children ages 6 to 17 (0.4% decline), and young adults ages 18 to 24 (0.9% decline). All other age groups are expected to see positive population growth between 2020 and 2045, with seniors ages 65 and older experiencing the highest rate of growth at 70%.

For context, the statewide population of children ages 0-5 is expected to decrease by 7% over this period, while the statewide senior population is projected to increase 61%.

In terms of relative growth, the proportion of the San Bernardino County population made up of residents ages 65 and older is projected to grow from 12% of the population in 2020 to 18% by 2045. The age group of adults ages 45-64 is expected to grow from 23% to 24% of the overall population during this timeframe. The size of all other age groups is projected to shrink in varying degrees relative to the total population.


The summertime peak of 971 known cases reported on July 1, 2020 was eclipsed later in the year by a high of 5,447 known cases on December 29, 2020. Cases were trending downward in early January 2021.


Known COVID-19 Cases by Day in San Bernardino County, January 1, 2020 through January 15, 2021

Cases by Race/Ethnicity

Similar to findings across community indicators in San Bernardino County, racial and ethnic inequities in COVID-19 case rates are pervasive. Among Pacific Islander residents, there were nearly 20,000 known cases per 100,000 Pacific Islander residents as of February 11, 2021. This is nearly double the next highest case rate (11,674 cases per 100,000) among Native American residents and nearly quadruple the lowest case rate (4,963 per 100,000) among Asian residents. The COVID-19 case rate Equity Gap Score is 3.9 and the death rate Equity Gap Score is 3.7. An Equity Gap
Score of 1.0 signifies equitable conditions.1


COVID-19 Case Rates by Race/Ethnicity in San Bernardino County as of February 11, 2021


While the cumulative COVID-19 case rate in San Bernardino County is estimated to be above the state and national rates, the San Bernardino County COVID-19 death rate is less than both the state and nation. As of February 6, 2021, there were 90 deaths per 100,000 residents due to COVID-19 in San Bernardino County from the start of the pandemic (January 22, 2020) through February 5, 2021. This compares to 109 per 100,000 in California and 137 per 100,000 nationwide.


San Bernardino County COVID-19 cases per 100,000 residents

compared to 8,373 per 100,000 statewide

compared to 8,017 per 100,000 nationwide


San Bernardino County COVID-19 deaths per 100,000 residents

compared to 109 per 100,000 statewide

compared to 137 per 100,000 nationwide

Source: USA Facts ( based on source data from state public health departments and U.S. Census Bureau intercensal population estimates (January 22, 2020 through February 5, 2021)


Before the pandemic, approximately 20% of the San Bernardino County population stayed at home on a given day.
When the stay-at-home order went into effect, that rate grew to a high of 45% in mid-April. Since then, irrespective of spiking case rates in July 2020, the percentage of the population staying-at-home steadily declined to a pandemic-era low of 25% in October and early November. The “Limited” and “Regional” stay-at-home orders issued in late November through December 2020 prompted a slight rise to 30% staying at home; that level was holding into January 2021, even after the Regional Stay at Home Order was lifted on January 25, 2021. San Bernardino County’s stay-at-home levels have largely mirrored statewide levels over the past year and into 2021.



The March 19, 2020 stay-at-home order pushed an additional 95,000 San Bernardino County workers into the ranks of the unemployed reaching a total of 131,447 unemployed by May of 2020, or 14.1% of the labor force. The double-digit unemployment rates persisted until October 2020 when the rate fell to 8.7% and stayed in the single digits through the end of the year. At 9.2% unemployment in December, the unemployment rate is over two-fold the January 2020 rate of 3.9%. The December rise in the unemployment may be partially due to a rise in the number of people in the labor force. Under the threat of losing unemployment benefits at the end of 2020, residents may have felt pressed to reenter the labor force despite dismal prospects for finding a job.

