COVID-19 cases are on the rise from Buffalo to Poughkeepsie.

County health departments around the state are closely, and in some cases, nervously, monitoring positive cases climb back up from recent lows.

Despite mask mandates being lifted around the country, cases are spiking in counties around New York. In Orange County, cases have increased by 202% just this past month.

According to Orange County’s COVID-19 data, on March 18, there were 292 recorded active cases. Just a month later, on April 18, that number jumped to 882 active cases.

Jahan Keivanjah is an owner of Cure Pharmacy in Goshen. As a pharmacist, he’s witnessed the many waves of the pandemic.

"There is a surge of COVID," said Keivanjah.

He witnessed the omicron wave, and now he’s seeing more customers coming in with COVID again.

"We're seeing a gradual increase of cases, especially through our wastewater SARS-CoV-2, and that is correlating with some of the provider tested cases that are reported to us," said Orange County Health Commissioner Dr. Irina Gelman. "Overall, it's not as large of an increase as the rest of the state is reporting."

The Centers for Disease Control and Prevention (CDC) flagged 10 New York counties that have "high" community levels of coronavirus.

The state Department of Health also recommended three Central New York counties enact masking policies.

The CDC has listed Orange County’s COVID-19 community level as medium. However, experts believe the official numbers only tell part of the story.

Gelman said wastewater sampling data suggests Goshen is experiencing a rise in cases right now.

"The cases that are reported to us are actual provider tested cases with the prevalence of home-based test use and other testing kits being available. Clearly, those cases are not reported," said Gelman.

Gelman worries that large gatherings of people over Easter and Passover, and other vacation travel for spring break might drive up cases. She also cautioned against switching the local strategy from pandemic to endemic, where health assets treat the virus as something routine — something Ulster County did in March.

"At this point, as we are seeing an increase in cases, we have not reached endemic status yet nationwide and statewide, so it's very difficult to actually reach that endemic status locally," Gelman said.

Keivanjah administers both PCR tests and also sells at home test kits in his shop. He said he’ll continue offering advice and treatments for customers when they get sick.

"They could use some of the cough syrup, some of the over-the-counter inhalants that help them breathe," said Keivanjah.

Because although many New Yorkers are feeling COVID fatigue, experts advise the pros of wearing a mask and staying as clean as possible far outweigh the cons of getting severely sick.

"I think everybody's worried they don’t want to catch COVID," said Keivanjah. "Some people might have gotten fed up with it, in a sense. They just don’t want to hear any more about it."