Public health officials in Idaho have activated “crisis standards of care” to aid some of the state’s hospitals, which are buckling under a mass influx of coronavirus patients. The measure is “a last resort,” according to Idaho Department of Health and Welfare Director Dave Jeppesen. Due to staffing and bed shortages in the northernmost part of the state, the new designation will allow hospitals to allocate resources to patients most likely to survive. The crisis standards are a complex triage system that will ultimately only afford some patients “comfort care”—keeping them pain-free, but potentially denying them a hospital room, bed, or even life-saving medical equipment.

In northern Idaho’s largest hospital, there is currently one critical care nurse looking after up to six intensive care unit patients. More than 500 people were hospitalized across the state with COVID-19 on the first day of September; more than a third of them were placed in ICU beds. Experts have predicted that Idaho could see upwards of 30,000 weekly COVID-19 cases soon if the current rate of infection doesn’t slow. The crisis standards will remain in effect until more resources can be delivered, or fewer cases are reported.