Many U.S. hospitals have been operating at nearly maximum capacity since March 2020 as the COVID-19 pandemic continues to sicken people in waves. Managers have responded by adapting facilities to meet the demands related to treating the ongoing stream of patients. New data reveals the size of the burden on these facilities.

A new study found a 90 percent increase in hospitals reaching intensive care unit (ICU) capacity from July through December, with rural hospitals facing the biggest capacity issues, according to Fierce Healthcare. The study looked at ICU occupancy rates at 809 hospitals in rural, suburban and metro areas. The number of hospitals that reached 80-100 percent ICU capacity increased from 200 in July to nearly 400 in the middle of November.

As a result of these waves of patients seeking treatment, managers have looked for additional space to provide treatment.

In Austin, medical officials say they are likely to soon run out of hospital beds, according to KXAN. Austin-Travis County Interim Health Authority Dr. Mark Escott says the process of activating the city’s overflow hospital at the Austin Convention Center will start soon

In Waco, Texas, an increase in already high numbers of COVID-19 patients has led the city’s hospitals to expand their ICUs into areas of their facilities not typically used for the purpose, according to the Waco Tribune-Herald. Meek said it seems improbable that local hospitals would have to expand to emergency care sites outside their regular facilities amid the rising hospitalization numbers, but officials are still prepared for the possibility.