The global tally of confirmed cases of the coronavirus-borne illness COVID-19 climbed above 180 million on Friday and the death toll moved closer to 4 million, amid fresh outbreaks of the highly infectious delta variant around the world that experts say are concerning.

Israel, an early success story in containing the outbreak and getting its citizens vaccinated, is reinstating mandatory face masks in indoor settings from next week to combat a fresh wave of cases. The move comes just 15 days after it dropped the mandate. About 70% of new cases in recent weeks are understood to be caused by the delta variant and include many people who are fully vaccinated, according to local media.

Residents of parts of Sydney, Australia, are being asked to remain in place for at least a week as officials work to end an outbreak of the delta variant, the Wall Street Journal reported. In the U.K., which also has a high vaccination rate, delta variant cases have climbed 46% from a week ago, the Guardian reported.

Parts of Europe, meanwhile, including Spain, are moving in the opposite direction and are ending face-mask orders from Saturday, as Reuters reported. Neighboring France had already ended its face-mask mandate on June 17.

U.K. Prime Minister Boris Johnson announced a four-week extension to the country’s Covid-19 restrictions Monday as the country deals with an increase in Delta variant infections. WSJ’s Jason Douglas explains what that could mean for the global effort to contain the virus. Photo: Henry Nicholls/Reuters

See now: Brazil and Russia see fresh wave of COVID cases, showing pandemic is far from over in many places

Meanwhile, nearly all of the deaths from COVID in the U.S. are now people who have not been vaccinated, according to an Associated Press analysis, showing how effective the vaccines are in reducing deaths.

Government data from May shows that only about 150 of the more than 18,000 COVID-19 deaths in May were in fully vaccinated people. That translates to about 0.8%, or five deaths per day on average. The data shows that“breakthrough” infections in fully vaccinated people accounted for fewer than 1,200 of more than 853,000 COVID-19 hospitalizations. That’s about 0.1%.

The numbers suggest the U.S. could greatly reduce its death toll from just under 300 a day currently if everyone eligible got vaccinated.

The Centers for Disease Control and Prevention’s vaccine tracker is showing how slowly the program is now moving with 151.3 million Americans fully vaccinated, equal to 45.6% of the population. That means they have have received two doses of the vaccines developed by Pfizer Inc. PFE, +0.01%  with German partner BioNTech SE  BNTX, -0.50% or Moderna Inc. MRNA, +1.07% or one of Johnson & Johnson’s JNJ, +0.33% single-dose vaccine. That’s up from 45.4% a day earlier.

Among adults 18-years-and-older, 145 million people are fully vaccinated, equal to 56.2% of that group. Some 170 million people in that group have had at least one shot, equal to 65.7% of that population. The Biden administration said Thursday that over 70% of the U.S. population that’s 30 or older has received at least one shot.

But experts are concerned over the take-up rate in the South, in particular, where many states are still below 40% of their populations fully vaccinated. The list includes Alabama, Mississippi and Louisiana.

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Louisiana, which has vaccinated just 34% of its people, is introducing a lottery with $2.3 million in cash prizes for adults who get at least one vaccine dose, following other states who have offered similar incentives.

Ohio ended its lottery on Thursday with its vaccination rate still below 50%.

Elsewhere, San Francisco city workers will be required to be vaccinated against the coronavirus when a vaccine receives full federal approval, the AP reported.

See now: Moderna and Pfizer are already developing COVID-19 vaccine boosters. Do we need a third shot?

The policy covering 35,000 municipal workers may be the first by any city or county in the U.S. Employees who refuse to get vaccinated and don’t get an exemption could be fired, according to the policy posted to the city government’s website Wednesday.

In medical news, Roche Holding Group ROG, +0.51% said its COVID-19 drug has been authorized in the U.S. as a treatment for those who have been hospitalized with COVID-19 who are at least two years old, as MarketWatch’s Jaimy Lee reported.

The drug, Actemra, is already approved by the Food and Drug Administration as a treatment for rheumatoid arthritis. The intravenous therapy is reserved for the very ill, including those patients already taking steroids, on oxygen, or being ventilated. 

Latest tallies

The global death toll from COVID-19 stands at 3.9 million, according to data aggregated by Johns Hopkins University.

The U.S. continues to lead the world in total cases at 33.6 million, and by deaths that total 603,183.

 India is second in total cases at 30.1 million and third by fatalities at 393,310, although those numbers are expected to be undercounted given a shortage of tests.

Brazil has the third-highest caseload at 18.2 million, according to JHU data, and is second in deaths at 509,141.

Mexico has fourth-highest death toll at 232,068 and 2.5 million cases.

In Europe, Russia has overtaken the U.K. by deaths. Russia has 129,869 fatalities, while the U.K. has 128,312, making Russia the country with the fifth-highest death toll in the world and highest in Europe.

China, where the virus was first discovered late in 2019, has had 103,655 confirmed cases and 4,847 deaths, according to its official numbers, which are widely held to be massively underreported.

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