After a week in which Hawaii reported more new daily cases than in any other week of the pandemic, Gov. David Ige announced Tuesday that he was reimposing restrictions to try to curb the surge.

“Social gatherings will be limited to no more than 10 people indoors and 25 people outdoors,” he said at a news conference. All indoor events will be reduced to 50% physical capacity and includes bars, restaurants, gyms and houses of worship, he said, and masks must be worn at all times except when actively eating or drinking.

The measure is in effect immediately and comes five days after Ige, a Democrat, ordered all state and county employees to show proof of vaccination by Monday or face weekly testing. While that policy affects tens of thousands of residents in Hawaii, Ige said that he believed it was not enough.

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“We know that we won’t see benefits from the increase in vaccinations going up for another six to seven weeks,” he said Tuesday. “In the meantime, we must take action now in order to slow the spread of COVID-19, especially with the new delta variant, which has wreaked havoc in our communities.”

Hawaii, which has had the country’s fewest cases per capita over the course of the pandemic, has seen its number of patients hospitalized with COVID soar from only 40 on July 1 to 246 on Tuesday, of whom 235 are unvaccinated.

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“That’s a pretty rapid trajectory,” said Hilton Raethel, president and CEO of the Healthcare Association of Hawaii, a nonprofit representing hospitals, skilled nursing facilities, assisted living facilities, home care companies and hospices. “Hospitals are full, and then you have all these COVID patients; that really stretches our health care system.”

Raethel said Tuesday that the first of 550 additional health care workers would be arriving this weekend from the mainland United States. Only once during the pandemic did the state need reinforcements from the mainland, he said, and that was last September and October during Hawaii’s last peak.

“We’re not even at the peak of the surge yet,” he added. “The numbers tell us that the worst of the surge is in front of us.”

The state, with a population of 1.4 million, has a seven-day average of more than 500 cases per day and a test positivity rate of 7.25%, Ige said Tuesday.

Eighty-six percent of Hawaii residents 18 and older have had at least one dose, but only 65% are fully vaccinated, according to a New York Times database. People younger than 12 are not eligible for the vaccine.

Health care workers cannot take on any more work, says one union leader.

“Working short-handed and double shifts is becoming the norm,” said Daniel Ross, president of the Hawaii Nurses Association. “This all leads to more burnout and more injuries, which exacerbates the shortage of skilled nurses.”

This article originally appeared in The New York Times.