In his first in-person outdoor news conference since the start of the COVID-19 pandemic, Gov. Jay Inslee and health officials warned Washington residents of a “fourth wave,” with virus and hospitalization numbers on the rise again.

The state has faced this situation three times before, he said. Waves hit Washington and the country in March, June and November of 2020.

Each time, the state has fought back against the virus “instead of being passive, instead of being fearful,” Inslee said.

Along with wearing a mask and getting a vaccine, Inslee and health officials urged people to take social gatherings and events outside to keep virus cases down. With the weather warming, gathering outside is the next weapon in the fight against COVID-19, he said.

With vaccinations now open to everyone 16 and up, the state is in the final push, Inslee said. Locally, COVID activity continues to be on an upward trajectory. The ase rate in Spokane County is 227 cases per 100,000 residents, higher than the cutoff for counties to stay in Phase 3 of the state’s reopening plan.

“This is something we can do, we should do and we really have to do to break the cycle of the increasing COVID infection in our state,” he said.

The recent increase in cases includes 217 confirmed “breakthrough” cases, occurring in people who have been fully vaccinated and test positive for the virus two weeks or longer after their last dose.

These cases are very rare so far, with 217 out of more than 1.7 million people fully vaccinated in the state, or about 0.01% of people who have been fully vaccinated. The majority of breakthrough cases are asymptomatic or experience no symptoms at all, although about 12% of these people have been hospitalized.

The Department of Health is investigating five suspected deaths in breakthrough cases in people who had multiple underlying health conditions and were older than 67.

Breakthrough cases are expected, as the vaccines are not 100% effective, and variants could have an effect. The Department of Health has sent some samples for sequencing and found that some breakthrough cases are variant strains.

Health officials encourage all residents, vaccinated or not, to continue to follow public health guidance like masking in public spaces, limiting gatherings or keeping gatherings outdoors as a way to curb transmission.

Vaccination is also a key part of driving down case counts. With all residents 16 and older now eligible for the vaccine, doses are available at the Spokane Arena mass vaccination site, local providers and pharmacies. Find an appointment on the state’s Vaccine Locator website or by calling (800) 525-0127, then press #.

The Pfizer-BioNTech vaccine is the only vaccine approved for 16- and 17-year-olds, and teenagers that age might need guardian approval before seeking vaccination.

Here’s a look at local numbers:The Spokane Regional Health District confirmed 131 new cases on Thursday and no additional deaths.

Death data continues to shift as the data is reconciled with the Department of Health and will fluctuate until Tuesday.

There are 46 people hospitalized with COVID-19 in Spokane.

The Panhandle Health District confirmed 31 new cases and three additional deaths on Thursday.

There have been 293 deaths due to COVID-19 in Panhandle residents.

There are 37 Panhandle residents hospitalized with the virus.