The US states of Florida and Louisiana were at or near their highest hospitalisation numbers of the coronavirus pandemic on Monday, driven by the still-spreading Delta variant, as one doctor warned of the "darkest days" yet.
More than 10,000 patients were hospitalised in Florida as of Sunday, surpassing that state's record. Louisiana was expected to break its record within 24 hours, prompting Governor John Bel Edwards, a Democrat, to order residents to wear masks again indoors.
"These are the darkest days of this pandemic," Dr Catherine O'Neal, chief medical officer of Our Lady of the Lake Regional Medical Centre in Baton Rouge, Louisiana, said at a news conference with Edwards. "We are no longer giving adequate care to patients."
O'Neal urged Louisianans to get vaccinated, warning that hospitals were overwhelmed. Many nurses were out sick with the virus, she said, leaving the state with a staffing deficit of 6,000 people.
Hospitalisations in Arkansas are also soaring and could eventually break records.
In California, political leaders in eight San Francisco Bay Area counties reinstated mandatory indoor mask orders in public places as of midnight Tuesday morning.
Governors of New York and New Jersey said transport, jail, hospital and nursing home workers would be required to get vaccinated or submit to regular testing. Denver Mayor Michael Hancock said inoculation would be mandatory for the city's more than 11,000 employees.
New York Governor Cracks Down
New York Governor Andrew Cuomo urged bars, restaurants and other private businesses to require that customers be vaccinated before they can enter. Cuomo said vaccines could be made mandatory for nursing home workers, teachers and healthcare workers if case numbers do not drop.
New Jersey Governor Phil Murphy suggested he could clamp down even further on residents and businesses.
The moves represent the latest attempts by policymakers to spur reluctant Americans to get vaccinated as the highly contagious Delta variant of the coronavirus surges nationwide.
Florida Governor Ron DeSantis, a Republican, has taken the opposite stance. He issued an executive order last week barring schools from requiring face coverings, saying parents should make that decision for their children.
District officials in Broward and Gadsden counties, facing a threat by DeSantis to withhold state funds, said on Monday they were dropping mask mandates this fall, the News Service of Florida reported.
Florida has one of the worst outbreaks in the nation and about one-quarter of the country's hospitalised Covid patients, according to data from the US Department of Health and Human Services.
Mary Mayhew, head of Florida's hospital association, said the latest surge sent hospitalisations rising to 10,000 from 2,000 in less than 30 days, although deaths have remained well below peak numbers.
"It is a much younger age group that is getting hospitalised," Mayhew said. "For the last year, so many heard repeatedly that COVID had the greatest risk for our elderly, for individuals with serious underlying conditions, but the Delta variant is clearly a significant risk for younger people."