California now has one of the lowest coronavirus infection rates in the country, with 1.9% of people testing positive for the disease in the last week as the nation’s most populous state has so far avoided the uptick feared heading into the end-of-year holidays.

Coronavirus hospitalizations in the state have fallen about 14% in the last month — a trend state data models forecast will continue for the next month — but Gov. Gavin Newsom on Monday continued to sound the alarm about the potential for another winter spike that could overwhelm hospitals in some areas.

Visiting a coronavirus vaccination clinic in San Francisco, Newsom urged people to wear masks and get COVID shots ahead of the long Thanksgiving holiday weekend. He pointed to at least 27 states that have seen at least a 10% increase in cases in the past week.

“Ask the governor of Michigan (or) Colorado how they are doing,” Newsom said. “States are struggling because people are taking down their guard or claiming ‘mission accomplished.’ … I don’t want to see that happen here in California.”

Newsom has struck a more cautious tone compared to the spring when he lifted nearly all of California’s pandemic restrictions and told people who were vaccinated they could stop wearing masks and socially distancing in some places. But a summer surge prompted some of the state’s largest local governments to bring back mask mandates and other restrictions, creating a dizzying patchwork of policies across the state.

Last winter brought the deadliest surge of the pandemic to California and while a repeat isn’t expected because so many people are vaccinated the state still could see a lesser surge as people gather indoors for the holidays. That possibility prompted Santa Cruz County to reinstate its mask requirement on Sunday, just a few days after neighboring Monterey County lifted its mandate,

“Unfortunately, a potential winter surge appears to be a significant threat to the health and safety of our community,” said Santa Cruz County Health Officer Dr. Gail Newel said in a statement.

Santa Cruz County, located along the coast south of San Francisco, has a per capita infection rate only slightly above the state average. Of California’s 58 counties, the ones with the highest rates are nearly all rural and have lower vaccination rates.

Fresno County, an agricultural powerhouse of nearly 1 million people located in the Central Valley, is the most populated county among those in the top 10 for infections per 100,000 people. Los Angeles County, with its more than 10 million residents making up about a quarter of the state’s population, has an infection rate that falls in the bottom third.

Los Angeles became the nation’s epicenter for the outbreak last winter when California saw its worst surge. Things got so bad that the National Guard had to bring in refrigerated trucks to store bodies at overwhelmed hospitals.

But all of that happened before a coronavirus vaccine was available. Now, more than 75% of people 5 and older in California have gotten at least one dose. For adults 18 and older, more than 91% have received at least one dose. Nearly 5 million people have gotten a booster shot.

Newsom continued to urge parents to get their children vaccinated. While speaking to reporters at the vaccine clinic he was interrupted by a child crying after receiving a shot. He joked that scene wouldn’t lead a public service announcement “but it is a very human moment.” He then turned to applaud the child.

California plans to require all students in public and private schools to receive the coronavirus vaccine as a requirement for attending in-person classes. But that mandate won’t take effect until the federal government gives final approval to the vaccine for children 5 and older.

In the meantime, California requires all public school staff and students to wear masks while indoors. Newsom said state officials might lift that rule once more children are vaccinated.

“The virus will dictate those terms,” he said.