Welcome to the first wave, Spokane.

Gov. Jay Inslee visited Spokane on Thursday amid soaring COVID-19 infection rates that are higher than they’ve ever been and increasing hospitalizations. What he found was equal parts disheartening and hopeful.

“Spokane is right on the verge of a very dire situation because of this pandemic,” Inslee said. “It is right on the verge of a runaway pandemic.”

The number of COVID-19 patients in the region’s hospitals have doubled in the past week. It’s even worse at the region’s largest medical center, where Dr. Dan Getz, chief medical officer at Providence Sacred Heart Medical Center, said that hospitalizations there have almost tripled.

Spokane County had 41 new cases of COVID-19 on Thursday, bringing the countywide total to 1,122. The county has reported more than 100 new cases in the past three days alone, including 24 people who tested positive with a direct link to Borracho Tacos & Tequileria in downtown Spokane.

Inslee encouraged Spokane County residents to adhere to the new masking order, which goes into effect on Friday and requires Washington residents to wear masks in any public place, building or outdoor area when 6 feet of physical space cannot be maintained between people.

The state Secretary of Health issued a stronger order for Yakima County, which requires businesses to not serve anyone who is not wearing a mask. That could be next for Spokane County if virus transmission does not slow down.

“If people don’t abide by this order, we could go to the next step, which would require businesses to essentially not do business with people who don’t follow the order,” Inslee said.

On Thursday, Inslee met with front-line workers in hospitals and grocery stores.

Luc Jasmin III, who leads the Washington Childcare Centers Association, said families he works with are under a lot of stress from the pandemic.

“They don’t know what they will do to pay rent,” he said of those workers who have lost their jobs.

Jerome Stark, who works at Fred Meyer, described a scene from the store’s produce section recently. About 30 people were in the produce section and while all four workers were wearing masks, just one customer wore a face covering.

“That really bothers me,” Stark said, thanking the governor for the order requiring mask-wearing in public.

Inslee echoed Stark’s comments later in the day speaking to reporters, saying it’s not fair to essential workers who have to be there when people come in without masks.

“For me, it’s fair to protect people serving you,” Inslee said, noting that wearing a mask protects the wearer from spreading respiratory droplets to others.

Getz, similarly, asked the community to wear masks, noting that the younger demographic of people in the area getting the virus might not get that sick themselves, but do have the ability to potentially pass it on to someone who is vulnerable and could get very ill from the virus.

“This first wave we’re seeing is people between 20 and 40 years old,” he said. “Those are probably most of the people not wearing masks right now.”

Inslee also met with local hospital officials, health district leaders and elected officials in Spokane to discuss the pandemic.

Hospitalizations have increased at all Spokane area hospitals, with 17 county residents receiving treatment , in addition to at least 14 others, from outside the county, as of Wednesday.

Hospitals in Yakima and the Tri-Cities are near capacity, and Vice Admiral Dr. Raquel Bono, who is leading the state’s health system response to COVID-19, said the plan is to ensure that no single hospital becomes overwhelmed.

“What we wanted to do was avoid any one hospital from going into crisis mode, so part of that agreement among all the hospitals is that they will help each other out, and that continues to help each of the counties,” Bono said.

Hospital capacity, along with the virus’ rate of reproduction, are two factors state officials are watching closely.

“That’s why we were disturbed to find out that hospitalizations have doubled here in Spokane County and are predicted to double again in the next two weeks,” Inslee said.

The current projected “R naught” in Eastern Washington is 1.5. The modeling term means that more than one person is likely infected for each confirmed case of COVID-19.

Spokane County is surrounded by counties that are in Phase 3 of the governor’s reopening plan. Inslee said on Thursday that he had “increasing concerns” about allowing those counties move to Phase 4.

Inslee said he is hopeful that Spokane can retreat from the growing numbers if more people wear face coverings. He pointed to Yakima County as an example of a community that doubled its mask usage in the past few weeks.

The most recent worksite outbreak at Borracho is connected to one employee and 23 patrons who were mostly ages 19 to 29, a release from the health district says. Young people in their 20s and 30s make up 40% of the county’s cases. The outbreak at Borracho is tied to the past two weekends.

Spokane County Health Officer Dr. Bob Lutz said the cases represent what happens when individuals do not physically distance or keep groups sizes below five people, as is required in Phase 2.

“We understand that many of us crave meeting up with our friends at our favorite hang-outs,” Lutz said in a news release. “We can have those social connections, but it’s vital we socialize while also maintaining the required health measures put in place to slow the spread of COVID-19 in our community.”