Health officials are sharing encouraging news about COVID-19 case counts, but say it’s too early to loosen requirements for mask-wearing.

“The numbers have been going down,” Chatham Health and Natural Resources Director Robert Duncanson told the health board Monday. Twelve cases were reported in the first week of September, then seven and nine cases, and just five cases in the final week of the month. “And that mirrors a trend nationwide,” he said. Slowly and steadily, more people are getting vaccinated, “which is a great thing,” he added.

The two-week positivity rate, which reflects uncontrolled growth of the pandemic when it is over 5 percent, stands at 2.41 percent in Orleans, 3.23 percent in Harwich and 3.41 percent in Chatham, as of Sept. 30. The numbers in the towns have fluctuated somewhat in recent weeks, but “the trend is going in the right direction,” Duncanson said. Statewide, the positivity rate is 2.09 percent.

In Chatham, September saw 35 confirmed cases of COVID-19, compared to just eight cases in September of 2020. But last year, September was the last month before an upward swing in cases.

“Then we started into the Thanksgiving and Christmas spikes,” he said. Without the benefit of a vaccine, case counts, hospitalizations and deaths began to climb.

The prevalence of the vaccines hasn’t caused case counts to bottom out, but as predicted, has led to fewer hospitalizations and deaths. Of Chatham’s 35 cases last month, only one patient required hospitalization.

“In most of the cases where people voluntarily provide that information to the contact tracers, their symptoms have been mild,” Duncanson said.

Given that fact, health board member Richard Edwards wondered what the real prevalence of COVID-19 might be. If 35 people were tested, perhaps 100 people were asymptomatic and fully vaccinated but still carrying the virus and infecting others, he speculated. Duncanson said there is no way to know the true scope of the spread of the virus without testing everyone.

Not everyone who is tested is doing so because they feel ill, Duncanson added. Some are getting tests before they travel or meet with family. “I don’t think we’re only testing symptomatic people,” he said.

The problem, Edwards opined, is that the FDA and the CDC are focused on preventing hospitalizations and deaths, “and they completely ignore the fact that a lot of vaccinated people are getting infected and spreading it to other people.”

Duncanson said the bottom line is that public health officials still need to encourage eligible people to get vaccinated. Nationally, there are about 70 million such people, according to a recently published report.

“You really hope you can reach those 70 million in some fashion,” he said.

The continued spread of the virus also underscores the need for face coverings in certain settings, he added. Wearing masks is encouraged in all indoor public places in Massachusetts for all unvaccinated people and for fully vaccinated people who have weakened immune systems or underlying medical conditions. Wearing masks remains mandatory on public transportation, in healthcare or congregate care facilities and certain other settings.

On Sept. 20, the Chatham health board approved an emergency order requiring even vaccinated people to wear face coverings while attending any indoor town meeting or any gathering of two or more people in a town meeting room, including the community center gymnasium and fitness room. Health board member Noble Hansen said he’s already heard push-back from people who don’t want to wear masks while exercising or using the gym at the community center.

The day after the health board issued its order, select board member Dean Nicastro asked it to consider allowing an exemption from the policy for people at the dais who are socially distanced and fully vaccinated. Nicastro said the mask was causing his glasses to fog up, and might have to attend meetings remotely.

This week, health board members uniformly rejected the idea of issuing an exemption. Hansen said he favors “one uniform policy,” and rather than issuing a waiver for some, suggested the health board consider what standards need to be met before the order can be relaxed or eliminated altogether.

Board member Carol Boyce agreed that the order should set “a single standard for everyone.”

Duncanson said he would transmit the health board’s decision to the town manager and select board.