BOISE, Idaho — Idaho’s public health leaders have expanded health care rationing statewide amid a massive increase in the number of coronavirus patients requiring hospitalization.

The Idaho Department of Health and Welfare made the announcement Thursday. St. Luke’s Health System, Idaho’s largest hospital network, asked state health leaders to allow “crisis standards of care” on Wednesday because the increase in COVID-19 patients who are unvaccinated has exhausted the state’s medical resources.

Crisis standards of care means that scarce resources, such as ICU beds, will be allotted to those patients most likely to survive. Kootenai Health in the city of Coeur d’Alene was the first hospital in the state to officially enter crisis standards of care last week.

Idaho is among the least vaccinated U.S. states, with only about 40% of its residents fully vaccinated against COVID-19. Only Wyoming and West Virginia have lower vaccination rates.

More than 1,300 new coronavirus cases were reported to the state on Wednesday, according to the Idaho Department of Health and Welfare. The mostly rural state ranks 12th in the U.S. for cases per capita.