BOISE, Idaho (AP) — Idaho Gov. Brad Little on Tuesday called in 220 medical workers available through federal programs and mobilized 150 Idaho National Guard soldiers to deal with a surge in unvaccinated COVID-19 patients that is overwhelming the state’s hospitals.

The Republican governor during a remotely held announcement said the moves are a last-ditch effort to avoid activating for the first time statewide crisis standards of care that could force medical professionals to decide who lives and who dies.

The last week has seen about 1,000 newly confirmed coronavirus cases per day, most of them unvaccinated. The number of intensive care unit beds has been well under 100 during that time, and Little said only four were available on Tuesday in the entire state.

“We are dangerously close to activating statewide crisis standards of care — a historic step that means Idahoans in need of healthcare could receive a lesser standard of care or may be turned away altogether," Little said.

The 220 workers through the federal programs include 200 medical and administrative workers available to Idaho through a contract with the U.S. General Services Administration.

The U.S. Department of Defense is sending a 20-person medical response team to northern Idaho, where vaccination rates are among the lowest in the state and where help is most needed. The military medical personnel include nurses, respiratory therapists and medical doctors.

This is the second time Little has mobilized the Idaho National Guard to help with a surge in COVID-19 cases, this one coming about two months after the first deployment ended.

The guardsman will again support short-staffed medical facilities and help with logistical support such as screenings and lab work.

Johns Hopkins University reports that about one in four people seeking a COVID-19 test in Idaho in the last month have been positive. Medical professionals generally cite the more easily spread delta variant as behind the surge, especially in pockets with unvaccinated residents.

Little said that on Monday he toured a nearly full intensive care unit in Boise.

“What I saw was heartbreaking,” he said. “Among the COVID-positive patients, all of them were unvaccinated. Some were young, two were middle-aged, two patients were pregnant. I was told the average age of the patients was 43. All of them were struggling to breathe, and most were only breathing with the help of a machine.”

Idaho has one of the lowest vaccination rates in the nation, with only about half of people ages 12 and up fully vaccinated. Vaccinations in August picked up, with about 730,000 Idaho residents now fully vaccinated.

Little, as he has done for months, urged unvaccinated Idaho residents to get the vaccine to protect themselves and others in their communities. He said that would also take some of the strain off exhausted healthcare workers.

“It is our ticket out of the pandemic,” he said.

Idaho has had more than 220,000 COVID-19 cases and 2,331 deaths, according to the Idaho Department of Health and Welfare.

In mid-August Oregon’s governor said she would send up to 1,500 National Guard troops to hospitals around the state to help healthcare workers pushed to the brink by a surge of COVID-19 cases driven by the delta variant. Gov. Kate Brown, a Democrat, said the Guard members would serve in roles like material and equipment runners in the most stricken hospitals and assist with COVID-19 testing, among other things.