As the Covid-19 Delta variant tightens its grip on the United States, that grip is nowhere tighter than in the southern state of Louisiana, where the sky-high rate of infections is the worst in the country.

With hospitals hammered and healthcare workers struggling amid a furious virus surge that has brought the state's daily average of infections to 126 per 100,000 inhabitants, historic New Orleans has opted for decisive action: on Monday it will follow New York and San Francisco in requiring what amounts to a "health pass" for entry to an array of venues.

"We're here today because we really have no choice," said Mayor LaToya Cantrell. "The situation is dire and we are simply out of time."

People in New Orleans will now be required to present either proof of vaccination or a negative virus test to be admitted to a variety of venues
People in New Orleans will now be required to present either proof of vaccination or a negative virus test to be admitted to a variety of venues AFP / Emily Kask

People will now be required to present either proof of vaccination or a negative virus test to be admitted to bars, restaurants, sporting arenas and fitness centers -- and even to attend major outdoor events including NFL football games at the city's Superdome.

This aggressive approach has polarized residents of the state's biggest city.

Some put aside their doubts and resigned themselves to heading to a vaccination site for their first dose.

A temporary vaccination site in a parking lot in the Treme neighborhood of New Orleans did less business than a nearby virus testing center
A temporary vaccination site in a parking lot in the Treme neighborhood of New Orleans did less business than a nearby virus testing center AFP / Emily Kask

But others, either defiant or oblivious, shrugged off the new rule and, as night fell, converged on the busy streets of the French Quarter, the night-life epicenter in this city of 400,000.

Every night, hundreds of tourists and partyers converge in New Orleans' French Quarter, with few sporting masks
Every night, hundreds of tourists and partyers converge in New Orleans' French Quarter, with few sporting masks AFP / Emily Kask

At a vaccination site set up in a parking lot in the Treme neighborhood -- an area devastated by Hurricane Katrina in 2005 -- the authorities were also offering virus testing.

But in a reflection of the broader divide across Louisiana -- where cases have exploded as vaccinations have lagged -- dozens of cars were lined up for testing, while three National Guardsmen manning a vaccination tent had little to do.

Despite a stepped-up pace of immunizations since mid-July, only 37.9 percent of the state's population is fully vaccinated, compared to the 51.1 percent rate nationwide.

Hospitals in Louisiana are hammered amid a furious virus surge that has brought the state's daily average infections to 126 per 100,000 inhabitants
Hospitals in Louisiana are hammered amid a furious virus surge that has brought the state's daily average infections to 126 per 100,000 inhabitants AFP / Emily Kask

For Justin, who is 34, and his 26-year-old partner Jen, the health-pass requirement made a difference. The two Florida natives said they are "hooked" on sports and cannot imagine being barred from the events, or gyms.

"It definitely pushed me over the edge," said Justin, a software engineer. He said he and Jen, a makeup artist, had been waiting for the US Food and Drug Agency to give the vaccines final approval.

"I'm a big-time gym guy," he added. "So that's my main motivator, honestly."

New Orleans' historic French Quarter is as lively as ever, even as the Delta variant tears through the US South
New Orleans' historic French Quarter is as lively as ever, even as the Delta variant tears through the US South AFP / Emily Kask

People getting their inoculations cited a variety of reasons.

Jenny, an immigrant who speaks little English, said she was getting the jab to keep her job in a restaurant that is requiring all workers to be vaccinated.

Richard was lined up for a virus test, but said he planned to return in a few days for a vaccination. His reason: to protect his son.

This is not the first time Covid-19 has brought Louisiana to its knees.

The first wave, already serious, grew far worse after last year's Mardi Gras celebration, the climax of New Orleans' festive winter season that each February draws a sea of partygoers to the French Quarter.

The city had canceled all big events and banned public assemblies. But now, even as the Delta variant tears through the US South, the French Quarter is as lively as ever.

Every night, hundreds of tourists and partyers converge there, with few sporting masks.

Bourbon Street, the main pedestrian avenue, has shrugged off last year's gray tones and is now as colorful as ever, with the cheap, plastic necklaces people throw to each other in the street and the tall, neon-colored plastic cocktail glasses that people here, unlike in most US cities, are allowed to enjoy in public.

Thirty-year-old Niko -- sporting a green Celtics cap and dark sunglasses despite the fact the sun had set long ago -- explained why he was wearing a mask.

"I believe Covid still exists," he said. "But at the same time we still got to live."

Like him, Sherry Carpenter -- who had come from neighboring Arkansas with her two daughters -- did not want to hear about the vaccine.

With a mask in hand, she flatly rejected the idea of a health pass.

"I think everyone should have the freedom of choice," the 53-year-old cleaning woman said, comparing the issue to abortion.

Like it or not, New Orleans will on Monday step into the largely uncharted territory of health passes -- and will have to strike a balance between the pleasures of the French Quarter and the pitfalls of the Delta variant.