California will require all state employees to prove they’ve been vaccinated or wear a mask in the office and get tested for the coronavirus at least once a week. New York City is taking similar action for its municipal workforce.

Covid infections globally increased the most in two months amid the spread of the Delta variant, a surge across the US and low vaccination levels in most Southeast Asian nations. The US Centers for Disease Control and Prevention told Americans to avoid travel to Spain.

Infections in Tokyo almost doubled from a week ago, according to city data released on Monday. Meanwhile, Olympics organisers reported 16 more cases, including three among athletes, on the fourth day of the spectator-free games.

Key developments:

• Global Tracker: Cases approach 194.2 million; deaths 4.16 million
• Vaccine Tracker: More than 3.86 billion doses administered
• Snowmobiles, rifles and gold on offer in world’s Covid lotteries
• An unusually deadly outbreak in Taiwan was driven by complacency
• Why is the Delta variant more dangerous? (Video)

Model shows 60% of US cases unreported

As many as 60% of Covid-19 cases in the US have gone unreported, and the coronavirus has infected nearly one in five Americans, according to a new model out of the University of Washington.

The model, which aims to mitigate biases in data capture, estimates that 65 million people, or 19.7% of US residents, had been infected as of 7 March 2021. The findings, which appear in Monday’s issue of Proceedings of the National Academy of Sciences, indicate the US is unlikely to reach community-level protection without continuing an ambitious vaccination campaign.

Africa must build vaccine capacity: WTO

African nations should build capacity to produce vaccines on the continent and work with pharmaceutical companies to ensure that the raw materials needed to produce the inoculations are available, according to World Trade Organization Director-General Ngozi Okonjo-Iweala.

While a waiver on the Trade-Related Aspects of Intellectual Property Rights, or TRIPS, is seen as a way to improve the supply of Covid-19 vaccines to the world’s least inoculated continent, Okonjo-Iweala cautioned that only a handful of African countries have the capacity to produce the life-saving drugs.

“There are a handful of countries — maybe Tunisia, Morocco to some extent, Senegal, South Africa — where we have some capacity; that’s why we are importing 99% of our vaccines,” Okonjo-Iweala said in a webinar hosted by the United Nations Economic Commission for Africa. “If we get IP today, we won’t be able to do anything with it because we don’t have investment, we don’t have manufacturing capacity.”

California issues vaccine mandate for workers

California will require all state employees to prove they’ve been vaccinated or wear a mask in the office, and get tested for the coronavirus at least once a week, state officials announced on Monday.

In addition to the requirement for state employees, California will require workers in all healthcare facilities — public and private — to provide proof of vaccination or wear a mask and submit to twice-weekly tests.

New Jersey hospitalisations jump by a third

New Jersey hospitalisations have increased more than a third in a week, to 419 patients, and almost 20% of the patients were in intensive care, according to Governor Phil Murphy. Though that was nowhere near the 2,400 people hospitalised in April during the state’s 2021 peak, Murphy warned that more people are likely to require medical care.

Over the past week, the state averaged 936 positive tests a day, about triple the number from May. The positivity rate hit 3.84%, versus 0.88% a month ago. The transmission rate continued to rise, to 1.44%, indicating that each positive case is leading to at least one more.

Murphy also disclosed that of all individuals who were hospitalised or died from mid-January to mid-July, more than 99% were unvaccinated.

“I beg you: Unless more of you, for whatever reason haven’t been vaccinated, step up and get your doses, these risks will remain,” Murphy said at a Trenton virus update.

Pfizer, Moderna expand child studies: NYT

Pfizer and Moderna are expanding the size of their studies in children aged five to 11 — a precautionary measure designed to detect rare side effects including heart inflammation problems that turned up in vaccinated people younger than 30, the New York Times reported.

Multiple people familiar with the trials said the Food and Drug Administration had indicated to Pfizer-BioNTech and Moderna that the size and scope of their paediatric studies, as initially envisioned, were inadequate to detect the rare side effects, including myocarditis, an inflammation of the heart muscle, and pericarditis, inflammation of the lining around the heart, the newspaper reported.

NYC extends vaccine mandate to all employees

New York City Mayor Bill de Blasio announced on Monday that all municipal workers will be required to receive the Covid-19 vaccine or get tested weekly starting 13 September, when students return to classrooms.

The vaccine mandate is the first expansion of a policy announced last week that requires healthcare workers in public hospitals and clinics to be vaccinated by 2 August or submit to weekly tests. About 60% of the city’s more than 42,000 public hospital employees have been vaccinated, according to Mitchell Katz, president and chief executive officer of the system. Only 54% of people are fully vaccinated in the city, which missed its goal of fully vaccinating five million New Yorkers by the end of June. Just over 4.5 million New Yorkers are fully vaccinated.

“The Delta variant has thrown us a curve ball,” De Blasio said in a briefing. “If someone is unvaccinated, unfortunately they pose a greater risk.”

Austria steps up control measures

Austrian authorities will increase scrutiny of measures aimed at containing the spread of the coronavirus amid growth in new cases. Restaurants, hotels and other services will be more closely monitored to check whether customers are vaccinated, have recovered or can show a recent negative test, the government said in a statement.

Travellers returning from Spain, the Netherlands and Cyprus will also face mandatory tests in Austria. Seven-day coronavirus incidence, a measure of the risk of contagion, increased to the highest since early June on Friday, though hospitalisations have stayed low.

Iranian cases jump to daily record

Infections in Iran climbed to the highest on record, with 31,814 new cases registered over the past 24 hours. The death toll rose by 322 overnight, the highest since May 12. The country now has recorded 89,122 deaths and more than 3.7 million cases.

Singapore eyes opening border

Singapore expects to vaccinate about 80% of the population with two doses by around early September, and aims to cover a similar proportion of people aged 70 and above, Finance Minister Lawrence Wong told Parliament on Monday. The city-state will then be able to begin reopening borders, especially for the vaccinated, to travel. DM

With assistance from Elise Young.