BOISE, Idaho (AP) — Idaho Gov. Brad Little on Monday ordered a return to some restrictions to slow the spread of the coronavirus as intertwined health care systems across the state showed early signs of buckling.

The Republican governor returned the state to stage 3 of his reopening plan and said indoor gatherings will be limited to 50 people or less. He didn't order a statewide mask mandate.

State officials continue reporting surging infections, with 650 more on Sunday for a total approaching 60,000 along with 573 deaths.

The state’s positivity test rate is fourth-worst in the nation, according to The COVID Tracking Project.

St. Luke’s, with hospitals in southwestern and central Idaho, is reporting that 20% of hospitalized patients are suffering from COVID-19. Its hospital in Twin Falls is postponing elective surgeries and sending children in need of medical care to Boise.

Primary Health Medical Group, the largest independent medical group in Idaho, has had to close two of its 19 urgent care clinics in southwestern Idaho because of sick or quarantined staff. The clinics are a buffer keeping hospital emergency rooms in the region from getting clogged with patients not needing emergency-level care.

In northern Idaho, Kootenai Health in Coeur d’Alene said it is near capacity due to the coronavirus.