According to a 2020 study, working women are experiencing the worst effects of the COVID-19 employment shocks, unlike in previous downturns, which hit working men the hardest. There are two key reasons for this variation. First, the sectors that have been hit hardest are those more likely to employ women (restaurants and other retail establishments, hospitality, and health care). Second, women have been more affected by the pandemic-induced closure of childcare centers and the transition of school to distance learning.2


Monthly Number Employed and Unemployed and the Unemployment Rate in San Bernardino County, 2020

Source: U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics

Underemployment and Lost Productivity

While many San Bernardino County workers lost their jobs in 2020 due to closures associated with the pandemic, many more had reduced hours and/or income. Fully one-in-five San Bernardino County residents surveyed between May and August of 2020 reported that they had reduced hours, income, or both. Productivity has also been hampered for parents with children ages 18 and younger. Almost half of parents nationwide (49%) report that because of the need to balance work and parenting responsibilities, they feel that they can’t give 100% at work during the pandemic.3


of San Bernardino County workers reported they lost their job

compared to 11% statewide


of San Bernardino County workers reported they had reduced hours and/or income

compared to 19% statewide

Source: May-August 2020 fielding of the California Health Interview Survey

Working During a Pandemic

More San Bernardino County employees work as “essential workers” than the statewide average – 26% compared to 19% statewide. This circumstance likely contributes to the fact that only 16% of San Bernardino County employees surveyed between May and August of 2020 reported they had switched to working at home, compared to 24% statewide.


of San Bernardino County workers reported they continued to work as an essential worker

compared to 19% statewide


of San Bernardino County workers reported they switched to working at home

compared to 24% statewide

Source: May-August 2020 fielding of the California Health Interview Survey

Travel and Trade

Despite decreased passenger volume due to the pandemic, ONT recorded six straight months of traffic growth between April and October, regaining almost 50% of passenger volume compared to 2019, making its recovery first among airports in California and third nationally. Meanwhile, as people increasingly turned to online shopping, the tons of freight moving through ONT never experienced any lasting decline and, overall, rose 55% between January and December of 2020.


Monthly Passenger and Freight Volume at Ontario Airport, 2020

Note: Freight totals include U.S. mail

Source: Ontario International Airport (


K-12 Education Moves Online

As of March 2020, schools in San Bernardino County (and statewide) were required to move to online instruction. This move prompted an unprecedented effort on the part of San Bernardino County Superintendent of Schools (SBCSS) and individual public school districts throughout the county to provide the necessary technology and connectivity for students, and the necessary training and resources for teachers and staff. To support the districts, SBCSS provided:

  • over 8,300 devices, such as Chromebooks
  • 400 hotspots
  • 665 trainings to support remote learning and teaching
  • over 2,000 hours of training or consultation services for teachers and staff

While most schools remained online in 2020, in August 2020 the state provided schools and districts with the opportunity to apply for waivers that would allow them to return to in-person instruction under strict guidelines. A plan to adhere to the guidelines and a community case rate of 14 or fewer daily cases per 100,000 is required for approval. Toward the end of December 2020, no San Bernardino County district had a case rate that low. However, the waivers are typically issued for individual schools, so a school’s case rate may be lower than the district as a whole, enabling in-person instruction despite higher district-wide case rates.4

Child Care Crisis

The pandemic had a dramatic impact on childcare, including many temporary closures and some permanent closures, with family childcare home (FCCH) providers more likely to report a permanent closure than center-based providers. Since the start of the pandemic, approximately 65 FCCH facilities closed permanently and 63 were temporarily closed as of the week of December 31, 2020. This equates to at least 16% of the 788 known FCCH providers operating in the county prior to the start of the pandemic.5 This was the highest count of temporary closures of FCCH since tracking began in early April 2020.

In contrast, while the number of temporarily closed childcare centers remains significant (354 as of December 31, 2020), it is substantially lower than the high of 528 temporary childcare center closures the week of April 27, 2020. In addition to these temporary closures, there were approximately eight permanent childcare center closures. The combined temporary and permanent closures as of December 31,2020 equates to 62% of the 587 centers in the county, compared to 91% the week of April 27, 2020.

The childcare closures and the transition to home-based public K-12 education has had a profound impact on the ability for parents with children to work during the pandemic, particularly women. Nationwide, 32% of women ages 25-44 who became unemployed during the pandemic said that childcare was the reason for that unemployment.6


Weekly Count of Childcare Facilities that Temporarily or Permanently Closed in San Bernardino County After the Start of the Pandemic, 2020

*Baseline is before the pandemic started.

Note: These counts include approximately 65 permanent closures of Family Child Care Home settings and eight permanent closures of Child Care Centers. The operating status of some settings is unknown due to non-response of some providers to regular surveys asking about operational status.

