Billings, Montana — Montana, the first state to ban COVID-19 mandates for employees, has one of the lowest vaccination rates and the highest hospitalization rates in the country. Some hospitals have reached the point of not accepting new patients and are preparing to ration care.

The intensive care unit at Billings Clinic is operating at 175% capacity. Dr. Jaimee Belsky, an emergency room doctor there, is trying to keep up with the crush of COVID patients. The hospital’s emergency department is “beyond slammed at this moment,” a spokesperson said, adding that the department has 9 ICU patients and 13 others waiting to be seen. 

“I keep a scalpel in my pocket in case we have an emergency airway,” Belsky said. “We’re getting to where if we don’t see an improvement in the number of patients, soon we’re going to have to start looking at do we need to ration care?”

Pam Lee’s 35-year-old daughter, Hilary, is one of those patients fighting for their lives. The restaurant manager was planning to get the COVID vaccine but contracted the illness at the end of September. Within two weeks she was on a ventilator. 

“I was a nurse for over 40 years. And so I knew this could happen. I was praying it never would, but here we are,” Lee said. “I can’t even think. It is painful to watch, and these things can be prevented.”

Belsky urged people to talk to their friends and family about getting the vaccine. In Montana, only 57% of those eligible to receive the vaccine have been vaccinated, according to the Centers for Disease Control and Prevention. 

“Explain to them, ‘Yeah, it’s getting better in some parts the United States, but it’s getting worse here,'” Belsky said. 

After contracting COVID, Lee’s daughter spent days calling all of her unvaccinated friends, telling them to get the shot. Her family can only hope it’s not too late for her. 

Meg Oliver

Meg Oliver is a correspondent for CBS News based in New York City.