In the wake of a holiday travel week and the growing spread of the Delta variant, local reports are coming in with a bit more frequency of fully vaccinated people testing positive for COVID-19 and even getting sick. Public health officials aren't yet sounding alarm bells or talking about new lockdown orders, but don't be surprised if there's some sort of change with mask guidance in SF's future.

Daily new case counts have been rising in San Francisco in recent days, mirroring what has been happening for several weeks in neighboring counties and down in Southern California. The vast majority of new COVID cases and hospitalizations continue to be seen in unvaccinated Californians, however both SF General and the Marin County Public Health Department report seeing an uptick in cases among vaccinated people.

Marin County Health Officer Dr. Matt Willis tells ABC 7, "Right now, we're about one in five of our cases are among people who are vaccinated, before that was about one in ten." He adds, "Obviously the concern there is that the vaccine may not be quite as effective against the Delta variant."

Two out of 13 COVID patients currently in Marin hospitals are vaccinated individuals, and Willis says they're both older, have underlying conditions, and they are faring better than others who are hospitalized who were not vaccinated, suggesting that the vaccines are doing their job even in the most vulnerable patients.

Anecdotally, SFist has been hearing of cases of multiple vaccinated individuals who spent the Fourth of July holiday on the East Coast and came back COVID-positive. And ABC 7 reports on the case of one vaccinated Hollister man, Sean Fruit, who traveled to Las Vegas by car with his family and became sick on his return last month, infecting his two children. The kids had mild symptoms, but Fruit, who has a history of sinus infections, says he was sick in bed with incredible pain.

Fruit says he regrets not wearing a mask indoors when he was allowed to take it off while in Vegas.

In SF, daily new cases were up to 36 on a seven-day average basis as of July 8, which is triple what the seven-day average was a few weeks earlier. When full reopening happened on June 15, SF was seeing closer to 10 to 12 cases per day.

Hospitalizations across the Bay Area have gone back up to mid-May levels, with 332 COVID patients in area hospitals as of Monday, up from a low around 200 in mid-June. A similar uptick has been seen statewide.

According to ABC 7, out of nine COVID patients at SF General in the last week, two were fully vaccinated.

As NPR reports, the Northeast continues to see very low infection rates, while new cases are ticking up in places where vaccination rates are lower, in the South, Midwest, and parts of California.

Parts of the 880 corridor through San Leandro and Oakland landed on a list of emerging hot spots from the Centers for Disease Control this week. As Dr. Nicholas Moss, the health officer for Alameda County, tells ABC 7, "If you look at the map in the neighborhoods where we're seeing the highest rates, those are also the places where vaccine rates are lower."

Dr. Russell Rodriguez, chief medical officer for John Muir Health in Contra Costa County, says most of the hospitalized patients they've seen are unvaccinated.

"I have patients who had been admitted to the hospital for COVID symptoms that were not vaccinated that were somewhat sorry at the time of their admission that they had waited for whatever reason," Rodriguez said.

Dr. Chris Colwell, chief of emergency medicine Zuckerberg San Francisco General Hospital, issued a dire warning about the infectiousness of the Delta variant, telling the station, "I really believe we are at a point where we can say pretty confidently that you're either going to be vaccinated or you're going to have COVID."

According to state data, the number of breakthrough cases among vaccinated people remains very low, but it is slightly higher than was reported two weeks earlier. As of June 23, going back to January 1, the state estimated that 0.039% of vaccinated Californians had seen post-vaccination infections, or a total of 7,553 out of 19.5 million vaccinated residents. As of July 7, the percentage rose to o.o51%, with a total of 10,430 post-vaccination cases identified.

Health officials continue recommend wearing masks indoors in environments where you're mixing with many people from outside the area, or when you're traveling to parts of the state or country where vaccination rates are low.

Governor Gavin Newsom has said that no new statewide mask order would be coming, and it's now just up to the unvaccinated to go get their shots. SF Mayor London Breed said last week that any decision about changing mask orders would have to come from the Public Health Department.

Related: Data Finds 'Breakthrough' COVID Cases Exceedingly Rare Among Vaccinated Californians