Source: Child Care Resource Center


The onset of the coronavirus pandemic and the resulting stay-at-home orders in March 2020 led to a marked increase in San Bernardino County residents applying for and receiving CalFresh, CalWORKs, and Medi-Cal. Policies may have also contributed to the increase. For example, county staff continually review participant eligibility for services; however, discontinuing a participant’s benefits during the pandemic was temporarily suspended, potentially contributing to the increase, particularly for Medi-Cal. By July 2020, caseloads for CalFresh and CalWORKs began to decline — likely due to the extension of unemployment benefits, which kept many residents afloat during unstable times. However, as residents feared the expiration of the unemployment benefit extension in December, the County saw another sharp increase in applications for CalFresh, CalWORKs, and Medi-Cal at the very end of the year.


Monthly Count of Participants in CalFresh, CalWORKs, and Medi-Cal in San Bernardino County, 2020

Source: San Bernardino County Human Services, Transitional Assistance Department


According to May-August 2020 responses to the California Health Interview Survey, 1-in-10 San Bernardino County residents reported difficulties paying for their rent or mortgage as a result of the pandemic. This was the same level as residents statewide. As many as 46,680 households in San Bernardino County (or approximately 7% of all households) were behind on rent as of mid-December 2020; Latino, Black, and Asian households were nearly three times as likely as White households to be behind on rent.7


of San Bernardino County residents surveyed between May and August 2020 reported that they had difficulty paying their rent or mortgage as a result of the pandemic

compared to 10% statewide

Source: May-August 2020 fielding of the California Health Interview Survey


of San Bernardino County households were behind on rent as of mid-December 2020

compared to 8% statewide

Source: National Equity Atlas

Meanwhile, as some residents struggled to pay for housing, the median price of sales of existing single-family homes continued to grow through 2020, albeit somewhat slower than the statewide average. In San Bernardino County, prices increased 16% compared to 25% statewide. The median number of days an existing single-family home was on the market in San Bernardino County reached a high of 45 days in February 2020 but was down to just 10-12 days in the last quarter of 2020, signaling a hot local housing market. Statewide, the trend for days on market was similar to San Bernardino County’s, from a high of 31 days in January 2020 to a low of 9 days in November 2020.


Median Price of an Existing Detached Single-Family Home in San Bernardino County, 2020

Source: California Association of Realtors


Median Number of Days an Existing Detached Single-Family Home Remained on the Market in San Bernardino County, 2019 and 2020

Source: California Association of Realtors


Aside from the direct impacts of COVID-19 on community wellness, the pandemic has had a profound impact on how and when medical care is delivered and accessed. Early in the pandemic, elective procedures and preventative care visits were largely placed on hold as the medical system adapted to offering care during a pandemic. These adaptations included a pivot to telehealth and modified in-person protocols.

Telehealth – once a niche service delivery platform in medicine – expanded dramatically and many medical and behavioral health visits moved online. For example, starting early in the pandemic, Arrowhead Regional Medical Center (ARMC) launched their Telehealth initiative and as of early 2021 had rolled out 30 virtual clinics across all major specialties. Telehealth has helped fill the gap for medical and mental health care visits that were postponed or unable to take place in-person during the pandemic; it has also increased access to care in many rural areas. However, as health and wellness data become more widely available in 2021 and beyond, it is possible that the benefits of telehealth may be eclipsed by an overall reduction in access to healthcare when care is limited to telehealth, rather than as a supplemental option, as in the case with the pandemic.

In-person care also adapted during the pandemic, focusing on serving populations that lack the technology to access telehealth services, live in congregate settings, or require in-person care. For example, San Bernardino County Department of Behavioral Health social workers, clinicians, and alcohol and drug counselors took their services to COVID-19-positive individuals at the Glen Helen campground, providing referrals, case management, and connections to housing. The San Bernardino County Multi-Department Skilled Nursing Facility Outreach and Support Team (SO+S) has provided staff at highly vulnerable skilled nursing facilities with personal protective equipment and training on how to use it, COVID-19 prevention training, and other supports. It is possible that these efforts contributed to San Bernardino County’s lower death rates from COVID-19. As health data become increasingly available, the county will have a better sense of the short- and long-impacts of the pandemic on mortality, morbidity, and overall wellness.


of San Bernardino County residents reported an increase in snapping or yelling at family members or loved ones during the pandemic stay-at-home orders

compared to 17% statewide

Source: May-August 2020 fielding of the California Health Interview Survey

“I’m just writing to extend my deepest thanks to the people at the Merrill Crisis Stabilization site. I visited a few weeks ago when I was out of medication and unable to see my regular doctor. Everyone at the facility was accommodating, kind, and made me feel like they cared about making sure I got the services I needed. This is a trying time for everyone and we would do well to have more people like the folks at the Merrill facility helping those of us with mental health issues. Thanks again.”

