The Virginia Department of Health is reviewing whether residents in areas experiencing substantial and high transmission rates of the novel coronavirus  should consider wearing masks indoors — even if they are fully vaccinated.

Though a precaution, the recommendation from the Centers for Disease Control comes as multiple counties and metropolitan areas around Virginia are seeing increased transmission rates, according to the CDC COVID data tracker.

Transmission rates reflect percent positivity over a seven-day period, the site says.

Around the Lord Fairfax Health District, transmission rates range from moderate to high.

As of Friday evening, rates were showing as moderate in Winchester, substantial in Shenandoah, Frederick, Clarke and Page counties, and high in Warren County.

The transmission rates are indicative of the virus continuing to spread around the area, said Dr. Colin Greene, health district director.

“I think it’s safe to say right now most of them are the delta variant,” he said.

The CDC’s rates of increase are based on population, Greene said, so it doesn’t take much of an increase in small areas like Clarke or Warren to show a significant rise in new COVID cases per capita.

On Friday, the health district reported 21 new cases and a seven-day average of 24 new daily cases.

Among those, Warren reported seven new cases and a seven-day average of three new daily cases.

Winchester, with a moderate rate of increase as of Friday, reported no new cases and a seven-day average of two.

Frederick reported 11 new cases and a seven-day average of 10 new daily cases, Clarke reported one new case and a seven-day average of two, Page reported one new case and an average of three, and Shenandoah reported one new case and an average of four.

So, how should the public translate those reports?

“We don’t absolutely know,” said Greene.

Though he said that an increase in new cases is concerning, he also stressed that the data from the CDC is a one-size-fits-all way of measuring a very diverse country that doesn’t easily reflect what’s happening in the Northern Shenandoah Valley.

Nevertheless, that doesn’t diminish the risk of the delta variant around the area, particularly to unvaccinated people.

“Our upward trend, it’s there,” Greene said. “County by county I’m not sure how useful that information is."

To see if the data is trending up or down, he continued, “You need to look [at it] over time.”

It’s also important to consider the area’s vaccination rate, hospitalization rate and death rate.

“And along with what time of year it is. All of that has to be put together to make a decision,” he said.

“The biggest thing to keep in mind for me is the difference between 2020 and 2021.”

Though he said that the summer of 2020 showed a similar increase in cases starting in late July, the vaccine wasn’t available yet to help quell sharp spikes in cases, hospitalizations and deaths.

Now that at least half the local population is vaccinated, the health district is much better off, he said.

“The risk of people dying in huge numbers is just not there anymore,” he said. “We’re looking at a whole lot of people who might get a really bad cold from this.”

Greene recognized that unvaccinated people might have a range of reasons why they don’t want the vaccine, including mistrust in the government or the vaccine itself since it’s new and was developed so quickly.

“I’m just a government talking head to most people and they’re not convinced yet,” Greene said.

Furthermore, he said the knowledge that people can still get COVID even after receiving the vaccine turns off some people to its legitimacy or effectiveness.

“No, it’s not a perfect vaccine,” he said.

But that doesn’t mean it isn’t a very good vaccine.

Other vaccines have managed to prevent transmission enough that they eradicate disease, he said, referencing the polio vaccine.

“The biggest success was smallpox,” he said. “That’s the gold standard for a perfect vaccine.”

The CDC estimates that three in 10 people who contracted smallpox died from it.

“And now it’s gone, completely eradicated,” Greene said.

With the COVID vaccine still so new, it’s not yet known how effective it will be long-term, but Greene said it’s already more effective than the flu vaccine, which requires a new vaccine each year.

“Stopping half the flu cases is better than stopping none of them,” Greene said.

For now, he said, there’s no official recommendation that people fully vaccinated against COVID will need a booster shot this fall.

Contact Josette Keelor at