Adams County has extended last month’s public health order into 2021 as COVID-19 cases continue to be the highest in the metro area, the Tri-County Health Department announced Tuesday.

The public health order, which first went into effect on Nov. 7, is now set to expire on Jan. 7.

In addition to standard Level Red COVID-19 regulations, the public health order includes a countywide curfew that prohibits anyone who is not an essential worker from being on public streets between 10 p.m. and 5 a.m.

Officials said the extension is an attempt to prevent a “surge on surge” during the holiday season as two weeks of Level Red restrictions haven’t lowered cases in the county.

“The threat of further hospitalizations and deaths is very real in Adams County,” said Dr. John Douglas Jr., executive director of Tri-County Health Department.

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“We understand that people are tired of this, but these public health measures are the road map for a faster and more sustainable recovery in our community without the necessity of moving to the complete Stay at Home orders that we had in the spring.”

As of Monday, there are 32,677 known COVID-19 cases in Adams County. The county’s positivity rate is 14.5% and its two-week incidence rate has reached 1,150 per 100,000 people.

Hospitalization rates in the county are also rising. Adams County’s hospital admission rate as of Nov. 30 is six times higher than in early September.

Current rates are even higher than during the first COVID-19 surge in the spring.

“At this critical point in the pandemic, we have to balance the health of our residents and our hospital system, while keeping our economy stable and people fed and housed,” said Emma Pinter, Adams County commissioner.

Though Adams County is currently at Level Red restrictions for counties with high levels of transmission, hospitalizations and positivity, it still risks advancing to Level Purple if hospitals begin to reach capacity.

Level Purple would trigger another stay-at-home order.

Under the current public health order, restaurants are limited to outdoor dining only, alcohol sales must end at 10 p.m. and spectators are prohibited at all sporting events, including high school.

The nighttime curfew applies to all non-essential workers and businesses.