Alaska on Saturday activated emergency crisis protocols that allow 20 medical facilities to ration care if needed as the state recorded the nation’s worst COVID-19 diagnosis rates in recent days, straining the state’s limited health care system.

The declaration covers three facilities that had already announced emergency protocols, including the state’s largest hospital, Providence Alaska Medical Center in Anchorage. The state’s declaration also includes the other two hospitals in Anchorage and facilities across the nation’s largest but sparsely populated state…

According to data collected by Johns Hopkins University Center for Systems Science and Engineering, one in every 84 people in Alaska was diagnosed with COVID-19 from Sept. 22 to Sept. 29. The next highest rate was one in every 164 people in West Virginia.