On Thursday, July 22, Philadelphia health officials issued updated COVID-19 safety recommendations to reduce the spread of the highly contagious delta variant.

Acting Health Commissioner Dr. Cheryl Bettigole said the city has been observing a small but alarming increase in COVID-induced hospitalizations among children, as well as more than a doubling of overall positive infections.

Over the past two weeks, the city has seen an average of 64 cases per day. Bettigole said in a statement that it’s up to adults to “step up,” as children under 12 can’t yet be vaccinated.

“They need you to step up. If you still have questions you need answered, call your doctor or our health department staff and get the information you need. And then get it done,” Bettigole said in a statement.

Currently, the COVID-19 vaccines are not approved for children under the age of 12. Federal health officials say that approval may not come until the winter of 2022. 

So far, the CDC reported that at least 335 American children under the age of 17 have died from coronavirus. More than 16,6000 have been hospitalized as of July 8, according to a report from the American Academy of Pediatrics. 

Philadelphia Mayor Jim Kenney concurred with the city’s new recommendations, adding that vaccinations are the best way to combat the spread and protect each other. 

“The numbers make it clear,” he said. 

In addition to urging residents to get vaccinated if they haven’t already, the health department strongly recommends that all Philly residents, whether vaccinated or not, return to wearing masks within all indoor public spaces. 

Officials also laid out a few more public health recommendations including opting to gather in outdoor spaces rather than indoor, and to continue avoiding large crowds, whether inside or outside.

They also suggested masking indoors around people whose vaccination status is unknown, and to consider double-masking while indoors. 

As of Thursday, around 917,700 Philadelphia residents have received at least one dose of the COVID-19 vaccine, and more than 750,000 are fully vaccinated — just over 60% of all adults. 

The delta variant has led to an increase in infections across the U.S. The highly-infectious mutation has resulted in a major rise in cases. 

According to data from Johns Hopkins University, the seven-day rolling average for new daily cases in the country increased just over the past two weeks to more than 37,000 as of Tuesday, July 21, a jump from less than 13,700 on July 6.

"We will continue to vaccinate anyone who is ready, and encourage them to join the million-plus people who received this life-saving vaccine in Philadelphia," Kenney said.

Health department spokesperson James Garrow said on Thursday that the new health guidance will remain a recommendation for now, but if things continue to worsen, a mask mandate will be considered. 

"Rather than overreact and clamp down — potentially alienating people — we’re trying to work with people to stand up and do the right thing to protect our children,” Garrow said.