PHOENIX (AP) — Arizona on Wednesday tied a previous record for coronavirus deaths in one day during the current virus surge while its available hospital bed capacity dropped to a record-low since the start of the pandemic.

And there's no end in sight, according to Arizona State University researchers who are tracking the pandemic.

The state is now seeing higher case numbers than it did when Arizona was a national hotspot in June and July. There are fewer measures in place to slow the spread and limited backup resources for hospitals than were available in the summer, said Dr. Joshua LaBaer, executive director of ASU's Biodesign Institute.

“We’re in the thick of it now, worse than we were in the summer and with less options available to us than in the summer,” LaBaer told reporters during his weekly briefing. Greater demand for hospital beds in the winter than in the summer and an inability to import nurses like the state did during the previous surge are stressing existing resources, he said.

LaBaer noted that Gov. Doug Ducey had closed bars and in-person dining for restaurants at the height of the summer surge. But Ducey for weeks has refused to reimpose those restrictions even as cases rose amid predictions that hospitals would soon be overwhelmed.

As the state's virus vaccination campaign begins, the state Department of Health Services reported 4,848 additional known COVID-19 cases and 108 deaths, bringing the state's totals to 429,219 cases and 7,530 deaths. Immunizations with a new COVID-19 vaccine began Tuesday for healthcare workers. Nursing home patients and staff will follow as supplies allow.

A record 92% of Arizona's inpatient beds were filled Tuesday, either by coronavirus patients or people hospitalized for other reasons, leaving only 8% available, according to the state’s coronavirus dashboard.

The dashboard indicated that the hospitals occupied on Tuesday were almost evenly divided between 3,809 coronavirus patients and 4,040 non-virus patients.

Arizona's rate of bed usage has hovered in the 10% range since early December.

“We’re pushing on almost one of two beds in the hospitals right now is that one disease,” LaBaer said. “That’s a staggering statistic when you think about the things that can afflict people. And it certainly means that hospitals at this point are having to make decisions about keeping people out of the hospital to keep beds available for the COVID patients.”

For people with new a cancer diagnosis or who need another urgent surgery, that could mean delaying those procedures, he said.

Hospital executives and public health experts have warned that the current surge, which has spiked since Thanksgiving, could exceed the health system's capacity this month.

Wednesday's report of 108 known deaths tied the number reported on Dec. 9 when state health officials said that day's report included results of reviews of past death certificates that newly attributed some additional deaths to COVID-19.

Department of Health Services officials did not immediately respond to a query from the Associated Press asking whether Wednesday's report included results from death certificate reviews.

The state recorded the highest number of daily coronavirus deaths on July 30 of 172 during the summer surge of infections.

The latest big increase in the state's death toll from COVID-19 came as the seven-day rolling average of deaths in Arizona rose from 24.6 per day on Dec. 1 to 64.1 on Tuesday.

The state's rolling averages of daily new cases and daily positivity in COVID-19 testing also increased during that period.

Meanwhile, Arizona in the week ended Tuesday had the fourth-worst coronavirus diagnosis rate among U.S. states, with one person in every 155 having been diagnosed with the virus between Dec. 8 and Dec. 15.

The diagnosis rate is calculated by dividing the state’s total population by the number of new cases over the previous week.

The number of infections is thought to be far higher than reported because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

In another development, the Pima County Health Department announced Wednesday that its director, Dr. Theresa Cullen, had tested positive for COVID-19, part of an apparent outbreak involving 11 department employees.

At least one department employee tested positive before there was a protest at the department’s building last week involving dozens of people, including some not wearing masks and some who entered the lobby, a county statement said.

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Associated Press reporter Bob Christie contributed to the report.