RALEIGH — As COVID-19 cases and hospitalizations are once again on the rise in North Carolina, state officials have said 13 of the state’s 100 counties demonstrate at least “substantial” community spread of the disease.

And that viral spread is increasing rapidly, according to a report from the N.C. Department of Health and Human Services.

The news comes as health officials across the country continue to warn of the growing threat of the more contagious delta variant.

North Carolina’s update of its County Alert System, which has monitored the spread of COVID-19 in a color-coded map since November, reports that the level of viral spread has increased in 40 of the state’s 100 counties since the previous update two weeks earlier. There is still just one county designated as red, which indicates “critical community spread,” but the number designated orange, indicating “substantial community spread,” has risen from one to 12.

Guilford, Forsyth, Davidson and Randolph counties are among the 54 counties where the level of viral spread generally held even from the previous report to the new one.

The alert system looks at three metrics: case rate, the% of tests that are positive, and hospital impact. Vaccination rates are not one of the metrics used.

In order for a county to be labeled red, it must have more than 200 new cases per 100,000 residents with at least 42 total cases over a 14-day period. It must also have either more than 10% of tests returning positive, or a high impact on local hospitals.

For orange counties, there must be between 101 and 200 new cases per 100,000 residents with at least 21 total cases over a 14-day period. There must also be between 8 and 10% of tests returning positive, or a moderate impact on local hospitals.

Now, more than 94% of all new cases are being detected among people who are not vaccinated, DHHS Secretary Mandy Cohen said in a news release accompanying the report.

“Unvaccinated North Carolinians are unnecessarily getting sick, being hospitalized and dying,” she said. “Don’t wait to vaccinate.”