Everyone in the Boise area is now recommended once again to wear a mask indoors, as a rising COVID-19 surge mounts in Idaho.

The Centers for Disease Control and Prevention determined that Ada, Elmore, Valley and Lewis counties are at high community risk, which means that the most stringent public health measures the CDC offers are now in place.

In the affected counties, all residents should wear a well-fitting mask in public indoor settings, regardless of vaccination status, according to the CDC. Residents should also consider avoiding nonessential indoor activities in public where they could be exposed, and also talk to a health care providers about whether other precautions are necessary.

Canyon County is at the medium risk level, when immunocompromised people should talk to a health care provider about whether to wear a mask, according to the CDC.

At all community risk levels, the CDC recommends staying up to date with COVID-19 vaccinations.

The CDC’s risk levels are measured by three metrics aimed at measuring hospital strain and community transmission: the number of new COVID-19 admissions per 100,000 people in the past seven days, the percent of staffed inpatient hospital beds occupied by COVID-19 patients, and the number of new COVID-19 cases per capita in the past seven days.

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In Ada County, Idaho’s Department of Health and Welfare says the state has 218.9 cases per 100,000, which is above the 200 threshold. Idaho’s most populous county also has 10.8 hospital admissions per 100,000 people, which is over the 10 threshold and tipped the county in the highest risk level.

The county’s percentage of staffed inpatient beds occupied by COVID-19 patients is 5.1, below the 10 threshold.

On Thursday, St. Luke’s Health System, the largest hospital system in the state, reported that its hospitals are not strained but that a surge is underway.

The hospital system has seen a doubling of COVID-19 in-patients over the past month.

Idaho’s test positivity rate has risen for nine straight weeks across Idaho, to a rate of 11.7% the week of June 5. Public health experts aim for a rate below 5%.

The testing rate, which does not include most at-home tests, likely does not represent the full picture of disease spread in the state.