Even with an additional 100 beds at El Paso’s University Medical Center and an outdoor tent, the hospital is so full it’s sending patients to a children’s hospital and airlifting patients critically ill with the novel coronavirus to other cities. In April, the hospital had 67 hospitalizations from covid-19 — on Thursday, there were 937.

With surging infection rates and hospitalizations that have risen over 350 percent this month, El Paso County Judge Ricardo Samaniego on Thursday ordered a two-week shutdown of all nonessential businesses.

“What I am doing now is not anything that has not been tried, but things that have worked not only for our community but for other communities as well,” Samaniego, a Democrat, said at a news conference announcing the order.

But within hours of his announcement, El Paso Mayor Dee Margo (R) questioned whether the order was legal, and Texas Attorney General Ken Paxton (R) quickly said that it violated executive orders from Gov. Greg Abbott (R) allowing businesses to reopen in limited capacity.

“El Paso County Judge Samaniego has no authority to shut down businesses in El Paso County,” Paxton tweeted from the attorney general account “This is a direct violation of @GovAbbott’s executive order. My office is quickly exploring all legal actions.”

The judge acknowledged on Thursday that his shutdown contradicted the governor’s order, but added that he had consulted with health-care experts, county judges and his legal department.

“I feel we stand in strong, sound, legal ground to do what I need to do at this point in time,” Samaniego said.

Abbott’s office has not yet commented on the judge’s order, but the case sets up a political conflict at a moment when cases in Texas are soaring. In the past week, there has been a 16 percent increase in infections, according to The Washington Post’s coronavirus tracker. So far, there have been more than 886,000 cases of the coronavirus in Texas and almost 18,000 deaths. In comparison, New York, which was one of the first major hot spots in the country, has had more than 500,000 cases.

El Paso County has had more than 45,000 cases, with nearly 8,000 of those cases emerging in the past week, The Post’s tracker shows. For several consecutive days, the average daily cases have exceeded 1,000.

“The hard truth is that the people who are dying are El Pasoans,” Samaniego said. “And I have a responsibility to do everything I can to protect El Pasoans.”

Abbott, meanwhile, has taken increasing steps over the last two months to open the state. In September, he issued an executive order expanding indoor capacity at establishments to 75 percent. And earlier this month, the governor allowed bars to open in “qualifying counties.” Samaniego requested Abbott exclude El Paso County from the list of permitted counties.

Paxton has frequently argued that Abbott’s orders supersede those of local officials. In July, Paxton issued guidance to the state’s Education Agency that local authorities could not force schools to close because of local health directives, causing the organization to announce it would no longer fund schools that closed because of coronavirus spikes.

Samaniego has taken other steps to try to quash the rising case load in his county. On Sunday, the judge ordered a citywide curfew from 10 p.m. to 5 a.m., which would last until Nov. 8.

But as numbers kept climbing, so did the hospitalizations. The judge said that as of Thursday, 44 percent of El Paso’s covid-19 cases in the county are hospitalized. Many hospitals have built outdoor tents to accommodate more patients, and the city set up a field hospital at the El Paso Convention Center. Samaniego warned of dire consequences if the city continued at its current rate.

“If the trend continues in that same direction we would exhaust the same resources, including the convention center and tents at the hospitals,” he said on Thursday. “We need to build capacity for our hospitals, build capacity to shore up contact tracing, identify hot spots and clusters and locally address the problems.”

The judge’s order on Thursday would shut down nonessential businesses, including tattoo parlors, hair salons, nail salons, gyms, massage businesses and in-person dining. Samaniego said that election activities are considered essential activities and services, and would not be impacted by the order.

At Thursday’s news conference, Samaniego said that he is “very cognizant and respectful of the governor’s orders,” but added that during an earlier visit to the city, Abbott said that “local officials do have levels of flexibility to make sure they are able to contain the spread of covid-19.”

The judge also said that he had a recent discussion with Abbott that was “not fruitful,” adding that “I haven’t gotten the support and the flexibility to do the things I’ve wanted to do.”

Margo, who is up for reelection, didn’t attend the news conference and said in a statement to the Dallas Morning News that “the judge did not consult me and refuses to return my call,” which led him to ask Paxton to clarify whether the ruling contradicted Abbott’s orders.

Rep. Veronica Escobar (D), who represents El Paso, endorsed the judge’s order, saying that the city needs “enforcements” to keep the virus at bay.

“We all absolutely have to follow the rules but if there is not strong enforcement then it makes it unfair for those who do follow the rules and who do make the sacrifices,” Escobar said at the news conference. “Ultimately, we all pay the price.”

Samaniego added that the order is a temporary measure to protect the citizens of El Paso and implored people to stay home, social distance and wear masks.

“There is no way we are going to be successful if we don’t have a united front,” he said.