New York, one of the states hit hardest and earliest by Covid-19, is taking steps to limit a new winter wave of infections as transmission rates approach those of April 2020 and the US braces for the Omicron variant, discovered in southern Africa.

Related: Two cases of Omicron Covid variant identified in UK

Late on Friday, Governor Kathy Hochul said: “While the new Omicron variant has yet to be detected in New York state, it’s coming.”

On Saturday morning, Joe Biden’s chief medical adviser, Anthony Fauci, sounded a similar warning, telling NBC he “would not be surprised” if Omicron was already in the US.

“We have not detected it yet,” Fauci said, “but when you have a virus that is showing this degree of transmissibility and you’re already having travel-related cases that they’ve noted in Israel and Belgium and other places, when you have a virus like this, it almost invariably is ultimately going to go essentially all over.”

New York has recorded more than 2.7m cases of Covid-19 and more than 57,000 deaths, the fourth highest state death toll, behind California, Texas and Florida.

On Saturday, the banner headline on the front page of the New York Post tabloid said simply: “Omi-God, Not Again.”

Hochul also issued an executive order postponing elective surgeries, a move designed to protect hospital capacity until at least 15 January, and a disaster emergency declaration.

Covid hospital admissions in New York have increased over the past month to over 300 a day. Hospitals with less than 10% staffed bed capacity, or those designated by the state, will be authorized to screen patients and restrict admissions in order to keep beds open.

On Friday, the World Health Organization warned of the emergence of the Omicron virus variant, citing an “increase in transmissibility” related to an “increase in virulence” and “decrease in effectiveness of public health and social measures or available diagnostics, vaccines [and] therapeutics”.

The federal Centers for Disease Control and Prevention said no cases of the new variant had been identified in the US to date, and said: “We expect Omicron to be identified quickly, if it emerges in the US.”

Nonetheless, the Biden administration ordered restrictions on entry from several southern African nations.

In New York, Hochul said: “We’ve taken extraordinary action to prevent the spread of Covid-19 and combat this pandemic. However, we continue to see warning signs of spikes this upcoming winter, and while the new Omicron variant has yet to be detected in New York State, it’s coming.”

The governor urged New Yorkers to mask up in indoor public venues, get tested when appropriate and to stay home when ill.

Two-thirds of New York state residents are fully vaccinated and close to 80% have received at least one dose, according to the governor’s office.

But New York state is divided between intensively vaccinated downstate areas, including New York City, and upstate areas that have lower vaccination rates and higher rates of infection.

According to the state health department, Buffalo and western New York has a 9.67% Covid positivity rate. The positivity rate in New York City is 1.65%, less than half the 3.84% state average. Vaccination rates in some regions are as low as 52%. In New York City, 97% of Queens adults and 94% of Manhattan adults have had the jab.

Hochul urged New Yorkers to get the vaccination, noting that just under 10% of adults in the state have not.

Related: Omicron: everything you need to know about new Covid variant

“The vaccine remains one of our greatest weapons in fighting the pandemic and I encourage every New Yorker to get vaccinated and get the booster if you’re fully vaccinated,” she said.

As parts of the US experience Covid surges, intensive care units in Michigan are approaching capacity. New York and other eastern states are watching closely.

On Friday the mayor-elect of New York City, Eric Adams, said the Omicron variant was “a concerning development that we must watch extremely closely, and be prepared to address as a city, state and country. Our health officials must … have response options available should it prove to be significantly more virulent.”

Adams and the outgoing mayor, Bill de Blasio, earlier came together to urge city residents to get the vaccines and booster shots.

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