Cars line up to receive a Johnson & Johnson COVID-19 vaccine at the drive-through vaccination site at Six Flags Hurricane Harbor (Waterworld) in Concord, Calif., on Wednesday March 31, 2021. (Ray Saint Germain/Bay City News)

State officials announced Monday that health care workers and state employees will now be required to get vaccinated against COVID-19 or get tested regularly if they cannot verify their vaccination status.

The requirement, which officials underscored is not a pure vaccination mandate, will take effect Aug. 2 for state employees and Aug. 9 for a broad range of health care settings and facilities, including outpatient and long-term care facilities.

Those who choose to remain unvaccinated or cannot verify their vaccination status will be encouraged to wear a medical-grade face covering and required to test negative for the virus twice a week if they work in a hospital, or once a week if they work in an outpatient care facility like a dentist’s office.

“Too many people have chosen to live with this virus,” Gov. Gavin Newsom said Monday during a briefing in Oakland to announce the new requirements. “We’re at a point in this pandemic where individuals’ choice not to get vaccinated is now impacting the rest of us in a profound and devastating and deadly way.”

The new requirements are part of the state’s push to get more and more people vaccinated as a wave of new cases, spurred by the ultra-contagious delta variant and cases among unvaccinated people, threatens to halt the state’s progress in mitigating the virus’ spread.

The vast majority of the state’s current cases, hospitalizations and deaths are also among unvaccinated residents, with the number of new cases per day per 100,000 residents around 14 for unvaccinated residents and just two per 100,000 for fully vaccinated people.

The delta variant also accounts for roughly 80 percent of the current cases that have been analyzed across the state, according to data from the California Health and Human Services Agency.

The California Medical Association endorsed the requirements for health care workers shortly after Newsom’s announcement.

“We’ve come too far to ease up now in our fight against COVID-19,” CMA President Dr. Peter Bretan Jr. said in a statement. “It makes sense for the health care community to lead the way in requiring vaccines for our employees. We will continue to do all we can to help convince all Californians that vaccines are safe, effective and critical as we come together to bring this pandemic to an end.”

While state and local officials have shied away from outright mandating vaccinations, cracks in that wall have begun to show even as more than 70 percent of eligible state residents have gotten vaccinated.

Last week, health officials in San Francisco, Contra Costa and Santa Clara counties urged employers of all sizes to consider mandating that their employees get vaccinated, both to protect their co-workers as well as their customers.

On Monday, the U.S. Department of Veterans Affairs became the first federal agency to require that its health care workers get vaccinated in the coming weeks, lest they face penalties like increased testing and potential removal.

University of California, San Francisco, Department of Medicine Chair Dr. Bob Wachter noted in a Twitter post that the country appears at a tipping point for vaccination requirements.

“As each organization and industry finds the courage to mandate or strongly incentivize vaccination, it makes it that much easier for the next one to do so,” Wachter said. “Until the pressure is on leaders who have NOT done it.”

Newsom and California Health and Human Services Secretary Dr. Mark Ghaly noted that first-dose vaccinations increased 16 percent last week over the previous week, but argued that that pace must be maintained to keep the virus at bay.

Public health officials have also cautioned that while current data has found that fully vaccinated people are well protected against serious illness and death if they contract the delta variant, a future variant may find it much easier to circumvent the available vaccines.

“The fewer people that are vaccinated, the more likely we could have more variants like this delta variant,” state Sen. Nancy Skinner, D-Oakland, said at Monday’s briefing. “Right now we’re seeing that it is not very harmful to a vaccinated person, but how do we know what the next variant is going to be like?”

In recent weeks, Newsom has hinted at the relationship between online misinformation and the remaining vaccination holdouts, but offered his strongest rebuke Monday, equating not getting vaccinated to drunken driving.

“You’re putting other peoples’, innocent peoples’ lives at risk, you’re putting businesses at risk, you’re putting at risk the ability to educate our kids by getting them back in person full-time,” he said, adding that public officials need to be clearer about the societal costs of the pandemic continuing to flourish among the unvaccinated.

State officials said they expect health care settings to be fully in compliance with the new requirements by Aug. 23, giving unvaccinated employees time to get fully vaccinated with either the one- or two-dose vaccine regimen.

Newsom, when asked whether the state will issue additional mask and vaccination mandates, said he hopes the private sector will take those steps before the virus forces the state’s hand.

Even so, the governor reiterated his frequent argument that such mandates will likely be unnecessary – as long as those who are eligible get vaccinated.

“We can extinguish this disease,” Newsom said. “You won’t be asking about mask mandates, that’s the wrong question. The question is, why haven’t we followed the science and why aren’t we finishing the job?”