With more than 1,000 people hospitalized with COVID-19 across Louisiana, Gov. John Bel Edwards on Friday encouraged everyone, whether vaccinated or not, to wear masks indoors if they can’t stay distanced from others.

But the Democratic governor stopped short of issuing a statewide face covering mandate or new restrictions on activities and businesses amid the state’s fourth spike of COVID-19, driven by the highly contagious delta variant.

Louisiana — which has among the nation’s lowest COVID-19 vaccination rates — is seeing thousands of new confirmed cases of the coronavirus illness each day, and its hospitalizations have surged in recent weeks.

Edwards said Louisiana has the highest rate of new COVID-19 cases per capita in the nation and has been labeled a “state of concern” by the White House.

“We’ve effectively lost six months of progress over the last two or three weeks,” said Dr. Joe Kanter, the governor’s chief public health adviser.

Edwards placed the blame squarely on people refusing to get immunized against the coronavirus in a state where only about 48% of those eligible for the vaccines have gotten at least one shot.

“It pains me to say this, but this one is on us. This surge is on us. How bad it gets, how long it stays bad, how many people ultimately die — on us,” the governor said.

In addition to a return to mask-wearing indoors, Louisiana’s health department is suggesting even those who are vaccinated should get tested for COVID-19 if they have been exposed to the illness and recommending that people work remotely from home if possible.

Edwards is requiring masks to be worn in state buildings under his control if social distancing isn’t possible.

The governor’s latest state recommendations represent a break from some of the guidance offered by the U.S. Centers for Disease Control and Prevention. But Edwards and state health officials said the severity and speed of Louisiana’s latest surge of coronavirus cases warrants such a response.

The soaring hospitalizations of mostly unvaccinated COVID-19 patients are putting medical staffs in Louisiana under stress, as public health leaders and state officials continue to plead for people to get the shots that can prevent the disease.

“Our staff is feeling stretched. Our staff is also as you can imagine disheartened that we are going through this not one, two, three, but four times,” said Dr. Katherine Baumgarten, Medical Director of Infection Prevention for the 40-hospital Ochsner Health system. “This time it is even harder because we know that this is largely preventable.”

More than 90% of all new COVID-19 cases, hospitalizations and deaths are among those who aren’t fully vaccinated, Kanter said.

New Orleans Mayor LaToya Cantrell and Shreveport Mayor Adrian Perkins also told their cities’ residents this week that they should mask up indoors, regardless of vaccination status.

“We cannot afford to lose one more person, and we cannot afford to go into another shutdown,” Perkins said at an event with LSU Health Shreveport to encourage vaccinations.

Dr. John Vanchiere, director of the COVID-19 Strike Team at LSU Health Shreveport, talked about the rising rates of children and adults in the hospital with the coronavirus illness, as he urged people to get the widely available shots.

“Despite the myths that are promulgated in some of the social media, our vaccines do not impact fertility. Our vaccines don’t have magnets in them or chips in them that are tracking you. And they are safe,” he said. “Our vaccines have been saving lives every day.”

But it was unclear how many would take the masking advice.

Many were going without face coverings Thursday, the day after Cantrell issued a mask advisory, in New Orleans’ French Quarter. At Rendezvous Linen and Lace, store owner Kichin Mirpuri was unmasked: “I’m vaccinated. And I keep clean all the time.”

Louisiana is holding a weekly lottery this summer to try to drum up interest in the COVID-19 vaccine, with $2.3 million in cash prizes and scholarships to be awarded. The second round of winners were announced Friday: 65-year-old Edwina Jones, of Marrero, won $100,000 in cash while 14-year-old Andrew Homan, of Slidell, received a $100,000 college scholarship.