BOISE, Idaho (AP) — Idaho health care experts say coronavirus is increasing as kids are returning to school — but most of the new infections aren't happening in school buildings.

Instead, it's likely because many people are treating the return to school like a return to normalcy and slacking off on precautions such as social distancing, hand-washing and mask-wearing that can slow the spread of thecoronavirus, Dr. Joshua Kern, vice president for medical affairs for St. Luke's hospitals in Jerome, Twin Falls and Ketchum, said Tuesday.

“It's not necessarily in-school spread, because they're always wearing masks there,” said Kern, part of a panel of health care experts discussing the coronavirus online.

Kern's region is again becoming a hot spot for coronavirus. The area was one of the first in the state hit by the pandemic in March when the Sun Valley region had the highest per-capita infection rates in the country outside of New York City and surrounding counties. Now the region is again seeing case numbers rise dramatically, he said.

“We've seen pretty significant rises, about 40 percent on average week-over-week,” Kern said. “Just kind of relentlessly marching up.”

The increase means one-quarter of the patients in his hospital are COVID patients, he said. Influenza patients are also starting to be admitted to the hospital, increasing demand on resources.

“That's an alarming number," Kern said. "Really we were doing OK, until I think people started relaxing and getting less controlled with their activities in the community.”

Idaho currently ranks sixth in the country for new cases per capita, according to a tally from Johns Hopkins University, with more than 48,660 total confirmed cases of coronavirus statewide. So far more than 500 Idaho residents have died because of COVID-19.

Still, in some of areas with the highest rates of spread, some groups don't appear to be taking the risk seriously. Brigham Young University-Idaho officials warned students on Monday that if they intentionally exposed themselves to coronavirus they would face suspension and possible expulsion. The warning came after school officials heard unconfirmed accounts of people in the eastern Idaho community intentionally exposing themselves to the virus so they could sell their blood plasma at higher rates to private blood banks in the region. Some private blood banks pay more for plasma that contains COVID-19 antibodies.

“The university condemns this behavior and is actively seeking evidence of any such conduct among our student body,” school officials wrote in the memo to students, saying students with financial woes should reach out to the school for help rather than endanger themselves.

In the Twin Falls School District in southern Idaho, at least 61 students and staffers have tested positive for coronavirus so far, The Times-News reported Tuesday. That prompted the district to switch to a hybrid system where students alternate in-person with online learning, and to cancel the homecoming dance.

One parent, Shane Klaas, told school officials that a group of about 200 people planned to hold their own unofficial homecoming dance, and masks wouldn't be required, the newspaper reported.

Dr. Richard Augustus, chief medical officer for West Valley Medical Center in Caldwell, said it seems people are getting sick of hearing about coronavirus and sick of social distancing. Still, he warned that the pandemic is a marathon, not a sprint, and participating in events like Halloween trick-or-treating puts people at high risk of catching and spreading COVID-19. He recommends people celebrate with home movie nights or at-home costume parties with immediate family members instead.

“Think outside the box, do something creative, have some fun, but be careful,” he said. “We cannot give up — it is not a point in this pandemic where we can stop being careful.”

Though less common than adults, children can experience catastrophic illness from COVID-19, St. Luke's Children's Medical Director Dr. Kenny Bramwell said. Some Idaho children have been hospitalized with COVID-19, including cases that are dire.

“One of the cases was severe enough that the patient ultimately needed to be taken in an airplane to another city to await a heart transplant,” Bramwell said. “This was a previously healthy teenager who now needs a heart transplant.”