PORTLAND, Ore. (AP) — Gov. Kate Brown on Tuesday announced a statewide indoor mask requirement in Oregon as coronavirus hospitalizations and cases reach record high numbers in the state and health care systems are overwhelmed.

Beginning Friday, everyone who is 5 years or older in Oregon — regardless of vaccination status — will be required to wear masks in indoor public spaces. Brown had urged local officials to implement their own mandates, but almost none did.

The newest coronavirus health and safety measure in Oregon applies to all indoor public spaces, including businesses, grocery stores, indoor entertainment venues and gyms. In addition, people older than two years old will be required to wear masks on public transit.

There are some mask exemptions for activities, including eating, drinking, swimming and organized sports.

The mask mandate comes as the state on Wednesday set a second consecutive record of hospitalized COVID-19 patients — 665 people. The previous record of 622 people hospitalized was set during November’s surge, when vaccine doses were not yet available.

Intensive care unit beds across the state are about 90% full, and some hospital regions have less than five ICU beds available, Brown said.

“When our hospitals are full, there will be no room for additional patients needing care –– whether for COVID-19, a heart attack or stroke, a car collision, or a variety of other emergency situations," Brown said.

The Pacific Northwest state is not alone. In Florida, Arkansas and Louisiana, COVID-19 is clobbering health systems with more people hospitalized with the virus than at any other point in the pandemic — straining and overwhelming the already limited staff.

Health officials in Oregon warned that, without new health and safety interventions in place, coronavirus hospitalizations would far exceed Oregon’s health system capacity in the next several weeks.

Brown described health the latest projections as a stark reminder that “the pandemic is far from over” and a “disappointing reminder that we still have dark days ahead.”

“The latest science is clear that both vaccinated and unvaccinated individuals are able to spread the delta variant,” Brown said. “Masks are simple, and they are effective.”

Oregon is the third state — joining Hawaii and Louisiana — to require vaccinated and unvaccinated people to wear masks inside public spaces statewide. The mandates emerge amid a surge in coronavirus cases, hospitalizations and deaths in the U.S., driven by the highly contagious delta variant.

Some states are going beyond mask measures, requiring health care workers and state employees to be vaccinated. On Wednesday Gov. Gavin Newsom announced that California would become the first state in the nation to require all teachers and school staff to get vaccinated or undergo weekly coronavirus testing.

In addition, local officials in several Republican-led states that banned mask mandates earlier in the pandemic — including Arizona and Florida — are now defying their state’s prohibitions as school districts require masks ahead of students returning to school.

Throughout the pandemic, health officials have described Oregon as a success story as it has had some of the lowest coronavirus case and death rates nationally – largely in part because of the state’s strict restrictions, which were lifted at the end of June.

As the delta variant began rapidly spreading across the state last month, Brown turned to county officials — giving them local control on whether or not to implement mask mandates.

“From the beginning of this pandemic, city and county leaders have asked me for local control and the ability to make local public health decisions when it comes to COVID-19,” Brown said.

Earlier this month, the governor announced that masks would be required in K-12 schools and in any indoor state agency building. In addition the state health authority made a statewide recommendation that people, vaccinated or not, wear masks while in indoor public spaces, but again stopped short of reinstating an indoor mask mandate.

As coronavirus cases spiked, there continued to be inaction by nearly all of the state's counties. A few counties issued mask mandates for county agency buildings. However only one county — Multnomah — announced a mask requirement for all public indoor spaces.

The Associated Press reached out to each Oregon's 36 counties this month to ask about plans to implement mask mandates. Out of the 16 counties that responded, nearly all indicated that they were concerned about the rise in coronavirus cases but only one had issued an indoor mask mandate and most gave a resounding “No” when asked if they had plans to issue one.

"At this point, those who are most likely to adhere to a mask mandate are already vaccinated, so I’m not convinced new mandates will be all that effective in containing the Delta variant,” Gilliam County Judge Elizabeth Farrar Campbell said.

While county officials said they felt the decision to implement mask requirements should be a local decision, health officials urged the governor to issue a statewide mandate as hospitals became overwhelmed with an influx of COVID-19 patients.

“OHSU believes the entire state should be masking,” Renee Edwards, the chief medical officer at Oregon Health & Science University, said Monday. “I recognize this is being decided at a local level, but every community’s actions will lead to consequences at a state and even a global level.”

In a final call to action, Brown met with county leaders and elected officials last week and urged them to institute mask requirements. The reimplementation of the mask mandate is occurring 44 days after the state lifted restrictions.

“The latest science is clear: although unvaccinated individuals are more likely to contract the disease, both vaccinated and unvaccinated people can spread the Delta variant,” Brown said. “Masks are a simple and effective way to make sure you are not unknowingly infecting your friends, family members, neighbors, and colleagues.”

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Sara Cline is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.