HELENA, Mont. (AP) — Montana’s most populous county is set to implement new restrictions in an effort to reduce the spread of coronavirus as the CEO of a Billings hospital warned that facilities and healthcare workers are overwhelmed as hospitalizations are rising.

Meanwhile, an uptick in cases in Flathead County has the health department recommending similar restrictions.

Yellowstone County health officer John Felton told the Billings Chamber of Commerce last week that he would restrict bar and restaurant capacity to 50% and limit gatherings to no more than 25 people, inside or outside. Businesses that sell alcohol would close at 10 p.m. Felton had initially said he would limit bar, restaurants and churches to 25% capacity.

“In working with our local restaurants it has become clear that even in the short term, that is not a sustainable number,” Felton said last Thursday.

Felton scheduled a press conference Monday afternoon to announce the restrictions and when they would take effect. He has said he expects them to last for a month.

Billings Clinic CEO Scott Ellner told chamber members that the virus is putting a strain on healthcare workers, "so much so that people are talking about giving up their careers in healthcare.”

If case numbers continue at the current rate, Ellner said he expected around 250 more hospitalizations in the next four weeks.

The hospital is adding capacity, moving some patients to other facilities and may look at putting two patients in some rooms, he said.

“I want to leave a sobering image in your mind,” Ellner told chamber members on Thursday. “Today we're having to call one of those companies that provides reefer trucks. And if you don't know what that means, it's the refrigeration trucks were we can put the bodies.”

It's not clear if Billings Clinic had ordered a refrigeration truck. Officials with the clinic did not return calls or emails from The Associated Press on Monday seeking comment.

Yellowstone County has reported 74 deaths due to COVID.

In Flathead County, the health department is asking the county Board of Health on Thursday to authorize new restrictions if the case numbers average 50 per day per 100,000 people during the week of Oct. 26-Nov. 1, or any Monday through Sunday following that. Those are the same case levels Yellowstone County used.

As of Oct. 9, there were 10 long-term care facilities in Flathead County with COVID-19 outbreaks, health officials said, and case numbers were straining the health care system and the ability to investigate cases.

Montana reported 423 new cases of COVID-19 on Monday, including 94 in Flathead County and 81 in Yellowstone County. Nearly 300 people are hospitalized and 212 people have died.

The state's total cases since mid-March have topped 19,000. The numbers are believed to be far higher because not everyone has been tested and people can have coronavirus without showing symptoms.

More than 7,400 people are considered to still have COVID-19, meaning they are under quarantine or isolation orders. Nearly 11,500 have recovered.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.