Kootenai County is at a crucial point in the fight against COVID-19.

Its major hospital, Kootenai Health, is full following a surge in patients. Schools have dozens of infected students and staff, and hundreds more are quarantining at home. And the Panhandle Health District reported Wednesday that 720 people in its five-county region have tested positive for COVID-19 in the past eight days.

The numbers have made Kootenai County a coronavirus hot spot, with 48 new cases reported Wednesday and 124 on Tuesday.

And yet Thursday, the Panhandle Board of Health is poised to consider whether to roll back masking rules that were put in place this summer to protect people and slow infection rates. Despite the soaring cases, many people have chosen to ignore the pleadings of health officials and experts to wear mask.

Kootenai Health’s dire news Wednesday, that it is at 99% capacity and has to delay elective surgeries, included a plea for community help while acknowledging “pandemic fatigue” following eight months of all things coronavirus.

“On behalf of your community hospital, health district, emergency services, and surrounding critical access hospitals, please stay vigilant,” the public hospital district wrote in a news release.

The hospital is treating 31 patients with COVID-19, with 11 of those patients requiring critical care.

The capacity claim is based on open beds and staff availability. Both are in short supply in Coeur d’Alene, and hospital officials are reaching out to Spokane, Portland and Seattle hospitals to seek spots for patients if necessary.

“We’re reaching a critical point here,” said Kootenai Health spokeswoman Andrea Nagle.

Kootenai County has the most cases in the five-county region of North Idaho, with 3,628 confirmed to date. The state considers Kootenai County a hot spot, and it recorded its highest seven-day average incidence rate this week at 38 cases per 100,000 residents.

The test positivity rate in the county is 8.7%, nearing the previous high of 9% recorded earlier this summer. At Kootenai Health, test positivity rates are the highest they have been since the pandemic began.

Panhandle Health District officials said most new cases are tied to outbreaks in health care facilities, churches, and long-term care facilities. Cases in school districts have also contributed to recent counts, leading to hundreds of students going into quarantine.

There are 162 cases tied to places of worship in the county. And there are five current outbreaks in long-term care facilities in the five-county region that account for 135 cases and 20 deaths. Coeur d’Alene Public Schools is reporting 20 active positive cases, while the Post Falls School District has 14.

There is a mask mandate in Kootenai County for residents who are in public spaces, including grocery and retail stores, but compliance seems to depend on the person and the establishment.

The Panhandle Health District Board of Health meets Thursday and the Kootenai County mask mandate is on the agenda.

The county is considered to be at the “moderate risk” level by the Panhandle Health District; however, with an incidence rate higher than 30 cases per 100,000 residents, Kootenai County could be considered to be a “substantial risk,” by the health district’s COVID-19 regional criteria.

The Inland Northwest has a higher incidence rate than Western Washington, state health officials said on Wednesday.

The Spokane Regional Health District confirmed 102 new cases on Wednesday, and two more residents have died from the virus.

Both Providence and MultiCare hospital systems in Spokane have capacity to take patients, but they are becoming crowded, too.

“Providence continuously works with our statewide partners to balance patient numbers across area hospitals,” a statement from the hospital system says. “At this time, local Providence hospitals have capacity to treat patients for regular and emergency needs. Although our patient census is high, we remain open and available for care.”

There are 45 COVID-19 patients being treated in Spokane hospitals, and 37 of them are Spokane County residents.

In Spokane County, Health Officer Dr. Bob Lutz said the county’s virus transmission is not slowing down. He said he has not installed new local restrictions because there are cases in so many sectors and environments.

“It’s really difficult right now because it’s all over the place,” Lutz said. “It’s people’s behaviors and what’s happening outside the workspace.”