New Mexico on Thursday suspended all nonessential surgeries and activated “crisis care” standards, a move that clears the way for a system of rationing amid a coronavirus surge that has overwhelmed the state’s capacities.

Under the twin orders by the state’s health department, elective surgeries will be banned until Jan. 4. Health-care providers, meanwhile, will be permitted to begin implementation of a statewide plan for stretching the state’s increasingly scarce health-care resources. The system ultimately could allow doctors to determine which patients receive care, depending on who is likeliest to survive.

The crisis-standards measure announced Thursday, which was deemed necessary by the “unsustainable strain on health care providers and hospitals,” will allow physicians and other health-care providers to treat covid-19 patients even if it is outside their practice area.

Leaders of the state’s largest hospitals have said that the system is a last resort but will probably be needed given an acute shortage of intensive care unit beds. Nearly 1,000 New Mexicans are hospitalized for coronavirus treatment, triple the total from the start of November.

Officials expressed confidence Thursday that standards will not suffer as a result of the shift. But they also warned that the state’s health-care system is operating on the brink and that relief is desperately needed.

“We are serving every New Mexican who needs us,” Gov. Michelle Lujan Grisham (D) said at a news briefing Thursday. “But we are getting to a place where it’s really dire, and we have to do better.”

Lujan Grisham had told The Washington Post of plans to activate crisis care in an interview last week.

New Mexico’s move came as hospitals nationwide face the extreme pressures of a pandemic that is spreading from coast to coast at unprecedented levels, with cases hitting new highs almost daily.

Since the pandemic began, New Mexico’s governor has taken dramatic action to try to limit the spread of the virus in her state, implementing some of the most restrictive measures in the country.

Last month, she shut down nonessential businesses, ended in-person dining and implemented a host of other measures as part of an attempt to “reset” the virus’s then-accelerating transmission across New Mexico.

Lujan Grisham on Thursday said that two-week effort had been a success: While cases had been growing exponentially at the time of her order, they have fallen by a third in the past two weeks. The state’s positivity rate has also declined significantly, while the growth in hospital admissions has slowed.

“All of this is exactly what we were looking for in a reset,” she said.

But she emphasized that the state remained vulnerable: New Mexico has fewer hospital beds per capita than nearly any other state in the country, as well as an unusually large population of elderly and low-income residents among its 2 million citizens.

“We are still in an extreme risk situation,” she said. “That’s true in New Mexico. That’s true in the rest of the country.”

Lujan Grisham said the strains on the system could affect not only covid patients but anyone needing health care, including expecting mothers, accident victims and cancer patients. She urged residents to stay home for Christmas, and to wear masks and maintain social distancing.

New Mexico reported an additional 23 covid deaths Thursday, bringing its total since the start of the pandemic to more than 1,800.

The state had nearly 1,800 new cases on Thursday, with 916 people in the hospital. Lujan Grisham called that “a frightening number.”

Statewide, there were only 33 ICU beds available in hospital covid wards.

The state’s decision to activate crisis standards was welcomed by hospital leaders Thursday. But it remained unclear how far they would go in using the more flexible rules to meet surging demand.

“Our team continues to be flexible and creative in creating capacity to treat those in need of care,” said Alexandria Sanchez, public information officer for University of New Mexico Health, one of the state’s largest health-care providers. “We appreciate the governor’s declaration, and will continue to do our best to care for our community.”

Lujan Grisham said the expected launch of a vaccination campaign next week represented a “huge bright spot in our fight against the pandemic.” But she said spikes from Thanksgiving and Christmas travel could mean the worst stretch of the pandemic could still lie ahead.

“We are bracing,” she said.