The strain of COVID-19 patients has forced one of Atlanta’s biggest hospital systems to postpone certain surgeries.

Piedmont Healthcare said some of its hospitals are postponing surgeries that require the patient to stay the night in general or intensive care beds. Piedmont did not say how many of its 11 hospitals were affected and declined to name them.

But a patient told The Atlanta Journal-Constitution he was informed a minor surgery slated for next week at Piedmont Rockdale in Conyers has been postponed indefinitely.

Piedmont is far from the only Georgia hospital at or near capacity. Many hospitals are having to divert incoming emergency room and intensive care patients because of a lack of beds or sufficient staffing, and health experts warn hospitals may soon face tough decisions about rationing of scarce resources.

The worst is likely yet to come. Georgia set a new record for confirmed and probable cases on Thursday, and health experts fear the state hasn’t seen its peak in cases or hospitalizations.

Piedmont, which operates its flagship location in Buckhead, said outpatient surgeries are continuing, as well as emergency procedures.

“Surgeries of an emergent nature continue, regardless of inpatient or outpatient status,” Piedmont spokesman John Manasso said in an emailed statement. “Our hospitals continue regular ongoing assessment of the surgical schedule and are accommodating as many procedures as possible.”

Hospitals across the state halted elective surgeries during the initial COVID-19 wave in March and April to conserve beds and vital personal protective equipment.

Piedmont’s announcement Thursday is the first confirmed instance of rationing of surgical services by a metro Atlanta hospital group in the current wave.

“Each of our hospitals reviews available resources daily related to current COVID volume, and, where possible, we continue to shift resources and transfer patients as needed to maintain appropriate capacity—as we have since the pandemic began in March,” Manasso said.

Jim Tudor, a retired lobbyist, said he went to Piedmont Rockdale for pre-operation screening this week for a minor procedure scheduled next week. On his way home, he said his surgeon’s office called and said his procedure had been postponed.

“My surgical scheduler said we’re not rescheduling right now,” Tutor said.

Despite the delay, he said he was grateful the notice. “I don’t think this is totally unexpected given Thanksgiving and Christmas gatherings,” he said.