IOWA CITY, Iowa (AP) — Hospitals filled up, major schools closed classrooms, the state sought emergency help with contact tracing and most inmates at one prison were infected as the coronavirus raged across Iowa.

One in every 100 residents in Iowa received a COVID-19 diagnosis in the week that ended Sunday, even as others reported delays in getting tests or were awaiting results. That was the third-worst rate in the nation, according to data from Johns Hopkins University.

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A record 1,392 people infected with COVID-19 were hospitalized statewide as of Sunday night, and the number was only expected to increase in coming days after a surge of infections. That included more than 100 people fighting for their lives on ventilators.

University of Iowa Hospitals and Clinics in Iowa City, the state’s premier hospital, was “very full” and making adjustments to free up beds for the most critically ill patients, a spokeswoman said Monday.

The public health department for Polk County, the largest in the state, reported over the weekend that hospitals in the Des Moines metropolitan area were also nearing their limits.

“We cannot stress enough how alarming and urgent the situation has become for hospitals and their health care workers,” the department said in a statement.

Staffing was a particular concern, as more workers are in isolation or quarantine due to community spread and others are exhausted from months of work fighting the pandemic.

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Hospitals are limiting procedures in order to preserve bed capacity, and transferring patients elsewhere when necessary, said Iowa Hospital Association President Kirk Norris. Some urban hospitals were looking to rural hospitals to accept transfers, he said.

“The Iowa hospital community message is that we’re here, open and prepared to care for all, but we need everyone’s help to stem this current tide of COVID-19,” Norris said.

Republican Gov. Kim Reynolds said she would announce “new steps to fight the virus” in a speech Monday night. She is facing growing pressure to issue a statewide mask mandate and to put limits on restaurants, bars and other gathering places where the virus has spread.

The Iowa Department of Public Health issued an emergency Request for Proposals on Monday seeking a contractor to conduct contact tracing and case investigation services. The department announced that proposals were due Tuesday, saying outside help was needed quickly “due to the steady increase in case volume” that has overwhelmed its resources.

For thousands of public school students, Monday marked the beginning of taking virtual classes from their homes. Several districts, including those in Des Moines, Cedar Rapids and Davenport, received waivers from the state last week to close in-person instruction for at least two weeks.

Statistically, the situation was most dire in three rural counties that house state prisons where the virus has spread among inmates and staff. In Jones County, 741 inmates at the Anamosa State Penitentiary had tested positive — roughly 3 of every 4 incarcerated there, according to the Iowa Department of Corrections.

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