MISSION, Kan. — The number of hospitalized COVID-19 patients jumped by nearly 27% over the Fourth of July weekend in a hard-hit area of Missouri where immunization rates are low, leading to a temporary ventilator shortfall and a public call for help from respiratory therapists.

The delta variant, first identified in India, is spreading rapidly, straining hospitals in Springfield and raising fresh fears that the situation could soon grow worse as holiday gatherings seed fresh cases. Missouri leads the nation with the most new cases per capita in the past 14 days.

As of Monday, CoxHealth and the city’s other hospital, Mercy Springfield, were treating 213 COVID-19 patients, up from 168 on Friday. As recently as May 24, the two hospitals had just 31 patients.

“After what we’ve seen in the last month everyone is just holding their breath, especially after a holiday weekend like this, knowing that there were large gatherings,” said Erik Frederick, the chief administrative officer of Mercy Springfield.

Many communities that held off on Fourth of July festivities in 2020 held them this year.

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MORE ON THE PANDEMIC:

— Indonesia seeks more oxygen for COVID-19 sick amid shortage

— Luxembourg prime minister hospitalized after positive test

— Iran reimposes virus restrictions as delta variant spreads

— Johnson says UK must live with virus as he announces easing

— Follow more of AP’s pandemic coverage at https://apnews.com/hub/coronavirus-pandemic and https://apnews.com/hub/coronavirus-vaccine

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HERE’S WHAT ELSE IS HAPPENING:

BERLIN — Germany is easing strict restrictions on travel from Britain, Portugal and some other countries that were imposed because of the rise of the more contagious delta variant of the coronavirus.

Germany’s national disease control center, the Robert Koch Institute, said late Monday that Britain, Portugal, Russia, India and Nepal will be removed from the country’s highest risk category of “virus variant areas” effective Wednesday. They will move into the second-highest category of “high-incidence areas.”

The U.K. had been in the top risk category since May 23, and was joined last Tuesday by Russia and Portugal, one of Germany’s partners in the European Union.

Airlines and others are restricted largely to transporting German citizens and residents from “virus variant areas,” and those who arrive must spend 14 days in quarantine at home.

People arriving from “high incidence areas” can avoid quarantine if they can prove that they are fully vaccinated or have recovered from COVID-19. Others can cut short a mandatory 10-day quarantine by testing negative after five days. Transport is no longer restricted.

Officials have said the listings would be reviewed as the proportion of infections caused by the delta variant in Germany rises. Although overall case numbers are very low, more than half of new cases are now believed to be caused by delta.

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LONDON — Prime Minister Boris Johnson says people in England will no longer be required by law to wear face masks in indoor public spaces and to keep at least 1 meter (3 feet) apart as soon as later this month.

Johnson confirmed Monday that legal sanctions will be replaced by individual “informed decisions” when the country moves to the final stage of its lockdown-lifting roadmap. He said that is scheduled to happen on July 19, though a final decision will come July 12.

The change will mean people can throw away masks after months of enforced face-covering, though businesses and transit operators may still require them. They will still be recommended in some enclosed spaces.

Britain has recorded more than 128,000 coronavirus deaths, the highest toll in Western Europe. Confirmed infections are rising due to the highly transmissible delta variant of the virus.

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BERLIN — Chancellor Angela Merkel says that Germany will donate 3 million doses of coronavirus vaccine to countries in the western Balkans region “as soon as possible.”

Germany said in late May that it was prepared to donate a total of 30 million doses to poorer countries before the end of this year.

Merkel said Monday that most of those doses will be given to the U.N.-backed COVAX program to get vaccines to needy nations, but 3 million will be given directly to the western Balkan countries. She spoke after a video meeting with leaders from the region.

She didn’t give a specific timeline for the donations.

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BERLIN — Germany’s disease control center says the country should aim to vaccinate 85% of people ages 12-59 and 90% of people over 60 to prevent the delta variant causing a strong resurgence of coronavirus cases this autumn and winter.

