AUSTIN, Texas — The resurgence of COVID-19 in Texas has put some cities’ health systems in dire circumstances, as intensive care unit beds fill up, officials say.

In Austin, the health department said there were only nine ICU beds available on Friday in the 11-county trauma service region that includes the city and serves 2.3 million people.

“We are running out of time and our community must act now,” said Dr. Desmar Walkes, Austin’s medical director/health authority. “Our ICU capacity is reaching a critical point where the level of risk to the entire community has significantly increased, and not just to those who are needing treatment for COVID. If we fail to come together as a community now, we jeopardize the lives of loved ones who might need critical care.”

In a joint statement, three hospital systems that serve the Austin area — Ascension Seton, Baylor Scott & White and St. David’s Healthcare — said the latest COVID-19 spike “is putting extraordinary pressure on our hospitals, emergency departments and healthcare professionals, and it has further challenged hospital staffing due to a longstanding nursing shortage.”

San Antonio is also facing a nursing shortage caused by an increase of coronavirus patients. City leaders had hoped the state would help fill the shortage, but in a letter sent Thursday to city and county leaders across Texas, the state directed local governments to instead make their own plans to increase hospital staffs before asking the state for help, the San Antonio Express-News reported.

The state previously hired staffing companies to send traveling nurses, doctors and respiratory therapists to help hospitals cope with COVID-19 surges.

In San Antonio, COVID-19 hospitalizations on Saturday were up by 430% since the start of July, the newspaper reported.

“We have patients waiting in the lobby; we have patients in the hallway,” said Tommye Austin, the chief nurse executive for University Health, one of the largest hospitals in San Antonio. “Every nook and cranny in this organization has a patient.”

As of Saturday, there were 6,251 people in Texas hospitals with COVID-19, which was the most since Feb. 24. Forty-four new COVID-19 deaths and 12,732 new cases of the disease were reported Saturday.

Despite the rise in hospitalizations and new cases, Republican Gov. Greg Abbott has repeatedly stood by his order banning mask state, county and local mask mandates.

As of Saturday, only 43.8% of Texas’ total population had been fully vaccinated. That trailed the national rate of 49.5% and was far behind Vermont, which had the highest rate of any state, at 67.5%, according to the U.S. Centers for Disease Control and Prevention.