MISSION, Kan. (AP) — The COVID-19 surge is stretching oxygen supplies and sending hospitals scrambling for more ventilators, even as there are signs of hope that the spread of the virus is slowing down in pockets of the U.S.

In Tulsa, Oklahoma, a hospital recently called 911 after coming within just a few hours of running out of oxygen because they needed an emergency transfer for a patient on high-flow oxygen. The hospital got a shipment later that day, but the experience was a warning to other hospitals, said Dr. Jeffrey Goodloe, the chief medical officer for the EMS system that serves Tulsa and Oklahoma City.

“If it can happen to one hospital, it can happen to any hospital,” Goodloe said. “There is no, ‘that is happening over there.’ There is here in a heartbeat.”

The oxygen shortages are yet another sign of the toll that the summer COVID-19 resurgence has taken on the nation’s hospital system. A handful of states including Florida, Oregon, Hawaii, Mississippi and Louisiana have set pandemic records for the number of COVID-19 hospitalizations, and many hospitals are dangerously short of staff and intensive care unit beds.

There is some good news, however.

The country is averaging 155,000 new infections a day, but the caseload trajectory has slowed down dramatically from earlier in August.

Florida, Missouri, Arkansas, Louisiana and Mississippi had slight declines in cases over the last two weeks. Florida has seen a dip in COVID-19 admissions in recent days, as have hospitals in Springfield, Missouri, an early epicenter of the delta variant-driven surge.

Vaccination numbers are also up, and White House COVID-19 coordinator Jeff Zients credited vaccine mandates that have been implemented across the country, including restaurants, workplaces, sports stadiums and schools.

“Importantly, we’ve accelerated the pace of first shots. In August, we got over 14 million. That’s almost 4 million more first shots in August compared to the prior month in July,” Zients said Tuesday.

But the numbers haven’t budged much in the one week since the U.S. Food and Drug Administration gave full approval to Pfizer for its vaccine after reviewing six months of safety data. The seven-day average for vaccine doses administered across the U.S. rose to 898,000 on Monday, up from 853,000 one week earlier.

Deaths are also on the rise, averaging more than 1,300 a day, in what health officials have predicted would happen as a result of the massive rise in cases and hospitalizations over the last month.

Georgia and Oklahoma have emerged as new spots where hospital and state leaders are sounding alarms about the lack of capacity and supplies.

COVID-19 infections and hospitalizations are on the cusp of surpassing January peaks in Georgia as hospitals fretted Monday that the delta variant of the respiratory illness threatens to suck some Georgia hospitals dry of medical oxygen, a key treatment for people struggling to breathe.

Gov. Brian Kemp signed an executive order calling up as many another 1,500 National Guard troops to help short-staffed hospitals with nonmedical jobs, on top of the 1,000 previously authorized.

Augusta University Medical Center has ordered 12 more ventilators to deal with the surge. The hospital was treating 122 COVID-19 patients on Tuesday, pushing its overall hospital census to a record of 501 patients.

The number of COVID-19 patients remains about 20 less than winter surge levels, but the hospital has been turning away transfers because it also is working through a backlog of patients who put off care at the height of the pandemic, said Dr. Phillip Coule, chief medical officer.

“We are watching our ventilator use very closely,” he said, noting that more of the hospital’s patients are needing high-flow oxygen and other treatments that sometimes lead up to the patients being put on ventilators. “We are concerned about it.”

With oxygen supplies, part of the issue is that hospitals have found success in treating coronavirus patients with high-flow oxygen tubes. But the method uses up to three times more oxygen than treatment methods used earlier in the pandemic, said Andy Brailo, chief customer officer for Premier, a group supply purchaser for hospitals.

Couple that with troubles finding enough drivers with the requisite hazardous material certifications to deliver oxygen to hard-hit hospitals, and supplies are running tighter than ever. Some hospitals have come within a day or two of running out. Others have resorted to using backup tanks that are normally used only when their main tank is being refilled.

In Orlando, residents have been asked to stop watering their lawns and washing cars because of oxygen shortages. That’s because Orlando treats city water with liquid oxygen and supplied that typically go toward water treatment have been diverted to hospitals.

Brailo said the oxygen issue has been particularly acute in Florida. He said he has recently heard of problems in Louisiana, Kentucky and Texas as well.

“Hospitals have started thinking, if we are out, what are the options we are going to have to take?” Brailo said. “In some cases, that may mean having to move patients. And that may mean going to much more invasive ways to make sure those patients are oxygenated.”

Dr. Ryan Stanton, an emergency room physician in Lexington, Kentucky, who has treated scores of COVID-19 patients, said doctors began discussing whether multiple people could be placed on a single ventilator over the past few days in private Facebook groups. He said that so far, no doctors have said they were attempting it.

“It is just a sign that you are getting at that critical breaking point,” he said of the discussion.