The Merrill Center is one of two Crisis Stabilization Units (CSUs) operated by the County. CSUs are unlocked, voluntary, 23-hour psychiatric urgent care centers that offer a positive, safe, and home-like environment to individuals aged 13 and older experiencing a mental health crisis. CSUs provide crisis intervention, crisis stabilization, medical evaluation, and peer support.


As San Bernardino County went into lock down in March 2020 and schools moved to online instruction, reports of child abuse and neglect fell substantially. Reports by childcare or school personnel fell the most – down 88% between February and April. Reports by health care providers also fell (down 48%) as office visits were postponed or moved online. While family, friend, or neighbor reports, as well as reports by representatives of a government agency or child welfare agency were somewhat higher in 2020 than pre-pandemic averages, the overall impact of the pandemic was reduced reporting. While only a fraction of reports typically result in a substantiated case of abuse or neglect, the reduction in reports is still concerning; fewer in-person interactions with families and children may mean substantiated cases of abuse or neglect are going undetected.


Monthly Child Abuse and Neglect Reports by Type of Reporter in San Bernardino County, 2020

Source: California Association of Realtors


Vehicle miles traveled (VMT) is a measure of how many miles are driven by all motorists on San Bernardino County freeways. Since traffic congestion is largely a function of road capacity, VMT can impact congestion. Indeed, as VMT declined in spring 2020, commuters on San Bernardino County freeways experienced dramatically less congested weekday conditions in the months after the first stay-at-home order was enacted. For example, the hours commuters spent in extreme congestion (speeds below 35 miles per hour) fell 83% between January 2020 and April 2020. Since then, weekday congestion has returned, but through the end of 2020 it had remained less than pre-pandemic levels.


Monthly Child Abuse and Neglect Reports by Type of Reporter in San Bernardino County, 2020

Source: California Association of Realtors


The March 2020 stay-at-home order led to better than average air quality in the spring of 2020 in San Bernardino County. However, as temperatures rose in May, so did ozone levels, ending the pandemic-induced period of good air quality. Wildfires in the fall of 2020 contributed to higher-than-average levels of poor air quality.


Monthly Child Abuse and Neglect Reports by Type of Reporter in San Bernardino County, 2020

Source: California Association of Realtors


Counties are the workhorses of American government. They bear tremendous responsibility to implement federal, state, and home-grown programs at the local level. This work is often behind the scenes and, for many, invisible. Yet one of the many things the pandemic has done is shine a light on the county public servants who quickly changed gears or built new systems so that residents could still access financial supports, exercise their right to vote, understand public health risks, remain housed, and much more. All of this is done in close collaboration with the county’s 24 incorporated cities and towns, local regional agencies, employers and labor organizations, and community-based organizations.

Perhaps the most visible contribution of counties during the pandemic is on the front lines of distributing the COVID-19 vaccine. This is a massive mobilization, which has been complicated immeasurably by the lack of supply. Yet the challenges associated with vaccinating an entire population are emblematic of the many other challenges experienced during the pandemic; it hasn’t been easy, nor has it been perfect, but when all is said and done, the COVID-19 story in San Bernardino County will be one of perseverance and resilience.

1See page 21 for a description of the Equity Gap Score. 2National Bureau of Economic Research, Working Paper 26947, April 2020 (as cited by the U.S. Bureau of Labor Statistics Monthly Labor Review, September 2020) 3Pew Research Center survey, October 13-19, 2020 ( 4San Bernardino County Public Health ( 5Since approximately 20% of FCCH providers did not respond to surveys inquiring of their operational status, the percentage of FCCHs that closed is likely an underestimate. Non-response for centers was small enough to not impact the estimated percentage of centers that closed. 6New York Times, article February 6, 2021 ( 7National Equity Atlas and Housing NOW! analysis of data from the U.S. Census Week 21 (December 9-21, 2020) Household Pulse Survey (; rate calculated using 2019 American Community Survey 1-Year Estimates for households