“We had months to prepare for this, we saw it happen in other states that were hit earlier. Why weren’t we prepared for what was coming?” said Sarah Newton, chief medical officer of the hospital in tiny Linton, N.D., population 997.

She said she saw coronavirus cases begin surging in late September and October, and on some days ill patients filled the hospital, a low-slung brick ­critical-access facility with 14 beds.

“I felt so emotionally overwhelmed by what I was seeing. I felt like I was screaming into a void. I was drowning in my own hospital,” Newton said.

The disconnect with what was going on inside the hospital and her community was extreme, Newton said. She would go outside and see no one wearing a mask or social distancing, “having giant weddings and going about their lives.”

This week, the unthinkable happened. She called several hospitals in the region and was unable to find an intensive-care bed in a bigger hospital to transfer a rapidly declining coronavirus patient who needed more help than her small facility could provide.