Spokane County has seen a spike in confirmed coronavirus cases in the past two weeks, and state health officials are worried the rest of Washington could be next.

“We are at extreme risk of cases escalating,” Secretary of Health John Wiesman told reporters Wednesday.

While daily case rates have decreased since summer, there are still between 300 and 400 cases confirmed daily in Washington state, a rate seen during the first wave of the virus in April.

State Health Officer Kathy Lofy said hospitalizations have also plateaued and possibly begun to increase statewide as well. Locally, that also appears to be the case. Last Friday, 31 Spokane County residents were hospitalized with the virus. On Wednesday, 39 county residents are receiving treatment for the virus locally.

Lofy said outbreaks statewide are in myriad settings, from restaurants to places of worship. King County Public Health reported at least 25 confirmed cases connected to the Salish Lodge and Spa on Wednesday.

Meanwhile, the Spokane Veterans Home confirmed that another staff member tested positive for the virus, a case confirmed through weekly testing implemented at the facility. The staff member was asymptomatic, and that makes three workers total who have tested positive for the virus in a week there. No residents have tested positive in recent weeks, and the facility continues to test veterans and residents this week.

In Spokane County, the Spokane Regional Health District confirmed 79 new virus cases and confirmed an additional death on Wednesday.

There are now 7,125 COVID-19 cases in Spokane County with an estimated 75% of those cases recovered.

Cases are found in various settings throughout Spokane County as well, from long-term care facilities to schools to workplaces.

Local school districts are set to send kindergartners back to in-person classes next week. Lofy said, according to research conducted during the pandemic, younger children appear to be less likely to get infected than students who are even a little older, between 10 and 14, based on what data health officials have now.

“If there are schools starting throughout the state, particularly in areas with higher rates in the community and areas with increasing rates, we’ll want to watch closely to see if there’s any spread,” she said.

Spokane County Health Officer Dr. Bob Lutz said cases found in local school districts are in students coming into school with it, not contracting it in their classrooms. Staff, however, pose a greater risk for transmission within the school setting, he noted, due to settings like break rooms.

State health officials continue to prepare for the statewide distribution of a vaccine when it becomes available.

Washington state received a little less than $5 million in federal funds to prepare for the vaccine response, Wiesman said. The health department is hiring some additional staff with those funds, as well as contracting with vendors to roll out the program when vaccines become available. Next month, the department will begin enrolling health care providers in the COVID-19 vaccination program. The federal government is planning to distribute vaccinations directly to providers, not to the state first.

This presents lots of logistical planning on the department’s part, which Wiesman acknowledged on Wednesday. The state plan is due to the Centers for Disease Control and Prevention in mid-October. On Friday, the National Academies of Sciences intends to publish its framework for equitable allocation of the COVID-19 vaccine, which will help states determine which health care partners to send the most vaccinations, and for which kinds of workers or residents.

In the meantime, health officials are asking state residents to double-down on their efforts to keep the virus at bay, especially as cold and flu season are approaching, and cold weather will drive people indoors.

“If you look at the trajectory of the outbreak we’ve had here in Washington compared to other states, we’ve done really well,” Lofy said. “And that’s because everyone in Washington has done such an amazing job.”

That being said, health officials are just as nervous about what could be ahead.

“I wish I could predict what’s going to happen,” Lofy said. “I’m concerned that this is the beginning of an uptick or wave. Other states are starting to experience upticks, which makes me nervous.”