PORTLAND, Ore. (AP) — As COVID-19 cases in Oregon surge and hospitals fill up, officials in the state's most populous county announced on Monday they are reimplementing an indoor mask mandate.

People 5 and older — vaccinated and unvaccinated — in Multnomah County will be required to wear masks in indoor public spaces including stores, restaurants and gyms. The mandate goes into effect on Friday.

“The more contagious delta variant has changed the game. Our hospitals are full,” said Health Officer Dr. Jennifer Vines. “And we now know that while the vaccine protects us really well from serious illness, it may not always stop us from spreading the virus. An across-the-board mandate buys us time to protect more people with vaccine.’’

Officials say that the mandate will be enforced and that people who defy the mask requirement could face fines up to $1,000.

The mandate issued for Multnomah, which has the second highest vaccine rate in the state — 75% of adults in the area are fully or partially adults vaccinated — may be around through the end of the year.

“If we reach high levels of immunity this fall, we might be able to reduce mask use before January,” Vines said. “But if other variants emerge or we see other concerning trends, it could be longer than that.”

The county's decision to reimplement mask mandates comes as Oregon physicians and nurses say they are overwhelmed and that hospital space is severely limited as more and more people need care due to COVID-19.

As of Monday, 575 people are hospitalized in Oregon due to COVID-19. Based on data from the state health authority, the state’s record of people hospitalized was 622 during November’s surge when vaccine doses were not yet available.

In addition, during Friday, Saturday and Sunday, health officials reported a total of 3,229 new confirmed and presumptive COVID-19 cases and 14 deaths,

“More than ever our hospitals are finding themselves at their fullest capacity — we will rapidly reach beyond the tipping point if we don’t act immediately,” said Renee Edwards, the chief medical officer at Oregon Health & Science University. “If we don’t do something today then more people will die because we will not be able to serve the Oregonians who need hospital care for COVID-19 and other urgent health care conditions.”

Earlier this month, Democratic Gov. Kate Brown announced last week that the state will require students and staff in K-12 schools to wear masks indoors this fall and that state employees, visitors or customers must wear masks in any indoor state agency regardless of their vaccination status.

In addition the state health authority made a statewide recommendation that people, vaccinated or not, wear masks while in indoor public spaces, but stopped short of reinstating an indoor mask mandate.

The governor said it is up to county officials to implement or issue mask mandates.

“From the beginning of this pandemic, city and county leaders have asked me for local control and the ability to make local public health decisions when it comes to COVID-19,” Brown said.

Some counties, including Benton, have issued mask mandates for county agency buildings. However, officials say that Multnomah is the first county in the state to require masks in all indoor public spaces.

“Why are we taking this difficult step now? It’s because we know that masks work. They are tried and true, they are affordable and they’re an effective way to limit the spread of this virus and its variants,” said Multnomah County Chair Deborah Kafoury. “Until enough of us are vaccinated across Multnomah, masks remain one of the best strategies that we have to keep each other as safe as possible.”

Last week Brown met with county leaders across Oregon, who asked the governor not to take statewide action, and again asking for mandates to be administered by local officials.

“I am calling on local leaders to take action now to institute mask requirements. At this point in the pandemic, local leaders are in a unique position to help deliver the message to members of their communities about effective safety measures like vaccination and masks," Brown said. "But the fact remains, we have a finite number of staffed hospital beds in Oregon."

When it comes to the reimplementation of statewide restrictions, officials have said that “nothing is off the table." However there is no “hardline” for if and when further statewide safety mandates would return.

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Sara Cline is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.