Two area counties are seeing “high” community spread of COVID-19 and two others “substantial” spread, triggering the Centers for Disease Control’s new recommendation that their residents — including those vaccinated — wear masks when indoors in public places.

The two counties seeing high community spread of COVID-19 are Perquimans and Currituck, according to the CDC’s COVID tracker. The two seeing substantial spread are Chowan and Camden.

The four other counties in Albemarle Regional Health Services’ eight-county health district — Pasquo-tank, Hertford, Bertie and Gates — are seeing only “moderate” spread of COVID, according to the CDC.

The CDC issued new guidance this week that reverses its earlier recommendations on mask wearing to prevent the spread of COVID-19. While the federal heath agency initially said persons fully vaccinated no longer had to wear a mask indoors, a recent surge in COVID cases related to the delta variant has changed that guidance.

CDC Director Rochelle Walensky said the agency is now recommending residents wear masks if their county has seen at least 50 new cases per 100,000 people in the last week. That criteria applies to roughly 60% of all U.S. counties, including the four in the Albemarle.

According to the CDC’s COVID tracker, Perquimans reported 15 new COVID cases during the seven-day period from July 19-25. That’s 111.42 new cases per 100,000 people, while the county’s positivity rate — the percentage of COVID tests that come back positive — was 5.38%.

Currituck reported 12 new cases from July 19-25, giving it a case rate per 100,000 people of 76. Currituck’s positivity rate, meanwhile, was 12.59%, which was higher than the state’s daily positive test rate of 10.8% on Wednesday.

Chowan reported 11 new cases during the seven days, giving it a case rate of 78.8. Its positivity rate was 9.25%. Camden reported fewer than 10 new cases, had a case rate of 46 and a positivity rate of 9.09%.

Walensky said the CDC’s updated guidance was prompted by new data suggesting vaccinated people can pass on the virus in rare cases.

“I know this is not a message America wants to hear,” Walensky told CNN. “With prior variants, when people had these rare breakthrough infections, we didn’t see the capacity of them to spread the virus to others, but with the delta variant, we now see that you can actually now pass it to somebody else.”

Walensky said unvaccinated people account for the vast number of new cases. Two-thirds of the vaccine eligible population has received at least one dose, she said. About 69% of the eligible population in North Carolina has gotten one dose while the percentage in ARHS’ eight counties as of July 22 was 54.59%.

Asked about the new CDC guidance on Wednesday, ARHS Director Battle Betts said his agency’s position has been that all unvaccinated people should wear a mask, “regardless of other factors.” He noted Gov. Roy Cooper is scheduled to hold a press conference on Thursday where he’s expected to address the CDC’s new guidance for vaccinated people in high COVID transmission areas.

Asked if ARHS planned to issue new masking guidance for the four counties seeing high or substantial spread, Betts noted that COVID metrics “constantly shift so we need to stay consistent in our messaging.”

“Perquimans and Hertford counties have been identified as potentially high risk in the event of a large outbreak and will be eligible for increased testing, tracing, and vaccine efforts by the state,” he said. “We will respond to any hotspot that pops up regardless of where it is within our service area.”