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If you live in the Seattle area, you might want to hang onto your COVID mask — King County could be seeing another mask mandate in the near future.

King County Public Health Officer Dr. Jeff Duchin said during a briefing Thursday that the numbers are alarming — especially considering the rapid spread of the more contagious BA.4 and BA.5 omicron subvariants, and their ability to evade immunity from vaccines and prior infection.

“We’re experiencing a sustained high level of COVID-19 transmission that has been increasing since April,” Duchin said. “We’re currently seeing more cases per day than we did during the peak of the delta surge. And we know that these numbers are a major undercount, as many people are using rapid at-home tests.”

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Duchin said hospitalizations . While vaccines — which still protect against serious symptoms, even if they are not always able to protect against infection from a variant — and less-severe variants mean lower hospitalizations and deaths than the delta and omicron waves, Duchin is worried about any increase in hospitalizations.

“Our regional health care system is under extreme stress right now, especially our hospitals,” he said.

Hospitals are filling up for a variety of reasons. There are the people who chose to or had to delay care during the pandemic now being treated, the usual summer injuries from sports and other outdoor activities, and the patients who are ready for discharge but who cannot get a spot in a nursing home, and thus are taking up beds. A lack of hospital staffing is also contributing to capacity problems.

Amidst this backdrop, the county is considering stronger measures than simply asking people to take precautions.

“We are in active discussions about if and when to re-issuing any mask mandate,” Duchin said. “It’s not an easy question because things change over time. For example, if we were seeing a level of severity of illness that we saw before people were as well-vaccinated as they are now, or during the delta surge, I think we would be moving more quickly to such measures as a mask mandate.”

Ultimately, Duchin said, we will not be able to mandate our way out of the pandemic; people will have to voluntarily take precautions to protect themselves and others.

“COVID-19 is not one-and-done. This is going to be a real long-term challenge for us … We’re not going to be able to have infinite series of mandates forcing people to do this, that, and the other,” he said. “They have the role, where things get very serious and we need short-term, immediate improvement. But over the long-term, we really do need people to understand that we need our business community, our leadership in the community, and our community members to take the steps that they need to take to protect themselves.”

To that end, he asked people and businesses to take actions such as encouraging indoor masking again, setting up COVID-safe spaces, and ensuring buildings are well-ventilated.

Vaccination is also key. While gotten their initial vaccines series, not everyone has been as diligent about going back for that first or second booster dose. Less than half of people under 35 have received a booster, Duchin said.

Boosters coming this fall will target BA.4 and BA.5, but Duchin said you should not wait until then to get your booster. It is perfectly fine to get a booster now, and another in the fall. While the current boosters were not specifically made for the newest variants, they will still provide additional immunity against infection, and even better immunity against severe symptoms.

People who are older than 50, or who are older than 12 and immuno-compromised, may right now qualify for a second booster — and talks are going on at the national level about expanding second-dose eligibility to other age groups.

“The COVID-19 pandemic, with the rapid evolution of new variants, is challenging us in ways we did not anticipate, and it requires long-term, sustained prevention strategies,” Duchin said. “We can minimize the impact to individuals and communities without going back to 2020-type restrictions.”