MARIN COUNTY (KPIX 5) – Health metrics point to a spike in COVID-19 cases, but this is a much different kind of surge than we’ve seen in the past, according to doctors.

There are more breakthrough cases among the vaccinated, but what’s reassuring for those who have gotten the shots, is hospitalizations and severe cases, are still very low.

In Marin County, health officials say about one in four recently infected have been vaccinated. About half of those are showing no symptoms.

“While we’re seeing the Delta Variant can break through and cause infection among vaccinated people, it is not leading to severe illness or death,” said Marin County Public Health Officer Dr. Matt WIllis.

Feelings about another uptick are mixed.

Linda Trung, who has been operating Cherry Blossom Salon for nearly 30 years, is asking customers to mask up, once again.

“I’m very nervous and very worried about the coronavirus coming back,” said Trung.

“I’m not terribly concerned.  I know the numbers are up but I am concerned about kids under the age of 12 carrying the virus around,” said rideshare driver David White.

Health experts, though, emphasize the vaccine is still highly effective.  Before, a spike in infections was followed by a surge in hospitalizations.

But only two of the 137 recently confirmed cases among vaccinated county residents ended up in hospitals and most notably, no one has died.

“Now cases and hospitalizations in highly vaccinated regions like the Bay Area are becoming de-linked and hospitalizations are mostly among the unvaccinated,” said UCSF infectious diseases professor of medicine Dr. Monica Gandhi.

For months, the rolling average of daily new cases remained in the low single digits, now it’s closer to 18.  The majority of cases is among the unvaccinated.

“When we see cases going up right now, which is natural because we opened up society, it is not the same thing as cases going up before high rates of vaccination,” said Gandhi.

In Los Angeles County, where an indoor mask mandate has been reinstated, the hospitalization rate is about twice that of the Bay Area. That’s one of the reasons, the mask rule indoors for those vaccinated is still just advice in the Bay Area, rather than a mandate.

If that number reaches closer to 5 per 100,000 according to Gandhi, mask rules could change again.