MIDDLESEX COUNTY, ONT. -- For the second day in a row, the Middlesex-London Health Unit is reporting four new COVID-19 cases and one new death.

The numbers reported on Tuesday for the previous 24 hours were identical.

The new cases bring the total in the region to 509, including 367 recovered and 52 deaths.

The most recent death was a woman in her 80s linked to a long-term care home.

Of the 52 deaths in the region, 32 are associated with seniors’ facilities, as are 167 of the cases.

Outbreaks at eight of those homes are ongoing, but there have been no new outbreaks reported since the weekend.

Of the total number of cases, 472 are in the City of London, which means all the new cases reported Wednesday are inside city limits.

Lambton Public Health is reporting the number of cases in that region rose to 254 as of Tuesday night, an increase of three in the previous 24 hours.

Of those, 185 have recovered and there have been 21 deaths, though no new deaths were reported.

Four outbreaks continue in the region.

At the hard-hit Vision Nursing Home, on new case was reported among residents, bringing the total confirmed cases to 23 residents and 20 staff members. There have been six deaths.

No new cases or deaths in surrounding regions

No new cases or deaths were reported as of Wednesday in Elgin and Oxford counties.

The total there stands at 73 cases, with 60 recovered and four deaths.

There is one active outbreak in Ingersoll, Ont., with all cases among health-care workers.

As of late Tuesday, there were also no new cases reported in Huron and Perth counties.

The running total is holding at 51 cases, with 44 recovered and five deaths.

There is one active outbreak at Maitland Manor in Goderich where a single resident has a confirmed case.

In Grey and Bruce counties there were also no new cases reported as of Tuesday.

The region has seen a total of 91 cases, with 84 of those recovered and no deaths.

Across Ontario, for a second day in a row, there were fewer than 300 new cases reported.