Idaho and Hawaii are preparing to ration care as COVID-19 cases strain hospitals in the states.

On Tuesday, the Idaho Department of Health announced that it had activated its crisis standards of care in the northern part of the state due to a severe shortage of staffing and available beds caused by a massive increase in patients with COVID-19.

The state is experiencing its biggest surge in coronavirus hospitalizations since the start of the pandemic because of mostly unvaccinated patients, according to the states declaration.

One hospital in northern Idaho, Kootenai Health, has been so overwhelmed with COVID-19 cases that the hospital stopped non-emergency surgeries, declined hundreds of transfer patients from other hospitals in recent months and converted a conference room to patient care after running out of bed space.

Different states and hospitals can ration care or enact crisis standards of care in different ways, but the idea is to give health care professionals guidance on which patients to prioritize as well as provide legal protection as they make such tough choices.

Some examples of crisis care choices include deprioritizing patients who are less likely to survive, denying some patients admission or discharging them earlier than normally recommended, NPR reported .

In Idaho, a declaration of crisis standards of care provides guidelines to health care providers on how to make decisions on patient care when there are not enough resources , with the goal being to extend care to as many patients as possible and save as many lives as possible, according to the state.