The number of coronavirus cases in California has topped 1.2 million, leaving the state's hospitals near a breaking point. There are projections that the state could run out of intensive care beds before Christmas. And Gov. Gavin Newsom says he's considering another statewide stay-at-home order to stop the surge.

Central California's San Joaquin Valley is under particular strain. With a spike in COVID-19 infections, the region's hospitals are suffering from a staffing shortage.

It's only made worse because hundreds of local health care workers are quarantined. And many other places around the state and country are also seeing peaking caseloads and can't send more medical staff to help, says Dan Lynch, director of emergency medical services for Fresno County.

"We just don't have someone to reach out to to help at this time, which is concerning because we haven't been through something like this," Lynch says. Until a vaccine arrives and the caseload goes down, "I think our hands will be full," he says.

Here are excerpts of Lynch's interview with NPR's Morning Edition.

How is the ICU capacity in Fresno now?

The hospitals are pretty full. In our county, especially in central California here, we tend to run at a higher level during this time of the season anyways with cold and flu symptoms that are entering the system. And so the addition of COVID to our system just adds that additional pressure.

At this time, our hospitals are very full. And the same thing with our ICUs. Two of our largest hospitals out of probably five hospitals, our ICU beds are completely full. So it's really a challenge with the hospital system now, mainly because of staffing.

Because you don't have enough doctors and nurses to help with the surge.

Not only that, it's the fact that the health care staff are becoming infected and also being placed out on quarantine because they are coming in close contact with some of these individuals and need to be quarantined. In one instance, our large hospital has over 300 health care workers that are actually on quarantine. So it's not an issue of not having enough beds, it's an issue of not having enough staff to staff those beds.

More patients, less staff. What are your options?

Our only option is to get more health care assistance so that we can get more staffing into our hospitals. We can move people to what we call an alternate care site, which is our convention center where we've set up about 250 beds. But when we have beds in the hospital, that's where people need to be — not on a cot in a convention center, because that takes staffing, too.

How worried are you though because we're now almost 9 months into this pandemic and we are seeing record infections in California and across the country?

I am very concerned this time around because we went through this in our first surge, if you want to call it, back in July and August. But California was kind of late in the game compared to the rest of the country and what advantage that gave us was that we could actually recruit resources, staffing from other areas, to come in to help us.

Right now we're seeing a lot of the country and the rest of the state of California increasing at the same time. So those available resources aren't there anymore. So that's the concern.

Bo Hamby, Taylor Haney and Mohamad ElBardicy produced and edited the audio version of this story. Avie Schneider produced for the Web.

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