Maryland’s hospital beds are filling up, as the state reported 2,765 new COVID-19 cases on Tuesday morning. Twenty-one hospitals are at more than 90% capacity and 130 patients are receiving treatment in so-called “surge beds” across three temporary hospital facilities meant to avoid overcrowding.

“It’s a scary situation for everybody involved. …We think it’s going to continue to get worse over the next at least several weeks,” Gov. Lawrence J. Hogan Jr. (R) said at a Tuesday press conference. “…Most of the educated projections say that we are not near the peak yet ― and that the worst part of this entire crisis is still ahead of us over the next month or two.”

Hogan announced a series of efforts on Tuesday aimed at alleviating burdens of health care workers, as a crush of post-Thanksgiving COVID patients are anticipated.

The 2,765 figure reported Tuesday is the third-highest daily total since the first reported case in Maryland eight months ago.

At least 4,516 Marylanders have died from the virus. The governor briefly paused during Tuesday’s press conference, choking back tears as he noted that the state recorded its youngest victim to date: a one-year-old boy.

More than 21,000 people have required hospitalization for treatment and 1,583 people were in hospital on Tuesday morning ― the highest figure since May 10. The state reported 350 COVID patients in intensive care units on Tuesday morning.

There are 6,816 Marylanders hospitalized for all illnesses; when the state reaches 8,000, hospitals will be required to expand their capacities by 10 percent within a week.

Every Maryland hospital is required to submit a surge plan to the state by Dec. 8.

“The current surge is not only increasing the burden on our healthcare system and filling available hospital beds, but it is also affecting our health care workers who are already spread thin and operating under immense strain and stress,” Hogan said.

State hospitals will need an additional 2,000 to 3,000 medical workers in the next few weeks to help alleviate round-the-clock staffing burdens. To recruit workers, the Department of Health and Maryland Hospital Association launched to fill temporary positions as doctors, nurses, clinical workers and support staff.

The state’s current hospital workers are already taking extra shifts and extra responsibilities, as well as sacrificing time away from their own families.

“Beds are filling up with significant numbers of patients, testing hospital surge plans, and our healthcare heroes: the nurses, doctors and other health care professionals to deliver that care in the most stressful environments,” said Dr. David Marcozzi, COVID-19 Incident Commander for the University of Maryland Medical System. “They persevere and are working extra shifts to carry the burden. That means potentially missing time at home during this holiday season. They do it for their patients, they do it to save lives. That said, those heroes are stretched thin, and we need to think innovatively on how to address potential staffing constraints.”

Hogan is also asking all Maryland colleges and universities to allow expedited graduation for students in health care fields and to develop emergency policies to award academic credit to any students who volunteer in health care during the pandemic.

Counties are being asked to deploy any available health care workers or other county employees to help staff testing and vaccination sites throughout the state.

The state is also urging hospitals and nursing homes to refocus workloads to shift non-medical duties away from nurses and licensed support staff, allowing them to focus on patient care.

New acting Health secretary

Hogan also announced Tuesday that the Maryland Department of Health’s Chief Operating Officer Dennis R. Schrader would become acting health secretary.

Tuesday marked the end of the tenure of Health Secretary Robert R. Neall, who announced in mid-November that he would retire from the Health Department after working for the administration for the last six years in various roles.

“He has been a longtime friend, trusted advisor and confidant and a dedicated public servant throughout his nearly four decades in public service ― most importantly as we went to war against this unprecedented deadly pandemic,” Hogan said, presenting Neall a governor’s citation. “We’re incredibly grateful to him for his service, and we wish him the very best in his retirement.”

Schrader, who has also been with the Hogan administration for six years, will step into the role immediately. Hogan said Schrader headed the state’s COVID testing and hospital surge efforts as chief operating officer.

Schrader was part of a confirmation battle over Hogan appointees in 2017, when the Maryland Senate refused to confirm him as Health secretary and the General Assembly ultimately passed a budget that temporarily stripped him of pay in the acting secretary position.

Hogan eventually appointed Neall to the position, ending the stalemate.

Hogan’s office did not immediately say Tuesday whether the governor intends to seek Schrader’s confirmation in the 2021 General Assembly or whether a different nominee will be put forward next year. Spokesman Michael Ricci said it was too early to discuss a timeframe on the appointment or next steps.

“Keep in mind that given Sec. Neall’s health concerns, we had to act on a compressed timeline to ensure continuity of leadership during the pandemic. Now that we have achieved that, we can look at next steps in the process,” Ricci said in an email.

Hogan also announced Tuesday that Acting Deputy Secretary for Public Health Services Dr. Jinlene Chan will lead Maryland’s vaccination acquisition and distribution efforts.

Hogan said Tuesday that the state is expected to receive a first batch of about 155,000 vaccines “relatively fast,” though that amount will cover only about half of the state’s frontline health care workers, and an even smaller portion of those Marylanders identified as priority recipients during Phase 1 of a vaccination plan.

“That’s a tiny fraction of what we need,” Hogan said. “…And so we have very difficult decisions … about the implementation and rollout of that plan.”

Going forward, Marcozzi will become the state’s senior medical adviser on COVID-19.

Marcozzi on Tuesday encouraged Marylanders to stay vigilant in the fight against the novel coronavirus.

“I do understand, we all just want to take one day off from COVID-19. Especially during the holidays. Unfortunately, the virus doesn’t take a day off,” Marcozzi said.

He also encouraged people to continue getting regular medical care to avoid exacerbating other medical conditions.

“Many providers have the ability to see you either by phone through a telemedicine application or in their office safely,” Marcozzi said. “We all need to stay physically ― and mentally ― healthy, particularly during this holiday season.”

By Danielle E. Gaines

Editor’s Note: This story was updated to include additional comment from the governor’s office.