All but two Maryland counties have ‘substantial’ or ‘high’ COVID transmission, data shows

Less than two weeks ago, just one locality in Maryland was colored orange on the U.S. Centers for Disease Control and Prevention’s map — signifying “substantial” coronavirus spread. None were red, which would mean the level of transmission is high.

As of Tuesday, all but two counties were in the substantial or high transmission zone.


The state each day inches closer to having 60% of its eligible population fully vaccinated against the coronavirus, an approaching immunization milestone that comes as coronavirus infections and hospitalizations have risen over the last month, according to Maryland Department of Health data.

“This is a reason for some concern,” said Dr. Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security. “It’s not yet at a crisis level, but it’s a very substantial increase over just a few weeks ago.”

Just Carroll and Queen Anne’s counties had as of Sunday what the CDC describes as “moderate” community spread.

Neither is among the jurisdictions in the state which have instituted indoor mask mandates, though about 59% of residents in Carroll County and 53.5% of people in Queen Anne’s have been fully vaccinated — the fifth and 11th largest proportions in the state, respectively.

“We’re likely to see Carroll and Queen Anne’s tip over into substantial transmission over the next couple days,” said Neil Sehgal, an assistant professor of health policy and management at the University of Maryland’s School of Public Health.

The rest of the Baltimore Metro Region already has substantial community transmission, and the CDC says Allegany, Cecil, Charles, Dorchester, Prince George’s, Wicomico and Worcester counties have reached high community transmission.

The federal agency calculates community transmission by evaluating measures including the new cases per capita over the past week and the seven-day average testing positivity rate.

It recommends masking indoors in jurisdictions that reach substantial transmission, or places which recorded at least 50 new cases per 100,000 people over the past week or where the percentage of COVID-19 tests returned positive over the past seven days eclipses 8%.


Only Baltimore City and Montgomery and Prince George’s counties have instituted indoor mask mandates, the city’s having taken effect Monday morning. Anne Arundel County requires masks in county buildings.

“As we see these outbreaks occurring, we liken them to wildfires. We’re not going to sit back and let a wildfire get through our neighborhood. We have to react,” said Dr. Boris Lushniak, dean of Maryland’s School of Public Health. “And one is reinstating this idea of indoor mask use. … The second aspect is this I hope has woken up a certain segment of our population who are resistant to get vaccinated.”

A month ago, Maryland was averaging 74 cases daily over a two-week span, health department data shows. As of Tuesday, the state saw an average of 619 cases daily over the last 14 days.

At 4.21%, the seven day average testing positivity rate is more than fourfold higher than a month ago, according to the health department.

About a month ago, the state averaged 1.35 cases per 100,000 people over the last seven days, the data shows. As of Monday, the case rate climbed to 12.46 infections per capita over the last week.

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Down to 120 people hospitalized with the coronavirus on July 10, according to the health department, there were 424 in hospitals Tuesday.


Lushniak said he was particularly concerned about the timing of the surge. He said the summer usually brings a decrease in the transmission of respiratory illnesses because people spend more time outdoors or with windows open. Soon, the temperature will start to drop and people will take refuge inside, in proximity to each other.

“If this is what its going to be happening now, what’s the fall going to be looking like?” he said.

Predicting the case count would continue to increase as people return to offices, college campuses and schools, Sehgal said it was “about as dangerous as it’s ever been” for unvaccinated people.

But the delta variant has changed the pandemic outlook, Sehgal said. “Because vaccinated people can get infected and can transmit, vaccinated people should be taking a different set of precautions.”

He said he’s no longer comfortable eating indoors at restaurants or sharing a meal indoors with anyone from outside his household. Anytime he’s with others from outside his household, Sehgal said, he wears a mask.

“This surge won’t last forever,” Toner added. “But the quickest way to bring it under control is through wearing masks and, of course, in conjunction with that, is those people who have not been vaccinated need to get vaccinated.”