Citing last week’s “alarming” coronavirus case increases and swiftly rising hospitalizations, Gov. Tom Wolf delivered a grim plea to Pennsylvanians on Monday, warning that hospitals are straining and could soon crack — but he stopped short of imposing any new mitigation measures.

“We’re still looking at things we can do,” Wolf said, after a briefing in which he said people could end up being denied hospital care if case trends continue and begged residents to help exhausted health-care workers by following pandemic guidelines. “If we need to do more we will, and we’ll be making that decision very shortly.”

As he indicated he was considering new mitigation measures, Wolf said he and other state officials had hoped their warnings and measures implemented two weeks ago, including a universal mask mandate and a stay-at-home advisory, would slow the spread. Instead, the state saw the fall surge worsen last week, with new case counts higher than 11,000 on Thursday and Friday and approaching 13,000 on Saturday.

Since Dec. 1, nearly 65,000 people in Pennsylvania have been diagnosed with new cases of the coronavirus. If the virus’ spread does not slow, hospitals will be overwhelmed, Wolf said.

Pennsylvania reported 6,330 new cases of the virus, the most ever reported on a Monday, when numbers are usually lower because of the weekend. The state also recorded 42 deaths. Philadelphia announced 2,719 cases Monday, accounting for those reported since Friday, and 22 deaths.

The state Department of Health reported 5,400 coronavirus hospitalizations by midday Monday, an increase of 2,000 patients over the last two weeks. Wolf said hospitals were “running low” on ICU beds, particularly in the northern part of the state.

He asked Pennsylvanians to recommit to staying home and wearing masks, saying everyone has a role to play in keeping the virus from overwhelming the health-care system.

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The picture was no less grim elsewhere in the country, where the average number of deaths per day, above 2,100, was at a level last seen in April. Last week, more than 15,000 people with COVID-19 died in the U.S., including 980 Pennsylvanians and 343 New Jerseyans.

“Nurses go home, cry in the shower, cry in their car alone because of the desperation and exhaustion they feel,” said Maureen Casey, a nurse at Penn State Hershey Medical Center who spoke via video at Wolf’s briefing. “We are quickly becoming overrun, our hospital is at capacity already, flu season truly hasn’t even started yet, and the COVID patients just keep coming. ... We just need people to wear a mask and help us control and flatten the curve again the way we did in the spring.”

‘Just a huge crisis’

If hospitals do reach capacity, people could have trouble getting care, Wolf and others warned, including for non-coronavirus emergencies such as heart attacks.

“This dangerous and disturbing scenario is not only possible, it becomes increasingly likely with every day that COVID continues to spread in Pennsylvania,” Wolf said. “Doctors and nurses are frightened right now, and they’re asking the public for help.”

Nurses working with coronavirus patients have reported depression, sleep disorders, and traumatic stress, according to the preliminary results of a national study of the effects of the pandemic on health care workers by Villanova University’s Fitzpatrick College of Nursing.

“These are incredibly stressed people who are experiencing horrific, horrific things in their workplace,” said Donna Havens, the college’s dean and a leader of the study. “This is just a huge crisis. And it’s very, very worrisome especially since we have not yet seen the effect of Thanksgiving … and then we’re going to be heading into Christmas.”

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Wolf said collaboration between hospitals to divert patients and free up beds may not be enough to keep facilities from becoming overrun.

At the Pennsylvania Office of Rural Health, a government partnership with Penn State University, director Lisa Davis said rural hospitals were trying to treat more COVID-19 patients at home to save space in hospitals for the sickest ones.

“The projections are that we will need all the hospital capacity in the state,” she said.

State health officials asked Pennsylvanians to get their flu shots, saying that could help keep hospital beds free. Flu activity is currently low in the state, according to the Department of Health, so officials urged residents to get vaccinated before the spread of the flu peaks.

Wolf and Health Secretary Rachel Levine said they would monitor the coronavirus numbers in the coming days when considering further mitigation measures. Wolf again said he was not in favor of a return to the spring’s color-coded lockdown system.

Levine said the case increases seen last week are, in part, the first result of Thanksgiving travel and get-togethers. The coming days’ numbers will be crucial, she said, since more than 10 days have now passed since Thanksgiving. The average incubation period for coronavirus can be up to 14 days.

“If you didn’t know before how urgent the situation is, please pay attention now,” Wolf said, later adding, “Maybe the understanding of this doesn’t occur all at once in everybody. We have to keep preaching this gospel.”

New Jersey gets ready for a vaccine

In New Jersey, where Sunday saw a record high of more than 6,000 new cases, the state’s health leaders, like national officials, said the full brunt of any Thanksgiving surge would be yet to come.

Hospitals remained stable through the weekend, but given the spiking numbers of positive tests, “we have to expect that some percentage [of those people] will eventually require hospitalization,” Murphy said.

The state reported 3,573 new cases and 17 deaths Monday. Since Dec. 1, more than 30,000 people in New Jersey have tested positive for the virus.

Citing the rising case numbers, two school districts in South Jersey changed plans: Washington Township School District will switch to remote instruction until Jan. 11, and Deptford School District will stay remote until Jan. 8 rather than resuming hybrid instruction.

“Each day, in some cases, each hour, brings new cases that is making it nearly impossible to staff many of our schools,” Washington Township School Superintendent Joseph N. Bollendorf said in a letter to parents Sunday, citing 236 new cases in the Gloucester County district last week.

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Murphy estimated that the state will receive between 300,000 and 500,000 doses of a coronavirus vaccine by the end of the month. The first doses will go to health-care workers and residents of long-term care facilities, Murphy said, but within a matter of weeks the vaccine will be in more hospitals and pharmacies. Large-scale regional distribution sites could be up and running by January, he said.

The number of residents refusing to cooperate with contact tracers has also reached a new high: 74% of those who test positive and are reached by tracers are ignoring them.

“It’s just really frustrating,” Murphy said. “You’d think that when we talk about people who have died every day, that would get people’s attention.”

Staff writers Rob Tornoe, Melanie Burney, Laura McCrystal, and Marie McCullough contributed to this article.