The Texas governor, Greg Abbott, appealed for out-of-state help to fight the third wave of Covid-19 in his state amid dire warnings while two more of the state’s largest school districts announced mask mandates in defiance of the increasingly hardline Republican.

Abbott’s request came on Monday as a county-owned hospital in Houston raised tents to accommodate their coronavirus patient overflow.

Private hospitals in the county already were requiring their staff to be vaccinated against the coronavirus.

Meanwhile, the Dallas and Austin school districts announced Monday that they would require students and staff to wear face masks. The Houston school district had announced it would implement a mask mandate for its students and staff later this week if its board approves.

The highly contagious Delta variant is causing a majority of new infections.

The Republican governor has directed the Texas department of state health services to use staffing agencies to find additional medical staff from beyond the state’s borders as the Delta wave began to overwhelm its present staffing resources.

He also has sent a letter to the Texas Hospital Association to request that hospitals postpone all elective medical procedures voluntarily.

Hospital officials in Houston said last week that area hospitals with beds had insufficient numbers of nurses to serve them.

Abbott also directed the state health department and the Texas division of emergency management to open additional Covid-19 antibody infusion centers to treat patients not needing hospital care and to expand vaccine availability to the state’s underserved communities.

He also announced about $267m in emergency Supplemental Nutrition Assistance Program food benefits for August. That was on top of the $3.9bn in benefits previously allocated since April 2020.

The governor is taking action short of lifting his emergency order banning county and local government entities from requiring the wearing of masks and social distancing to lower the Covid-19 risk.

Abbott has said repeatedly that Texans have the information and intelligence to make their own decisions on what steps to take to protect their health and the health of those around them. Dallas county judge Clay Jenkins filed a lawsuit asking a judge to strike down Abbott’s mask mandate ban.

One of Houston’s two county-owned hospitals, Harris Health System and Lyndon B Johnson hospital in north-eastern Houston, added nearly 2,000 sq ft of medical tents in the hope of taking control of the anticipated increase in patient volume and keep staff and non-Covid patients safe.

Last week, Houston area officials said the wave of Delta variant infections so strained the area’s hospitals that some patients had to be transferred out of the city, with one being sent to North Dakota.

The rolling two-week daily average of new Covid-19 cases in Texas has increased by 165% to 8,533, according to Johns Hopkins University research data.

About 45% of the state’s population has been vaccinated against the coronavirus, according to the US Centers for Disease Control and Prevention.

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