Scotland County Hospital’s doctors already are making difficult, often heartbreaking decisions about who they can take in. Wilson said some moderately ill people have been sent home with oxygen and told, “If things get worse, come back in, but we don’t have a place to put you and we don’t have a place to transfer you.”

Meanwhile, a staffing shortage is so severe that the hospital put out an appeal for anyone with health care experience, including retirees, to come to work. Several responded and are already on staff, including a woman working as a licensed practical nurse as she studies to become a registered nurse.

The hospital’s chief nursing officer, Elizabeth Guffey, said nurses are working up to 24 extra hours each week. Guffey sometimes sleeps in an office rather than go home between shifts.

“We’re in a surge capacity almost 100% of the time,” Guffey said. “So it’s all hands on deck.”