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Officials said Monday that people will soon have to wear masks again in western New York’s most populous county because of increased COVID-19 positivity and hospitalizations in the region.

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Starting Tuesday, people 2 and older must wear masks in all indoor public places in Erie County, including bars and restaurants, grocery stores, gyms and fitness centers, hotels and banks and hair salons.

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County Executive Mark Poloncarz said if the mask mandate doesn’t work by mid-December, the county will need a vaccine mandate for indoor dining.

Erie County, home to the city of Buffalo, reported 456 new cases per 100,000 residents in the past seven days, more than quadruple the federal government’s limit for high transmission, according to Poloncarz.

“This is one of the biggest seven-day periods ever,” Poloncarz said in a virtual briefing on Monday.

Poloncarz said cases are rising among K-12 students and staff and that 30-39-year-olds represent the most cases. He said there has been a 50% increase in COVID-19 hospital admissions in the last two weeks.

Hospitals in Erie County reported 249 patients as of Sunday, up from 168 on Nov.

About 63% of residents in Erie County are fully vaccinated.

But rates are lower in the southern and eastern parts of the county: including 38.4% in the 14034 zip code, which includes Collins in southern Erie County.

The vast majority of the state’s 62 counties are seeing a sharp increase in new COVID-19 positives, from Long Island to Niagara County in western New York.

And much of the state, from Saratoga to Erie County, is also seeing a sharp increase in hospitalizations.

The county has reinstated its mask mandate after Gov. Kathy Hochul warned last week that a Continued growth in COVID-19 The rates could mean that New Yorkers will again face more virus protocols in high-risk communities.

But the governor hasn’t laid down any specific protocols she can re-establish, including where or when they will take effect.

Health care workers in New York had until Monday to receive their first vaccine doses under a statewide mandate that has escaped court challenges.

About 95% of health care workers had a complete vaccine series as of November 17, according to state data.