DALLAS (NewsNation Now) — A surge of new COVID-19 cases are pushing hospital systems to the limit across the country.

In Idaho, health care is now being rationed.

On Thursday, the state activated “crisis standards of care” guidelines, citing the “massive increase of COVID-19 patients.” This means scarce resources and ICU beds will be allotted to patients most likely to survive.

“People either have to get better to go home, or if they succumb to their illnesses and die, that opens up a bed,” said Dr. Neeraj Soni, an emergency medicine specialist in the state.

“I get furious pretty fast because where we are right now, we didn’t have to do this,” said Kristen Connelly, an Idaho ICU nurse.  “Where we are right now is avoidable …. we didn’t have to go here!”

Idaho is one of the least protected states against COVID-19, with only 40 percent of the population fully vaccinated. According to Johns Hopkins, about one in 200 residents tested positive for the virus in the last week.

“There are no vaccinated, critically ill COVID patients in these units,” said Dr. James Souza, the chief medical officer at St Luke’s Regional Medical Center in Sioux City.

In Texas, there were only 326 ICU beds available across the state Thursday.

In Washington and Utah, elective surgeries have been canceled.

In Alabama, all ICU beds are currently occupied. Dozens of patients in recent days left without the care they need and staff shortages have reached critical levels.

In Nevada, the hospital association is urging people to stay out of the emergency rooms. The daily statewide rate of new cases is almost a thousand per every 100,000 residents.

“There’s patients lining up right now in the hallway, coughing,” said Dr. Kamran Khan, a Las Vegas physician. “Most of these patients are unvaccinated.“

On Thursday, the CEO of Pfizer published an open letter urging the Food and Drug Administration to approve a booster dose. In the letter, he says the amount of time that has passed after vaccination appears to play a significant role in breakthrough cases and that his research teams observed a strong immune response following a third shot.

The FDA is set to meet Friday morning to discuss booster shots.

Dr. David Peterman from Primary Health Medical Group, Idaho’s largest independent primary care and urgent care system, joined NewsNation to discuss overwhelmed hospitals. See the interview in the player below.