Health officials in the San Joaquin Valley are pleading with the state to help them transfer hospital patients to Los Angeles amid an ongoing surge of COVID-19.

“We don’t have enough hospitals to serve the population and the needs,” Fresno Interim Health Officer Dr. Rais Vohra told the Los Angeles Times. Vohra said hospitals there are “often running over capacity, so that they’re holding dozens and dozens of patients in the emergency department.”

Ambulances are stuck outside emergency rooms waiting to unload patients, according to Dale Dotson, operations coordinator for the Central California Emergency Medical Services Agency. As previously reported, ambulance crews in Fresno have stopped transporting people unless they have a life-threatening emergency.

Vohra said it’s difficult to transfer hospital patients across counties in California. But “they have hundreds and hundreds of open beds in Los Angeles County.” It wasn’t immediately clear what actions Fresno wants the state to make. Los Angeles County said it “welcomes patients from other counties while ensuring healthcare services are readily available for residents in our county.”

The Central Valley is ground zero for COVID-19 hospitalizations in the Golden State. Of the region’s 4 million people, nearly 800 are hospitalized with COVID-19. In Los Angeles, which has a population of more than 10 million people, just 558 COVID-19 patients are hospitalized.

One major reason for the discrepancy is the difference in vaccination rates. The vaccination rate in Fresno is 55%, well below the state’s vaccination rate of 63%. Los Angeles’ is 65%.