As the D.C. region barrels towards another pandemic autumn, cases and hospitalizations are continuing to rise.

Just last week, key metrics like the rolling average of new cases per day, the positivity rate, and hospitalizations looked similar to the numbers reported locally in April, before vaccines became widely available. Now, the region’s case numbers and hospitalizations are hitting levels not recorded since earlier this spring, when vaccination rollouts were still hobbled by low supply and overwhelming demand. While hospital capacity remains stable and the rise in infections has not yet led to a similar spike in deaths from the virus, the consistently climbing metrics and plateauing vaccination rates underscore the severe infectiousness of the delta variant.

On Thursday, D.C. reported 210 new COVID-19 cases in one day, marking the first time the city has recorded more than 200 infections since February. (One day in early March, the District reported more than 300 daily cases due a backlog.) Since Aug. 11, the Centers for Disease Control and Prevention has classified D.C.’s level of spread as “high,” the most severe category. As of this week, the city’s average rate of new cases per 100,000 residents has hit levels not seen since March, per D.C.’s coronavirus data.

Hospitalizations due to COVID-19 in the city dipped significantly in the early summer months, but began to climb this August. As of Wednesday, 116 people in the city were hospitalized with the virus, and 26 of those people are being treated in intensive care units. One month ago, a total of 21 residents were hospitalized due to COVID-19. The number of patients hospitalized with the virus last topped 100 in late April into early May, and began steadily declining throughout the summer.

And on Thursday, the city reported that three residents — a 63-year-old male, an 82-year-old female, and a 53-year-old male, died of coronavirus. It’s the first time in several months that the District has reported as many deaths in one day related to COVID-19.

While the virus is not surging in the region as drastically as it is in other parts of the U.S. with lower vaccination rates, like Florida or Mississippi, the consistently increasing local metrics have many parents and educators concerned as students head back to in-person classrooms. D.C. Public Schools is set to return to in-person learning next Monday, and several school systems in the Maryland and Virginia suburbs have already kicked off the school year. 

On Thursday, the Maryland State School Board passed an emergency regulation requiring mask-wearing in all school buildings, amid a sharp increase in cases across the state. (Montgomery and Prince George’s counties public school system already instated such a requirement.) Maryland’s average positivity rate, which had dipped below 1% for most of June, is now almost at 5%. On Thursday and Friday, the daily case count topped 1,000 new infections — a 77% jump from this time last month. And as of Friday, more than 700 people in Maryland are hospitalized with the virus, a large increase from the levels reported in June and July.

Locally, Prince George’s County’s average rate of new daily cases per 100,000 residents is climbing toward 20, after dropping as low as one in late June. Eighty-six people are currently hospitalized in the county due to COVID-19, a nearly 25% increase from last week, but the county’s hospital capacity still remains manageable, according to its COVID-19 data webpage. 

Montgomery County, meanwhile, is one of the only local jurisdictions not currently reaching “high” spread of the virus, according to the CDC, and remains in “substantial” spread. Infections there are rising, but remain below the statewide pace. The county is also reporting high marks for its vaccination campaign — 99% of seniors have received at least one dose of a vaccine, and 72.9% of the total population is fully vaccinated.

“We have seen an increase in the number of cases, the case rate, and test positivity,” the county’s outgoing health officer, Dr. Travis Gayles, said in a media briefing this week. “But what’s encouraging, and quite frankly what has given me a little more ease and comfort, is that we’re not seeing a huge uptick in our hospitalizations as well as [the] fatality rate that accompanied similar increases in cases earlier in the pandemic.”

Meanwhile, Virginia reported grim COVID-19 news this week. On Thursday, the commonwealth’s health department announced the first death of a child with COVID-19 in the Northern Virginia area. Also on Thursday, 1,400 people were hospitalized with the virus statewide — the third-highest total of daily hospitalizations since the pandemic began. Deaths from the virus have also slightly increased in the past several days.

In Northern Virginia, the average number of daily new cases surpassed 400 today, a nearly three-fold increase from the average reported this time last month.

Public health and government leaders across the region are scrambling to boost vaccination numbers, in some cases turning to vaccine mandates for government workers to blunt delta’s spread.

D.C. currently has an indoor mask mandate, as do Prince George’s and Montgomery counties. Northern Virginia jurisdictions have “recommended” indoor mask wearing for all individuals, but Gov. Ralph Northam has not moved to reinstate a commonwealth-wide mandate. Across the region, some local business have also rolled out their own protection measures, like requiring proof of vaccination for entry. About 61% of Maryland’s total population is fully vaccinated. In D.C., an estimated 56.5% of the population is fully vaccinated, and in Virginia, also roughly 56%.

While fully vaccinated individuals can contract the virus, the overwhelming majority of individuals hospitalized and dying from the virus in the region are unvaccinated. Still, public health officials have encouraged even those vaccinated residents to get tested if they’ve been exposed to the virus. (Montgomery County Executive Marc Elrich led by example this week, receiving a COVID-19 test — with a negative result — after attending a large conference potentially linked to an outbreak of COVID-19.) In D.C., residents can pick-up self-administered COVID-19 tests at 16 different public libraries, or these recreation centers throughout the city. 

This story has been updated to reflect that the average number of new COVID-19 cases in Northern Virginia has increased three-fold over the last month.