ANCHORAGE, Alaska (AP) — Overwhelmed by a surge in COVID-19 patients, Alaska’s largest hospital on Tuesday implemented crisis standards of care, prioritizing resources and treatments to those patients who have the potential to benefit the most.

Health officials said statewide that there are 202 patients diagnosed with COVID-19 who are hospitalized, and nine additional patients are under investigation.

The percentage of patients currently hospitalized with COVID-19 is 17.5%, the state reported.

At Providence, one of only three hospitals in a city of about 300,000 residents, officials have developed and enacted procedures to ration medical care and treatments, including dialysis and specialized ventilatory support.

The emergency room is overflowing at Providence, and she said patients wait for hours in their cars to see a doctor for emergency care.

Walkinshaw noted that what happens at the Anchorage hospitals affects the entire state since specialty care can often only be provided in the state’s largest city.

Mike Dunleavy, a Republican who has recovered from COVID-19 and been vaccinated, said employees at Alaska hospitals are working long hours, some have left their jobs and there are capacity concerns.