Minnesota is receiving 25 staffed ambulances from the federal government to help hospitals transfer patients so medical centers are better prepared for a surge of those critically ill with COVID-19.

The state submitted the request to the Federal Emergency Management Agency after ambulance operators said the rising cases could soon exhaust their ability to transfer patients between health care facilities, according to the Minnesota Department of Health.

These “inter-facility” transports are up 493% compared with three weeks ago and are rising rapidly.

Hospitals will need more ambulances to transport patients as they try to create space for critical care patients in certain medical centers, the Health Department said in a statement to the Star Tribune.

“Hospitals are trying to create surge capacity by transferring some noncritical patients into other facilities so they can expand their surge and critical care capacity,” the department said. “The patients are those who may not be ready for discharge but still need care, so transferring allows them to be cared for at other facilities.”

Patients must be moved by qualified ambulances. FEMA is providing vehicles and staff through a contract with a national ambulance service, which is scheduled to work in Minnesota for two weeks starting Friday.

Last week, more than half of 103 ambulance services surveyed said they would need state and federal help if the expected COVID-19 surge continues and gets worse.

Ambulance companies must continue to provide 911 services, the state said, so their time for doing inter-facility transfers is limited.

“Many ambulance services are also experiencing staffing shortages,” the Health Department said. “In many cases, COVID-19 has depleted staffing to critical levels, leaving many rural communities with a single staffed ambulance unable to make multi-hour transports and urban areas with significant delays for inter-facility transport.”

The ambulances and staff will be stationed at Camp Ripley and deployed around the state as needed. The deployment is scheduled to end on Dec. 4, the state said, but could be extended.

Ambulances provided by the federal government will not answer 911 emergency calls, but will be available for inter-facility transfers when local services aren’t available, said Tony Spector, executive director of the state’s Emergency Medical Services Regulatory Board.

The need for extra ambulances is one of several examples of how COVID-19 is stressing the state’s health care system, said Dr. Bjorn Westgard, an emergency medicine physician with Bloomington-based HealthPartners. On Wednesday, the health system’s Regions Hospital in St. Paul was at more than 100% of its usual capacity.

“We turn areas of the hospital into ICU beds, and we pull ER docs to take care of COVID patients and … we’re at surge staffing, so nurses are having to care for more patients per nurse than they ordinarily would,” Westgard said. “We’re not overwhelmed yet, but we’re feeling the strain.”

Smaller medical centers among the nine hospitals operated by HealthPartners are particularly stressed, Westgard said, because 50 to 75% of patients are sick with COVID and need more intense care than is typical. When smaller medical centers look to transfer complex patients to larger hospitals, he said, they’re struggling to find open beds.

Larger hospitals such as Regions are getting full, too, which means some patients wind up “boarding” in the emergency room as they wait for beds to open upstairs, Westgard said. Doctors and nurses are making it work for now, Westgard said, stressing that patients should not delay seeking non-COVID care.

But the pandemic trends are bleak.

“All the projections are that we’re going to be in a dark place in two or three weeks,” he said, “if people don’t change their ways.”