Monday’s report by the Robert Koch Institute was based on mathematical modelling and survey findings. It comes as Germany’s infection rate is at its lowest in months. On Monday, the institute said that five new cases per 100,000 residents have been reported over the past week. But the more contagious delta variant is thought to account for more than half of new cases.

The report said the vaccination targets are reached soon enough, then “a strong fourth wave in the coming fall/winter appears unlikely,” provided people also use basic hygiene measures and reduce contacts if infection rates rise.

Germany had given 56.5% of its entire population at least one vaccine shot by Sunday and 38.9% were fully vaccinated.

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MADRID — Some regions in Spain are reinstating nightlife restrictions only weeks after dropping them, part of an attempt to stem a spiraling number of coronavirus infections among unvaccinated young people.

Fearing that the surging virus could strain healthcare services, health officials in several parts of the country are also hurrying to reach people under 30 with COVID-19 vaccines. Spain’s strict vaccination rollout has so far focused on older, more vulnerable groups.

On Friday, the 14-day contagion rate among those ages 20 to 29 years was nearly three times the national average.

The virus has also spread among teenagers as a result of trips and parties to celebrate the end of the school year.

Thousands have been in isolation nationwide after more than 1,000 infections were tied to student trips to the Mallorca islands and at least 700 have tested positive in mass screenings made in the Navarra region among students who went to a beach resort last month.

Nightlife will be completely closed in at least 16 towns of the northern Cantabria region, which leads the nation’s virus tally.

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MOSCOW — Early trials of Russia’s Sputnik V vaccine among children ages 12 to 17 have started in Moscow, city officials said Monday.

Deputy Mayor Anastasia Rakova said 100 volunteers have been recruited who haven’t been previously infected with the coronavirus and don’t have health issues that would prevent them from getting the shots. Rakova said the youths will receive a small dose of Sputnik V than what is usually administered for adults.

The new trial comes as Russia faces a sharp surge in coronavirus infections and struggles to ramp up its low vaccine uptake. As of last week, only 23 million people, or just over 15% of the country’s 146-million population, have received at least one shot of a coronavirus vaccine.

In the meantime, the number of daily new virus cases have more than doubled over the past month, going from roughly 9,000 a day in early June to over 24,000 this week. On Monday, Russia’s state coronavirus task force reported 24,353 new cases and 654 deaths.

Russian authorities have registered over 5.6 million confirmed cases of the virus in the pandemic and 138,579 deaths.

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BERLIN — The German government is rejecting calls to fine people who don’t show up to vaccination appointments and fail to cancel them beforehand.

The head of the German Red Cross’s Berlin branch, Mario Czaja, has suggested fines of 25 to 30 euros ($29.65 to $35.60) for people who fail to turn up for appointments at vaccination centers. He says the number of such no-shows has increased in recent weeks.

His call has drawn a mixed response. Chancellor Angela Merkel’s spokesman, Steffen Seibert, said Monday that appointments are “valuable” and appealed to people to cancel if they can’t keep them. But he said that “the federal government has no plans for fines.”

Health Ministry spokeswoman Parissa Hajebi said that “we want to motivate citizens to get vaccinated and we don’t to scare them off and threaten punishment.” She said the ministry didn’t have information that no-shows were a widespread phenomenon.

Germany had given 56.5% of its population at least one vaccine shot by Sunday and 38.9% were fully vaccinated.

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ISLAMABAD — Normalcy returned at COVID-19 vaccination centers across Pakistan on Monday, days after Washington delivered 2.5 million doses of the Moderna vaccine to Islamabad.

That enabled Pakistan's government to overcome shortages of specific vaccines which were needed to inoculate expatriate workers wishing to travel abroad.

Moderna vaccines were delivered to Pakistan last week by Washington in partnership with the COVAX global vaccine initiative and UNICEF.

Before receiving this vaccine, Pakistan had mostly relied on Chinese vaccines.

Pakistan faced the shortage of specific vaccines last month after some Middle Eastern countries asked travelers to produce a certificate to show they’ve received specific vaccines, including the Moderna, Pfizer or AstraZeneca shots.

