NEW YORK, United States (AP) — Workers in New York City-run hospitals and health clinics will have to get vaccinated or get tested weekly under a policy announced yesterday to battle a rise in COVID-19 cases fuelled by the highly contagious Delta variant.

Publicly employed nurses, doctors, social workers, custodians, registrars and colleagues will be covered under the order from city Health Commissioner Dr Dave Chokshi, and Mayor Bill de Blasio didn’t rule out eventually applying the same requirement to teachers, police officers and other city employees.

The city tried to turn the page on the pandemic this summer, citing its vaccination campaign to relax restrictions and encourage residents to resume their regular activities, workers to return to offices and tourists to visit. But the new requirement comes amid a slowdown in doses and what de Blasio called “a huge curve ball”, the more infectious Delta variant.

“Because of the Delta variant, increasingly the choice is between infection or vaccination. And that can mean the difference between life and death,” Chokshi said at a briefing with the Democratic mayor.

The number of vaccine doses being given out daily in the city has dropped to less than 18,000, down from a peak of more than 100,000 in early April. About 65 per cent of all adults are fully vaccinated. But the rate among public hospital system workers is lower: about 60 per cent, according to Dr Mitchell Katz, who runs it.

Meanwhile, caseloads have been rising in the city for weeks, and health officials say the variant makes up about seven in 10 cases they sequence.

De Blasio has emphasised that hospitalisations have remained fairly steady — at least for now. Rises and drops in hospitalisations generally lag trends in new cases by a couple of weeks.

The mayor reiterated yesterday that he doesn’t currently plan to reimpose a broad indoor mask mandate for the general public, as Los Angeles County has done. New York City residents still are required to wear masks in certain settings, such as public transit.

De Blasio said he doesn’t want unvaccinated people to see masks as a substitute, or vaccinated people to feel they got the shots in vain.

“If we push hard on vaccinations … I think that’s the best way to get this done,” he said.

De Blasio said the weekly testing rule could encourage more health care workers to get vaccinated.

The order, effective August 2, will cover the roughly 42,000 people who work in the city’s public hospital system, which includes 11 hospitals, as well as nursing homes and clinics. The policy also will cover some city Health Department employees.

Workers who don’t comply will face unpaid suspension, de Blasio said.

San Francisco last month announced a more dramatic step of requiring city workers to be vaccinated against the coronavirus when a vaccine receives full federal approval.

The private New York-Presbyterian hospital system announced in June that it will require its 48,000 employees to be vaccinated unless they have a valid exemption, over objections from a major health care union which it encourages vaccinations but opposes mandating them.

So does District Council (DC) 37, which represents some city public hospital workers. DC 37 greeted yesterday’s announcement by saying it supported more testing.

“We’ll need to see how the testing is being implemented, but our primary concern is the safety of our members and their patients, and testing gets to that,” spokesperson Freddi Goldstein said.

De Blasio said he hoped health systems and businesses nationwide would emulate the city’s policy.

“This is the first step in fighting back,” de Blasio said. “Everyone can do this now, and everyone should do this now to save lives.”