OAKLAND, Calif. — California on Monday became the first state to announce that it will require that all state and health care workers get vaccinated for COVID-19 or submit to weekly or bi-weekly testing, as officials grapple with a rising number of cases nationwide.

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The new rule will go into effect next month and apply to the state’s at least 238,000 government employees and at least 2 million health care workers across both the public and private sectors, The Associated Press reported.

“If they’re not vaccinated and cannot verify that they’ve been vaccinated, we are requiring that they get tested,” Gov. Gavin Newsom said Monday at a news conference announcing the decision. “California’s committing to vaccinating, verification… or testing on a weekly basis. … In healthcare settings, they’re committing to not only verification of vaccines, but also testing, and that testing cadence will increase to twice a week in high-risk, highly vulnerable settings.”

The announcement comes as officials across the U.S. consider measures aimed at encouraging skeptical Americans to get vaccinated against COVID-19. On Monday, New York City Mayor Bill de Blasio announced that city employees will be required to be vaccinated or submit to weekly COVID-19 testing beginning in September.

As of Sunday, the latest date for which data was available, about 62% of California’s population, or 21 million people, have been fully vaccinated, according to state officials. Authorities said an additional 3.1 million people have gotten at least one dose of the available COVID-19 vaccines.

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Nationwide, 69% of all adults have received at least one vaccine dose as of Sunday, according to data from the Centers for Disease Control and Prevention. About 50% of the total U.S. population has been fully vaccinated.

“Too many people have chosen to live with this virus,” Newsom said Monday, pointing to the rising number of cases which health officials have pinned on unvaccinated Americans and the prevalence of the highly transmissible delta variant. “That choice has led to an increase in case rates, growing concern around increase in death rates, and self-evidently around hospitalization rates. Not just in the state of California ... but across of the rest of the nation.”

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More than 3.8 million cases of COVID-19 have been reported across California, resulting in more than 63,800 deaths, according to the California Department of Public Health.

The United States leads the world with the most coronavirus cases and the highest death toll. Since the start of the pandemic, officials have confirmed more than 34.4 million infections and reported more than 611,000 deaths nationwide, according to numbers compiled by Johns Hopkins University.

More than 194.5 million COVID-19 cases have been reported worldwide, resulting in 4.1 million deaths, according to Johns Hopkins.

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