The governor of New York, Kathy Hochul, is considering using the national guard and out-of-state medical workers to fill hospital staffing shortages, as tens of thousands of workers are unlikely to meet a Monday deadline for mandated Covid-19 vaccination.

The plan, outlined in a statement, would allow the governor to declare a state of emergency and thereby increase the supply of healthcare workers to include licensed professionals from other states and countries as well as retired nurses.

Hochul said the state was also looking at using national guard officers with medical training to keep hospitals and other medical facilities adequately staffed.

Some 16% of the state’s 450,000 hospital staff, or roughly 70,000 workers, have not been fully vaccinated, the governor’s office said.

“We are still in a battle against Covid to protect our loved ones,” Hochul said.

“I commend all of the healthcare workers who have stepped up to get themselves vaccinated, and I urge all remaining healthcare workers who are unvaccinated to do so now so they can continue providing care.”

The plan comes amid a broader battle between state and federal government leaders pushing for vaccine mandates to help counter the highly infectious Delta variant of the coronavirus and workers who are against inoculation requirements, some on religious grounds.

On Sunday, Hochul attended a service at a large church in New York City, to ask Christians to help promote vaccines.

“I need you to be my apostles. I need you to go out and talk about it and say, we owe this to each other,” Hochul told congregants at the Christian Cultural Center in Brooklyn.

“Jesus taught us to love one another and how do you show that love but to care about each other enough to say, please get the vaccine because I love you and I want you to live.”

Healthcare workers who are fired for refusing to get vaccinated will not be eligible for unemployment insurance unless they are able to provide a valid doctor-approved request for medical accommodation, Hochul’s office said.

It was not immediately clear how pending legal cases concerning religious exemptions would apply to the state’s plan to move ahead and fire unvaccinated healthcare workers.

A federal judge in Albany temporarily ordered New York state officials to allow religious exemptions for the state-imposed vaccine mandate on healthcare workers, which was put in place by former Governor Andrew Cuomo.

A requirement for New York City school teachers and staff to get vaccinated was temporarily blocked by a US appeals court just days before it was to take effect. A hearing is set for Wednesday.

The highly transmissible Delta variant has driven a surge in Covid-19 cases and hospitalizations in the US that peaked in early September and has since fallen, according to a Reuters tally. Deaths, a lagging indicator, continue to rise with the US reporting about 2,000 on average a day for the past week, mostly in the unvaccinated.

While nationally cases are down about 25% from their autumn peak, rising new infections in New York have only recently leveled off.

In an attempt to better protect the most vulnerable, the Centers for Disease Control and Prevention (CDC) on Friday backed a booster shot of the Pfizer-BioNTech Covid-19 vaccine for Americans aged 65 and older, adults with underlying medical conditions and adults in high-risk working and institutional settings.

On Sunday the CDC director, Dr Rochelle Walensky, fleshed out who should be eligible for the booster shots based on their work in high-risk settings.

“That includes people in homeless shelters, people in group homes, people in prisons, but also importantly, our people who work … with vulnerable communities,” Walensky told CBS’s Face the Nation. “So our healthcare workers, our teachers, our grocery workers, our public transportation employees.”

Walensky decided to include a broader range of people than was recommended on Thursday by a group of expert outside advisers to the agency. The CDC director is not obliged to follow the advice of the panel.