DES MOINES, Iowa (AP) — Iowa's number of coronavirus cases, deaths and hospitalizations continued to surge higher Wednesday as medical professionals have begun to express concern that hospitals could be overwhelmed with patients if no action is taken to slow the virus spread.

Iowa hospitals had 596 coronavirus patients Wednesday, by far the highest number so far in Iowa. The 113 patients admitted in the past 24 hours also was the highest seen since the virus surfaced in Iowa in March. The number of patients needing intensive care unit services has also trended upward in the past month.

Iowa doctors and hospital officials are preparing for a system overrun by COVID patients by talking about how to transfer patients between hospitals and enacting surge plans that could turn non-hospital facilities into spots to handle any overflow.

“What we know is if the last four weeks are indicative of what happens over the next four weeks we will have the system overwhelmed,” said Suresh Gunasekaran, CEO of University of Iowa Hospitals and Clinics in Iowa City. “If hospitalizations continue to increase at the exact same rate they have been for weeks, the math itself tells you that you run out of beds.”

University hospitals, the state's only academic medical center, is often where other hospitals send patients with complex intensive care needs. It is seeing a significant volume of COVID-19 patients from around the state, Gunasekaran said.

He said Iowans need to understand that the coronavirus patient surge often displaces the ability to care for patients with other complex needs stemming from problems such as heart disease, cancer or neurological conditions.

State public health officials reported 1,814 new confirmed cases Wednesday and an additional 22 deaths for a total of 1,680.

Over the past two weeks, the rolling average number of daily new cases has increased by 249, an increase of nearly 23%, according to researchers from Johns Hopkins University. Iowa has averaged about 1,400 new cases a day for the past week.

“My take away from this is that things are bad but also they can and will likely get much worse because the number of new cases is just staggering,” said Dr. Rosanna Rosa, an infectious disease doctor with UnityPoint Health.

A spokesman for the Iowa Department of Public Health said the state is in regular, often daily, contact with health systems, hospitals and regional medical coordination centers to assess hospital capacity, staffing and resources.

“At this time, hospitals are reporting that they are able to manage the increased number of patients, and are prepared to implement surge plans to expand capacity if necessary,” spokesman Alex Carfrae wrote in an email.

He said staffing shortages can occur during times of seasonal illness or viral outbreaks and hospitals have a variety of solutions to maintain adequate staffing levels.

Rosa said a better public health approach would be to make it clear to Iowans that these illnesses and deaths are preventable, a point made in a recent report from the White House Coronavirus Task Force when it recommended Iowa enact mask requirements and limit crowd sizes.

Gov. Kim Reynolds has rejected a mask mandate.

State data indicates a 14-county region in the southeast corner of Iowa has fewer than 19% of its hospital beds available, but a doctor at a major hospital in the region said even that can be deceiving because there aren't always enough nurses and other necessary staff to tend to the beds that may appear to be available. Beds to be usable must have available doctors, nurses, physician assistants and respiratory technicians and when they get sick or must be quarantined, hospitals may not be able to put a patient in some of the beds due to staff shortages.

“We've got a lot of hospital staff that are getting infected in the community and getting exposed and having symptoms and not being able to be at work,” said Dr. Michael McCoy, chief medical officer at Great River Health in Burlington.

MercyOne hospitals in the Des Moines area have seen an increase in COVID patient numbers in the past month and now have around 30 to 40 patients, said Dr. Ravi Vemuri, an infectious disease specialist. He likened Iowa's coronavirus experience to a smoldering forest fire that never went out and occasionally flares.

He said Iowa likely opened things up too aggressively in May, which allowed virus activity to begin spreading again and gain momentum through the summer. The only answer is for Iowans to again limit activity by staying within their family bubble and when going outside the family unit they must wear a mask and remain distant from others, especially when indoors.

“Right at this moment we're sitting OK but as cases accelerate we might get into trouble,” he said.

Hospitalizations lag behind positivity numbers by a week to 10 days so the very high positive case numbers will lead to more people in hospitals.

Gunasekaran said it's imperative for the community to work now to flatten momentum of new cases.

“If the curve is going to continue to peak we will have a health care system that does get overwhelmed. It is possible,” he said. “The specter that's hanging over our head going into the winter is if we continue to see these kinds of hospitalization rates, will we really take care of all the patients that we want to? That's what’s worrying me.”

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The story summary on this story has been corrected to show a record 596 patients were being treated in hospitals on Wednesday, not Thursday.