It’s time to mask up again, Washington.

With COVID-19 cases and hospitalizations surging statewide, state Secretary of Health Dr. Umair Shah reinstated his indoor mask mandate in all public settings, including restaurants, grocery stores, gyms, retail locations and any public-facing office.

Beginning Monday, everyone – regardless of vaccination status – will be required to wear a mask in most indoor settings.

Gov. Jay Inslee said Wednesday he originally lifted the mask mandate because vaccination rates were increasing earlier this summer, but case rates are now at a point where they “pose a danger for the whole state of Washington.”

The source of the current surge of cases and hospitalizations is the delta variant, which in a way, officials said, is a new virus. The delta variant now makes up the vast majority of sequenced cases in the state, at 95% of samples tested at the end of July.

The delta variant is twice as transmissible as previous strains of coronavirus and has the ability to make people of all ages, not just elderly people, critically ill if they have not been vaccinated.

“We should all be concerned with what’s happening in our state,” Shah told reporters Wednesday.

Exceptions to the mask mandate include office spaces not easily accessible by the public where everyone is vaccinated, in vehicles with no public face-to-face interaction, and small, private indoor gatherings where everyone is vaccinated. It also does not include athletes who are actively engaging in sports, Inslee said.

The Department of Health is also strongly recommending individuals wear masks in crowded outdoor settings, such as concerts, fairs and farmers markets, Shah said.

“We know that masks work,” Shah said. “As a tool it has a more immediate impact and that’s what we need to see to turn the tide across our state; we hope this is an interim step and one that we see lifted once things are turned around.”

The governor said he is not ruling out further efforts to stop the rapid escalation of cases and hospitalizations, but he hopes masks and increased vaccination coverage among those who are eligible will be enough to keep both businesses and schools open and functioning.

Mask mandates and vaccination requirements, which Inslee expanded to include educators, state employees and health care employees, are two tools that can keep businesses and schools open, he said.

The expansion follows record-breaking COVID-19 hospitalization rates, according to Inslee’s office. Each of the state’s 35 local health officers, including Spokane County Interim Health Officer Dr. Francisco Velázquez, unanimously wanted and asked for the statewide mask mandate again, Shah said.

There are still 2 million eligible Washington residents who have not received a single dose of a COVID-19 vaccine, and the delta variant is hitting these people hard.

Of people hospitalized in Spokane hospitals in recent weeks, Velázquez said anywhere between 90% to 97% of them were not vaccinated against COVID-19.

With the skyrocketing increase of COVID-19 cases in Spokane County, the surge does not appear likely to slow down soon.

“If we do increase some additional precautions, such as masking, you can somewhat impact that curve, but given the rates we have and the experience we have with their virus going from where we are to a number that’s a lot lower will take some time,” Velázquez said. “The question is how much time will it take.”

Spokane County’s case rate has skyrocketed this month. Hospitalizations for COVID-19 are at an all-time high locally, above the previous highs reached last December.

There are 578 cases per 100,000 residents newly diagnosed in the past two weeks. The county’s test positivity rate is above 20%.

Among the four Spokane County hospitals and Kootenai Health, there are 250 patients hospitalized with COVID-19.

A look at local numbers:

The Spokane Regional Health District reported 347 new COVID-19 cases and two additional deaths on Wednesday.

There have been 707 deaths due to COVID-19 in Spokane County residents.

There are 165 patients hospitalized in Spokane .

The Panhandle Health District confirmed 111 new COVID-19 cases and six additional deaths on Wednesday.

There have been 350 deaths due to the virus in Panhandle residents.

There are 92 Panhandle residents hospitalized with the virus.