(NewsNation Now) — Just 4.3% of patients in one North Carolina hospital currently have COVID-19, but if cases surge, there might not be anywhere for non-COVID patients to go, officials say.

The remaining beds at Duke Raleigh Hospital are occupied by people who are otherwise sick and “require a lot of care,” as well as those patients who haven’t yet been placed in a skilled nursing facility, said Duke University Hospital Chief Medical Officer Dr. Lisa Pickett.

People sometimes remain at the hospital for weeks or months waiting for an appropriate placement, Pickett said.

Skilled nursing facilities “have the same staffing difficulties that everybody else does,” Pickett said. “There’s also a shortage in our state of facilities that meet the needs of the patients that we have.”

The North Carolina Health Care Facilities Association reports the average nursing home has more than 21 unfilled nursing positions. A total of 12,000 nurses are needed in these facilities statewide.

The lengthy insurance process also has compounded the issue, with approval sometimes only arriving once the bed no longer is available, Pickett said.

“It’s sort of a double whammy of a very contagious variant and everybody’s going to be traveling or in groups and with people they don’t live with, so we expect this to spread a great deal,” Pickett said.

In the meantime, the hospital could save space by postponing elective procedures — a measure Pickett said she doesn’t want to do “unless we absolutely have to.”