ROCHESTER, N.Y. (WROC/AP) — On Tuesday, Governor Andrew Cuomo announced New York would require state employees and health care workers to be vaccinated. Amid rising cases of coronavirus—which are largely happening in people who have not received the vaccine—a number of workplaces are considering, or have already put in place, a COVID vaccine requirement.

Plus, states and businesses scrambled Wednesday to change course after the federal government issued new guidance calling for the return of mask-wearing in virus hot spots amid a dramatic spike in COVID-19 cases and hospitalizations nationwide. The guidelines also call on all schools to require masks for students, teachers, and visitors, and districts around the country tried to navigate the latest advice.

The U.S. Department of Veterans Affairs announced it would mandate vaccinations for physicians, nurses, and some other employees. Workers with VA Finger Lakes, with locations throughout the Rochester area, will see that come into play.

“What we’re doing is running the numbers and names of those that have not been vaccinated, said Bruce Tucker, the Medical Center Director for VA Finger Lakes, “and we’ll be notifying them over the next few weeks that they have not been vaccinated, to set up the appointment to become vaccinated, or to ensure that if they can’t they fit in one of those two declination categories.”

Those categories, Tucker notes, are religious and medical exemptions. He said that around 80% of employees in their system are already vaccinated. VA Finger Lakes serves around 33,000 veterans, spanning the Rochester area to Northern Pennsylvania.

The CDC’s new guidance applies to places with at least 50 new cases per 100,000 people in the last week, which is roughly 60% of all U.S. counties, federal officials said. Nearly all of the South and Southwest are subject to the guidance, but most communities in the Northeast—with the exception of major metro areas like New York City and Boston—are exempt for now, according to the CDC’s COVID tracker.

Paul Keneally, an employment attorney with Underberg and Kessler, said he’s already seeing some companies mandate vaccinations for employees. “There’s a few companies that are clients of mine that are requiring the vaccination. Usually giving employees a bit of notice, a little lead time, saying ‘you have to be vaccinated by labor day or October first,'” Keneally said. “Some are choosing to do that, and they’re able to.”

In Provincetown, Massachusetts, where officials earlier this week re-imposed an indoor mask requirement following a surge in COVID-19 cases this month, store owner Patrick Patrick says he doesn’t mind asking customers to mask up once more. The owner of Marine Specialties, a long-running Army-Navy store, had been leery of officials dropping virus safety mandates ahead of what many expected would be a busy summer season.

He even tried to require customers to mask up in his store through the summer, before finally relenting in June. “If we’d stuck with masks all along, I don’t think we’d be having this conversation,” Patrick said, adding that he’s required all his staff to be masked and vaccinated. “They’re not entirely fun, but we wore them all last summer, and we didn’t have a single case in Provincetown. Now, see where we’re at.”

As of Tuesday, the town had reported more than 750 cases of COVID-19 associated with the most recent cluster, which started around the busy July 4 holiday. Officials have said many cases are so-called breakthrough infections in vaccinated people. Three people have been hospitalized, but no one has died.

Patrick says the business drop-off has been significant, but he hopes the return of masks helps bring visitors peace of mind. “I don’t see masks as bad for business,” he said. “Maybe for a nightclub or bar it is. But if it gets people back out and feeling safe, it’s worth it. We take care of public health and safety, the dollars and cents will take care of themselves.”

Nevada and Kansas City were among the locations that moved swiftly to re-impose indoor mask mandates following Tuesday’s announcement from the Centers for Disease Control and Prevention. But Other government leaders said they will hold off reinstating mask rules for now.

Pennsylvania Gov. Tom Wolf said he’s not considering imposing a mask mandate in schools or statewide, though he urged Pennsylvanians to follow federal guidelines. The Democrat said state mandates on masks were necessary before there was a vaccine. “People have the ability to make the decision to get a vaccine,” he said, speaking Tuesday on Pittsburgh radio station KDKA-AM. “If they do, that’s the protection.”

Conservative officials push back against reviving mask mandates, setting up the potential for a patchwork of regulations within states and counties. In a handful of Republican-led states, lawmakers have even made it illegal for schools to require masks. South Carolina’s governor said the state would not reverse its mask restriction, but Arkansas leaders are weighing whether to revisit an April law banning local and state government entities from requiring masks. Republican Gov. Asa Hutchinson has faced growing calls to lift that ban, at least for schools, as virus cases and hospitalizations surge in the state.

Ford Motor Co., meanwhile, said it would reinstate face mask protocols for all employees and visitors at its Missouri and Florida facilities. The two states are among the hardest-hit by the summer surge in which the U.S. is now averaging more than 60,000 new cases a day, driven by the highly contagious delta variant spreading through unvaccinated populations. In Missouri, the St. Louis County Council voted Tuesday to reverse the county’s mask mandate, just a day after it became one of the first reinstated in the country.

But Democratic County Executive Sam Page insisted Wednesday that the mandate remained in effect and blamed the pushback on politics. “This is a national problem that went all the way up to the top with the last president,” he said. “And we do have some folks in our country who work very hard to undermine public health efforts with a lot of very inflammatory rhetoric.”

On the other side of the state, Kansas City Mayor Quinton Lucas, a Democrat, promised to provide details Wednesday on his plans to order mask-wearing indoors in Missouri’s largest city. “We cannot ignore the rapid spread of the COVID-19 delta variant in Missouri—outpacing much of the country,” he said in a statement. “We will do all we can to ensure our corner of this state is safe.”

Meanwhile, in Springfield, a hospital began expanding its morgue capacity as the state’s virus death toll soared. Steve Edwards, the CEO of CoxHealth, said his company brought in temporary cooling equipment because 75 patients in area hospitals have died this month.

CDC Director Rochelle Walensky said Wednesday that her agency’s updated guidance was prompted by new data suggesting vaccinated people can pass on the virus in rare cases. “I know this is not a message America wants to hear,” she told CNN. “With prior variants, when people had these rare breakthrough infections, we didn’t see the capacity of them to spread the virus to others, but with the delta variant, we now see that you can actually now pass it to somebody else.”

Walensky stressed that COVID vaccines are working by preventing greater levels of hospitalization and death. Unvaccinated people, she also noted, account for the vast number of new infections. Two-thirds of the vaccine-eligible population in the U.S. has received at least one dose.

“We can halt the chain of transmission,” she told “CBS This Morning” on Wednesday. “We can do something if we unify together, if we get people vaccinated who are not yet vaccinated. If we mask in the interim, we can halt this in just a matter of a couple of weeks.”