SACRAMENTO (AP) — Teams of military doctors, nurses and other health care specialists are being deployed to eight California hospitals facing staffing shortages amid a record-breaking surge of coronavirus cases across the state.

The Air Force, at California’s request, assigned 160 people to increase capacity in intensive care units. Some teams arrived this week, including 20 people each to the Adventist Health Lodi Memorial Hospital in San Joaquin County on Wednesday; and Eisenhower Health Hospital in Southern California’s Riverside County on Thursday.

Both hospitals had beds available for extra patients, but they did not have the staff to care for them — highlighting a growing problem across the state as coronavirus hospitalizations reach record levels.

“I think people erroneously think of hospital capacity as all about beds and space,” said Carmela Coyle, president and CEO of the California Hospital Association. “It’s far more than a mattress and a pillow. The most important resource are the people who are taking care of patients.”

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On Thursday California reported its largest two-day total of confirmed cases, nearly 20,000, along with 258 deaths in the last 48 hours. There are more than 8,000 people in hospitals who have either tested positive for the coronavirus or are suspected to have it.

Coyle said some models suggest hospitals should prepare for four times as many coronavirus patients as they have now, raising questions about the future of health care staffing “in what may be a new era of virus and pandemic.”

Eisenhower Health Chief Medical Officer Dr. Alan Williamson said the hospital is at 80% bed capacity but was “virtually 100% of our staffing capacity.”

San Joaquin County’s seven hospitals were at 71% capacity on Wednesday, but 121% capacity in their intensive care units. A team of 20 doctors, nurse practitioners, respiratory therapists and nurses arrived from Travis Air Force base, according to Marissa Matta, spokeswoman for the San Joaquin County Office of Emergency Services.

Los Angeles County, where a quarter of the state’s nearly 40 million residents live, on Thursday reported its largest increase in additional cases — 4,592 — while hospitalizations remained above 2,100. County Health Officer Dr. Muntu Davis said coronavirus patients in hospitals “are needing intensive care at higher numbers than we’ve seen before.”

Just south of Los Angeles, in Orange County, cases are rising fast and medical workers are tired, said Dr. Clayton Chau, the interim public health director. He said that the county has capacity in its intensive care units in terms of beds “but we always have concerns of staffing.”

Hospitals are licensed to have a certain number of beds, but they typically don’t have enough people to staff all of them at one time. The facilities have plans to share resources for emergencies, but those plans are designed for local or regional disasters. The coronavirus pandemic has impacted nearly every hospital in the state for more than four months.

Zenei Triunfo-Cortez, president of the California Nurses Association, said hospitals were already facing a staffing shortage before the pandemic. She said the coronavirus has just made it worse.

“You would think that our hospitals would learn from that and would try and beef up the staffing so that if a surge happens again, they will be prepared,” she said. “If they really want to hire nurses, they could.”

John Pasha, an intensive care nurse at Good Samaritan Hospital in San Jose, said he often works shifts without a break because there are no nurses available to fill in for him.

“We’re all tired and we’re all exhausted,” he said. “We don’t have anything left to give.”

Copyright 2020 The Associated Press.