LOS ANGELES (AP/CBS13) — California on Thursday reported a record two-day total of 1,042 coronavirus deaths as many hospitals strain under unprecedented caseloads.

The state Department of Public Health’s website listed 583 new deaths, a day after 459 deaths. The previous two-day record total was 1,013 deaths at the end of December.

California’s death toll since the start of the pandemic rose to 28,045.

The state’s hospitals are trying to prepare for the possibility that they may have to ration care for lack of staff and beds — and hoping they don’t have to make that choice.

California avoided surging cases for months, but now the virus is raging out of control there and across the nation in the wake of Thanksgiving holiday gatherings that authorities say vastly spread infections. Only Arizona tops California in cases per resident.

A travel advisory issued Wednesday “strongly discouraged” people from out of state from entering California. It also said Californians should avoid traveling more than 120 miles from home except for essential purposes.

The state’s previous advisory, issued in November, encouraged people to stay home or within their region without giving a specific range in miles. It outlined quarantine guidelines for out-of-state travelers but did not explicitly discourage travel.

California this week ordered hospitals in the hardest-hit areas to delay many elective surgeries in order to free up space.

Sacramento County on Wednesday surpassed 70,000 total cases since the pandemic began and tallied over 940 deaths. As of Wednesday, the county’s COVID tracking website also reported 118 patients in ICU and 509 total hospitalized patients.

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Los Angeles County, the nation’s most populous with 10 million residents, is one of nearly two dozen in Southern California and the San Joaquin Valley that have essentially run out of intensive care unit beds for COVID-19 patients.

Health officials warned Wednesday that hospitalizations will continue for at least the next three weeks as people who ignored social distancing rules to gather for Christmas and New Year’s Eve fall ill.

Hospitals statewide with room have been told to accept patients from others that have exhausted their ICU beds but in fact most of the state is reporting struggling to provide ICU beds, with non-COVID-19 patients spilling into corridors, tents and cafeterias.

Vaccinations being administered at what Gov. Gavin Newsom has said is too slow a pace will take weeks or months to slow the spread.

About 12% of people who test positive for COVID-19 eventually are likely to need hospital care, authorities have estimated.

“The numbers are extraordinary,″ said Carmela Coyle, president and CEO of the California Hospital Association. “We’re not going to dodge this math. We need the state’s help.”

State officials also should override decisions by many county health officers that prevent recovering coronavirus patients from being released to skilled nursing facilities, despite fears that they could spread the virus, Coyle said.

“Focus on nothing other than saving lives for the next few weeks,” Coyle said.