Here we go again.

Local elected officials and public health leaders are concerned about a spike in new COVID cases and related hospitalizations as four cases of the more contagious Delta variant were confirmed in Travis County on Wednesday and amid continued vaccine hesitancy.

"I hate that we are here together again at a press conference talking about the virus," Austin Mayor Steve Alder said Thursday. "I had thought and hoped that we would not be in front of you again talking about a rise in COVID cases."

With rising new COVID cases and related hospitalizations, Austin-Travis County Interim Health Authority Dr. Desmar Walkes announced a return to Stage 3, according to Austin Public Health's risk-based guidelines.

At Stage 3, APH recommends high-risk unvaccinated individuals wear masks and take other precautions to mitigate risk. "This is due in part to the confirmed presence of the Delta variant in our community and the associated dramatic increase in new cases and hospitalizations that we've seen in the last few days," Walkes said.

The seven-day moving average for new COVID-related hospital admissions in the five-county Austin metro was 20 as of Wednesday, after 29 people were admitted, according to Austin Public Health data. The average has jumped from 14 a week ago.

Almost everyone hospitalized with COVID is unvaccinated, officials said, although they declined to provide more specific numbers. Walkes told KXAN last week that more than 90% of hospitalized patients were unvaccinated.

Of the 107 people hospitalized overall on Wednesday, 41 patients were in the ICU, where capacity is currently strained, Walkes said at the same press conference.

In addition to increased demand as Austinites shed their masks in favor of summer social outings and travel, there are also staffing shortages at area hospitals. "It's been a hard year," Adler said, adding that it's harder to hire nurses and other healthcare professionals at this stage of the pandemic.

Even before the four Delta variant cases were confirmed on Wednesday, public health leaders said it was very likely it was spreading through the community given confirmed cases in surrounding counties. Testing limitations—with the sequencing required to detect the variant only be used in limited cases—means that detection is also limited.

To reverse these trends, officials implored residents to get vaccinated, if they aren't already, and encourage others to do the same. "This has to stop, and we know how to make that happen," Walkes said, adding that all three vaccines—Pfizer, Moderna and Johnson & Johnson—are effective at protecting recipients from severe COVID disease and death.

As of Wednesday, around 70% of Travis County residents 12 and older have received one dose of the COVID vaccine and 62% are fully vaccinated. Although the county is approaching the threshold for herd immunity, which experts estimate is around 70%, the uptake rate varies across communities and ZIP codes.

Although demand for vaccine appointments has dropped off in recent months, there are still 14 providers in Travis County offering shots. Austin Public Health has also partnered with community organizations and will arrange for in-home appointments or to visit businesses. "Whatever you need to make this choice, we are prepared," Interim APH Director Adrienne Sturrup said.