There were a record number of people hospitalized with COVID-19 on Monday, according to the Covid Tracking Project. The data shows that 121,235 patients landed up in hospitals with a 40% increase in coronavirus patients in intensive care units over September’s figures of 16% in ICUs. Healthcare experts are concerned that the post-holiday surge may force facilities to ration nurses, respirators, and other medical care for these patients. This can lead to tough ethical decisions.

“When you run out of capacity, physicians and bioethicists in these hospitals will need to decide which patients are salvageable — and which patients aren’t,” said CNN medical analyst Dr. Jonathan Reiner.

Experts also warn that this surge may lead to an increased number of COVID-19 patients dying. As nationwide cases of COVID-19 continue to soar to unprecedented levels, according to the Centers of Disease Control and Prevention data tracker, healthcare officials say that the likelihood of surviving the disease if you are hospitalized is getting worse every day. A new study found that when communities had large numbers of COVID-19 cases, hospitals were more apt to be stressed and overburdened, causing mortality rates for hospitalized patients to rise.

According to USA Today, study authors Drs. David Asch and Rachel Werner of the University of Pennsylvania found that 11.8% of adults hospitalized with COVID-19 died within 30 days. “That is nearly four times higher than your likelihood of dying if you’re hospitalized with influenza, which is closer to 3%,” said the researchers.

“The number of people now hospitalized with COVID-19 has nearly quadrupled from its low in September,” Asch and Werner told USA Today. “Hospitals are buckling under that strain, with shortages of staff, supplies, and hospital beds.”

According to The New York Times, the nation’s hospitals have been slammed with a staggering number of patients with no available beds and a dire shortage of doctors and nurses. This has also led to a dangerous increase in the number of hospitals who have had to turn away emergency or urgent care patients.

However, some hospitals, like Martin Luther King Jr. Community Hospital in Los Angeles, have vowed they will not turn patients away, according to CNN.

“We use what in the battlefield is called triage techniques, which is doing an assessment of each person’s needs and prognosis and using scarce resources with patients that are most likely to benefit from them,” the hospital's CEO Dr. Elaine Batchlor explained. She added that her hospital has erected five tents outside the hospital and is using the conference room and chapel to shelter patients.