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As Utah hospitalizations for COVID-19 continued to climb Thursday and a medical director warned that some hospitals are approaching capacity, Gov. Gary Herbert showed no movement toward mandating masks for any part of the state.

“I much prefer us doing it on a voluntary basis,” Herbert said in a news conference. “... Until we can get a vaccine ... we’re just kind of treading water. How can we get through this right now until we, in fact, get this turned around?”

The Utah Department of Health reported 43 new hospitalizations on Thursday, bringing the 14-day total to 451 — the highest of any two-week period since the beginning of the virus.

“Our hospitals are near capacity,” said Dr. Tom Miller, chief medical officer for University of Utah Health. “We want to take care of all the patients who need our care without overrunning our beds, our nurses and our physicians.”

Utah doesn’t need to simply wait for a vaccine, Miller noted.

“Masks are our medicine right now, until we have an effective treatment or a vaccine,” he said. ‘I’m pleading with you to put your mask on. For 140 years, we’ve known that masks prevented the spread of disease. That’s why surgeons wear them.”

Miller added: “Let’s not shame or blame” and urged people to be positive examples by wearing masks.

Herbert acknowledged that counties with mask orders are seeing improvements. He pointed to Salt Lake County’s mask order as a “leg up” as he revised state guidelines to allow Salt Lake City schools to reopen in the fall. Data provided by the county’s health department shows weekly new cases are lower than they’ve been since mid- to late June.

In counties that have mandated mask-wearing, including Salt Lake, Summit and Grand, “we’re certainly seeing face-mask compliance,” Herbert said.

But that does not justify extending mask orders elsewhere, he said.

“I like what we have right now with local control. We have some of our rural counties which are in ‘green,‘” he said, referring to the lowest risk rating issued by the state. “There’d be no reason for that to be a challenge for them, to have to have everybody wear masks.”

In fact, data from local health departments shows sharp increases in new cases in the 10 rural counties that switched to “green,” or “new normal,” regulations. In total, those counties had been adding about one coronavirus case per day while under the higher risk ratings. Less than a week after shifting to green on June 20, those counties’ average daily increase had quadrupled. On Wednesday, the most recent day for which local data was complete, those counties identified 15 new cases.

For example, Kane County, which saw an increase of 13 cases in the past week, had more new cases per capita than any county in Utah except San Juan, where a nursing home outbreak has killed at least three and infected 50 in the past two weeks.

Asked whether there was some unique drawback to a mask order — as opposed to all the other restrictions tied to the state’s coronavirus guidelines, or state code in general — Herbert simply reiterated that “his preference is to see Utahns use masks voluntarily,” according to a written statement provided to The Salt Lake Tribune after Thursday’s news conference.

Statewide, the Utah Department of Health adjusted Thursday how it reports new data, which produced an artificially high daily increase of 954 new positive tests.

Not all of them were new cases, health officials cautioned.

“I need to provide a lot of context to these numbers,” state epidemiologist Dr. Angela Dunn said at the Thursday news conference, explaining the state has been “reviewing the antigen case results for accuracy” and decided to add such test results to the state’s case totals.

Antigen tests detect a protein that is part of the COVID-19 virus, while the more commonly used (and somewhat slower) PCR tests detect viral RNA, the health department explained.

Of those 954 new cases reported Thursday, according to a statement from the department, 251 are the result of antigen testing at some labs in Utah since late June. The agency will now include the results of antigen cases, both positive and negative, in the daily case count, after reviewing the accuracy of antigen test data.

Another 50 cases diagnosed earlier in July had been delayed in electronic reporting. Another 246 cases were diagnosed earlier this week, and were added to the total case count Thursday. The UDOH dashboard’s charts will reflect when those cases were first reported, Dunn said. UDOH also posted a three-minute video on YouTube to explain the changes to the dashboard.

The new and adjusted numbers mean 31,845 Utahns have tested positive for COVID-19 since the pandemic began.

The rolling seven-day average was at 619 cases per day, Dunn said Thursday, up from Wednesday’s average of 609. The rolling average for positive lab tests was at 10.4%.

When asked about studies saying recent street protests have not been found to be spreaders of the virus, Miller said, “when people are outside, and with some distance, there’s much less risk of spreading the virus.” Indoors, he added, is “where the virus moves from person to person.”

One more Utahn — a Salt Lake County woman, between ages 65 and 84, who had been living in a long-term care facility — has died from COVID-19, UDOH also reported Thursday. She brings the state’s overall death toll to 234 people.

There were 199 people in hospitals with the virus as of Wednesday. (Hospitalization statistics are a day behind case counts.) Since the pandemic began, 1,956 people have been hospitalized because of COVID-19 in Utah.

Another 7,448 tests were administered since the day before, UDOH reported. So far, 439,528 tests have been given in Utah.

Antigen tests, UDOH said in its statement, serve the same function as the PCR tests that routinely have been performed: to tell people if they have COVID-19 right now. This differs from blood tests, which look for antibodies from the virus and show whether a person has had COVID-19 in the past.

Both antigen tests, which are faster, and PCR tests rely on samples taken with nasal swabs, UDOH said.