BALTIMORE (AP) — Staffing and capacity challenges at several Maryland hospitals due to a surge of COVID-19 cases should prompt Gov. Larry Hogan to reinstate a public health emergency, the industry’s top advocate said on Tuesday.

Bob Atlas, president and CEO of the Maryland Hospital Association, said Tuesday that such a declaration would “make plain to everyone how serious the situation is right now.”

Maryland hospitals are nearly full, emergency departments are stretched thin and nursing shortages are exacerbating issues, Atlas told The Baltimore Sun.

“Hospitals are seeing a spike in COVID-19 cases, and hospitals have fewer clinicians ready to care for all patients who need hospital care,” Atlas said in an email. “Despite these challenges, hospitals are doing everything they can to ensure all Marylanders receive the best possible care.”

A health emergency declaration would apply only to health care, health care services, and health care staffing, Atlas said, while providing more protections and flexibility.

The state had a public health emergency in place for a year and a half. That and a broader COVID-19 state of emergency expired in August.

Hogan spokesperson Mike Ricci said the administration already has taken “a series of immediate, proactive actions” to help hospitals. They include more funds for staff, licensing flexibilities and utilizing alternate care centers more.

There are also new thresholds for when to make more hospital bed capacity available and expanded testing operations, Ricci said.

“Additional actions will be taken, as needed, in line with the data and the science,” Ricci said in an email.

Maryland Department of Health representatives declined to comment. The department said separately Tuesday that more than 1,800 people with COVID-19 were hospitalized in Maryland, which is nearly three times the number a month earlier.

More Maryland hospitals are using emergency standards of care, which means some surgical procedures are being postponed and documentation is being reduced.

University of Maryland Harford Memorial Hospital said Tuesday it would implement crisis standards of care in response to the “substantial increase of COVID-19 positive patients over the past month,” according to a news release.

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