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LONDON — Britain’s royal palace says the Duchess of Cambridge is self-isolating after a contact tested positive for the coronavirus.

Kate had been due to attend events with her husband Prince William on Monday celebrating the 73rd birthday of Britain’s National Health Service.

But the couple’s Kensington Palace office says the duchess is self-isolating at home after coming into contact last week with someone who subsequently tested positive.

Under current British rules, contacts of confirmed coronavirus cases must quarantine at home for 10 days.

The palace says Kate, who is 39, does not have any symptoms of COVID-19.

Both Kate and William received first doses of coronavirus vaccine in May.

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BRUSSELS — Luxembourg Prime Minister Xavier Bettel has been hospitalized and is under observation “as a precautionary measure” after testing positive for COVID-19 a week earlier.

A government official, who spoke on customary condition of anonymity, said there was no update with new information early Monday after Bettel had been taken in for 24 hours of testing and medical analysis on Sunday.

The 48-year-old Bettel announced his positive test just after he had attended an European Union summit with 26 other leaders from the bloc for two days. At first he experienced only mild symptoms. But on Sunday, he had to be hospitalized.

EU summit organizers said they were confident that all virus precaution measures had been strictly adhered to during the two-day meeting. So far, no other leader has said he or she tested positive.

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COLOMBO, Sri Lanka — Sri Lanka on Monday received a first batch of Pfizer's COVID-19 vaccine, becoming the first country in South Asia to get the U.S.-made COVID-19 jab.

Officials say 26,000 doses of Pfizer vaccine directly purchased by the Sri Lankan government was flown into the country on Monday.

Health authorities say that Sri Lanka had signed agreements to purchase 5 million Pfizer doses this year. The country is expected to receive about 200,000 Pfizer doses this month.

Sri Lankan President Gotabhaya Rajapaksa tweeted that “Sri Lanka becomes the first country in South Asia to acquire a contingent of Pfizer vaccines.”

Sri Lankan health authorities have so far used AstraZeneca doses manufactured in India, China's Sinopharm and Russia's Sputnik V in the country's battle against COVID-19.

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SEOUL, South Korea — South Korea has reported 711 new cases of the coronavirus as infections continued to grow in the greater capital area.

It was the third straight day of over 700 cases and the highest daily jump for a Monday since early January, when the country was enduring its worst wave of the pandemic.

Usually a smaller number of cases are reported at the start of the week, due to reduced testing on weekends, and the country’s caseload may grow faster over the next few days.

The Korea Disease Control and Prevention Agency said around 550 of the new cases came from the populated Seoul metropolitan area, where officials delayed a planned easing of social distancing measures to cope with a rise in transmissions.

Cases were also reported in most of the major cities and towns across the country, including Busan, Daejeon and the North and South Gyeongsang provinces.

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WASHINGTON — President Joe Biden says the American people are closer than ever to declaring independence from a deadly virus.

The president made the comments Sunday at a July Fourth celebration at the White House.

He told a crowd of service members and first responders to think back to where this nation was a year ago and think about how far the nation has come.

During the brief and optimistic comments, Biden said that thanks to the power of science, the country is seeing a return to normal and the return of economic health.

But he warned that the nation has not defeated the virus. He encouraged those who have not been vaccinated to get their shots. He said the vaccines are important for the nation to avoid where it was a year ago.

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JAKARTA, Indonesia — Indonesia is requiring foreign visitors to be fully vaccinated as one of the entry requirements as the country tries to curb the spread of COVID-19.

Ganip Warsito, National Task Force for COVID-19 Mitigation Chief, says that starting on Tuesday, both foreigners and Indonesian nationals entering the country have to show digital or physical proof that they have been fully vaccinated.

The obligation to show vaccination cards can be excluded in some cases, including diplomatic visas and service visas, and during official visits at ministerial level.

The government is also extending the quarantine time for foreign travelers from five days to eight days.

The Associated Press