With intensive care units full and projections showing big increases in hospitalizations through New Year’s Day, some California hospitals are faced with the prospect of not being able to provide critical medical care to everyone who needs it, which would significantly increase the chances of patients dying as they wait for help.

Medical staff are juggling resources to keep up, placing the overflow of ICU patients in other parts of hospitals not designed for them, clearing out critical care wards of patients who can survive elsewhere and in some cases keeping patients on ambulances for as long as eight hours until space is available.

But much more wrenching choices could be ahead as the COVID-19 surge shows no signs of slowing down. Many hospitals are now preparing for the possibility of rationing care in the coming weeks as the number of patients exceeds their ability to care for them. A document obtained by The Times outlining how to allocate resources was recently circulated among doctors at four Los Angeles hospitals.

Instead of trying everything to save each patient, their goal during a crisis is to save as many patients as possible, the document said. That means those less likely to survive will not receive the same level of care they would have otherwise.

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