The state experienced a 100% increase in the number of new cases in the past two weeks, according to a Fortune analysis of New York Times data. Alaska is averaging about 1,200 new cases daily, or about 176 per 100,000 residents—the highest concentration in the nation.

Providence Alaska Medical Center in Anchorage, the state’s largest hospital, in mid-September began rationing care, including dialysis and specialized ventilatory support to prioritize “those patients who have the potential to benefit the most,” according to a letter from the Medical Executive Committee of Providence, which represents physicians at the hospital. On Thursday, a second hospital in Bethel, Alaska, said it would also begin rationing care.

Because of the increase in people requiring hospital care, Alaska Gov. Mike Dunleavy contracted nearly 500 out-of-state health care workers to aid overwhelmed facilities across the state. The first hundred were assigned to hospitals Tuesday, and the rest are expected to arrive over the next week or so.

Even as COVID cases have soared in the state, the message from public officials regarding masks and vaccines has been mixed. Gov. Dunleavy has vehemently opposed any mask mandates and protested President Biden’s mandate that any employer with more than 100 workers require them to get vaccinated or submit to weekly testing.

Dave Bronson, who started his term in July as mayor of Anchorage, Alaska’s largest city, has dubbed mask mandates “unconstitutional” and called COVID-19 vaccines “experimental.”

Since Bronson was sworn in, four municipal public health officials have left the department, including Anchorage’s public health division manager, who resigned this week.

As some hospitals struggle with the rise in patients, health care workers across Alaska are searching for ways to protect themselves. According to Alaska Public Media, many welcomed the CDC’s decision last week to recommend boosters for certain groups of Americans, including those 18 to 64 years old with jobs that put them at high risk, such as medical workers.

As of Thursday about 50% of Alaskans have been fully vaccinated against COVID, putting it behind the average for the rest of the country. In total, 56% of the U.S. population has been vaccinated.

More health care and Big Pharma coverage from Fortune:

• Who can get a booster shot?
• New U.S. COVID cases are down 20%. See how your state is doing
• Funding paid leave and child care narrows gender wage gap, says new report
• Meet the International Science Reserve, the IBM-led project to prepare the world for future catastrophes
• Ex-FDA chief Scott Gottlieb on COVID vaccine rollout failures, mix and match vaccines, and end of Delta wave