PORTLAND, Ore. (AP) — COVID-19 case numbers in Oregon are on a steady rise as a new variant spreads and residents toss their masks, but hospitalization rates are still averaging fewer than 100 patients per day statewide — a far cry from previous peak virus surges of up to 1,100 patients, state health officials said Wednesday.

The seven-day average of daily cases as of Tuesday has more than doubled since early April and is now at 600 new cases per day, which is likely a “significant undercount” because of home tests that are not reported, said Tom Jeanne, Oregon’s deputy state health officer.

Studies done elsewhere indicate that the actual number of positive cases nationally could be between five to 10 times higher than those reported to health authorities, but officials remain focused on the hospitalization rate as a gauge of the surge’s severity, he said. There were 740 new cases Monday, the latest data available, and five deaths; officials expect hospitalizations will see a slight increase into May and June.

“We’re missing the majority of cases,” Jeanne said. “We can still follow the general trends even if the magnitude is not exactly right and what we worry about the most is the hospital capacity and our ability to treat people and keep them alive if they get COVID-19.”

Forecasts done by Oregon Health and Science University project hospitalizations to peak at 220 per day on June 10.

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Health officials said 83% of Oregonians have had at least one COVID-19 vaccine and more than 75% have completed the two-shot series. About 44% have gotten a booster dose.

Those who have not gotten vaccinated or who have not completed the vaccine series or gotten a booster should do so because the virus is still circulating widely, said Dr. Paul Cieslak, senior health advisor for the Oregon Health Authority. He estimated that between 50% and 60% of so-called breakthrough cases are occurring in people who have not been vaccinated or fully vaccinated.

“I think you take it as a given that there’s a lot of COVID-19 out there … If you’re in a crowded setting, you’re going to be exposed to the virus and what’s going to protect you is if you’ve been vaccinated and boosted or had prior infection,” he said. “There’s still a lot of it out there — and it’s not going away.”

People who are at high risk for severe illness, such as those with autoimmune conditions, diabetes or older adults, should check with their doctor now about how to access anti-viral treatments should they become infected, he added.

Oregon is receiving about 1,200 courses of the medication Paxlovid per week, and clinical studies show the medication is 89% effective in preventing hospitalization from COVID-19 if started shortly after symptoms appear, he said.