PHOENIX (AP) — Arizona, currently facing the worst COVID-19 infection rate in the country, is teetering on the brink of having to ration life-saving care, leaders of the state's major hospitals said Wednesday.

“During triage ... it does mean that we might have to make very difficult decisions about what type of care would be be available for a patient,” said Dr. Marjorie Bessel of Banner Health. “We hope we do not get there. We’re asking you, we’re imploring you today to help us avoid that.”

The chief clinical officers of Arizona's five biggest hospital systems spoke at a joint news conference — not just to get the attention of state officials but the public. Under a triage plan, triage officers at each hospital would decide which patients receive treatment if there are shortages in staffing, beds or ventilators.

The physicians believe at least 1 in 10 people in Arizona is infected with the virus. Despite the state ramping up vaccination efforts this week, the hospital officials said they still need people to keep wearing masks, only socializing within their household and avoiding large gatherings.

They also renewed a call for Gov. Doug Ducey to enact a statewide mask mandate and other mitigation measures “based on science and data.”

The Republican governor has rejected proposed statewide measures, saying they would only lead to workers in certain industries being out of work. In his State of the State address on Monday, he said he expects school districts to offer in-person learning to all students.

Hospital administrators disagreed with him.

“We understand that learning and bringing our children together is very important,” said Dr. Michael White of Valleywise Health. “But at this time with uncontrolled spread of the virus, we need to do things that we know will reduce the chance that the virus will spread and that is not gathering with people we don’t live with.”

Ducey's administration said Wednesday that people 65 and older can sign up to get the COVID-19 vaccine starting next week, mirroring updated recommendations from federal health officials. The Arizona Department of Health Services had previously allowed vaccines starting at age 75, with the younger cohort coming in later phases. Health officials say the change adds about 750,000 people to the priority vaccination list.

The state is allowing signups for the new cohort beginning Tuesday, though counties can set their own prioritization rules based on how many doses they have available, officials said.

Arizona on Wednesday reported over 5,600 additional COVID-19 cases and nearly 200 more deaths as hospitalization levels from the surge remained high but didn't set records.

The Department of Health Services reported 5,629 additional known cases and 191 deaths, increasing the state's pandemic totals to 641,729 cases and 10,673 deaths.

Arizona had the worst state COVID-19 diagnosis rate over the past week, with one of every 105 people being diagnosed with COVID-19 from Jan. 5 to Tuesday. The rate is calculated by dividing a state's population by the number of new cases over the past week.

According to the state's coronavirus dashboard, 5,055 COVID-19 patients occupied inpatient beds as of Tuesday, down from Monday's record high of 5,082. There were 1,158 COVID-19 patients in intensive care beds, down from Monday's record of 1,183.

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.

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Associated Press writers Jonathan J. Cooper and Paul Davenport in Phoenix contributed to this report.