PAPEETE, Tahiti (AP) — France’s worst coronavirus outbreak is unfolding 12 time zones away from Paris, devastating Tahiti and other idyllic islands of French Polynesia.

The South Pacific archipelagos lack enough oxygen, ICU beds and morgue space – and their vaccination rate is barely half the national average. Simultaneous outbreaks on remote islands and atolls are straining the ability of local authorities to evacuate patients to the territory’s few hospitals.

“The problem is, there are a lot of deaths before we get there,” lamented Vincent Simon, the head of the regional emergency service.

French Polynesia is France’s latest challenge in juggling resources to battle the pandemic in former colonies that stretch around the world. With more than 2,800 COVID-19 cases per 100,000 inhabitants, it holds France’s record for the highest infection rate.

And that’s only an estimate: Things are so bad that the multi-ethnic territory of about 300,000 has stopped counting new infections as local health authorities redeployed medical staff to focus on patient care and vaccinations instead of testing.

Of the 463 virus-related deaths reported in French Polynesia throughout the pandemic, most took place over the past month. Vaccine skepticism, high obesity and diabetes rates, and the decision to reopen to some tourists this summer have been among the explanations for the current health crisis.

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Tensions have surfaced with other virus-ravaged French territories. While the central government in Paris sent hundreds of health care workers to the French Caribbean over the summer, Polynesia received just 10 backup nurses. After weeks of pleading by Polynesian officials, the French government promised this week to send 100 more.

French Polynesia, whose 118 islands stretch across an area as large as Europe, has broad autonomy from Paris but relies on the central government for health care.

“We need help. We have said it before: we cannot get by without it,” Tony Tekuataoa, the head of emergency services at the French Polynesia Hospital Center in Tahiti, told local television.

More than 330 people are hospitalized with the virus, including 55 in intensive care – well beyond the territory’s capacity.

Beds, mattresses, oxygen cylinders, oxygen concentrators: Everything is lacking. With 15 to 20 new deaths per day, funeral directors can no longer meet the demands of families. The macabre dance of ambulances and coffins animates local media coverage.

Hospital authorities are opening new COVID-19 wards. All medical and paramedical professionals have been requisitioned. The regulatory agency dispatches equipment and personnel in a permanent state of emergency.

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The surge is taking a toll on medical workers’ mental health. Meanwhile, disputes over vaccinations are tearing some families apart.

“The caregivers were not prepared to see so many deaths,” said Philippe Dupire, medical director of the French Polynesia Hospital Center.

The hospital’s workers appealed directly to Macron with a photo on its Facebook page showing the lobby where the president made a speech during a July visit and the same lobby a month later – now packed with 20 hospital beds occupied by virus patients.

To curb infections, local authorities imposed a curfew at first, then localized lockdowns and now they’ve shut down schools. Obligatory vaccinations have been announced for some sectors, despite objections.

Vaccinations are rising, but eight months into the campaign, only 38% of the total population is fully vaccinated, while 50% have received a first dose. That compares to 67% and 73% nationwide.

Meanwhile, more than 90% of those in intensive care are unvaccinated, as were a large majority of those who have died.

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The government’s minister for overseas territories, Sebastien Lecornu, blamed the lag on vaccine skepticism in a population particularly sensitive to disinformation. Distrust of authorities is also an issue among indigenous populations, scarred by the legacy of France’s nuclear tests on Polynesian atolls and decades of efforts for reparations.

Concerned about the potentially deadly consequences of vaccine avoidance, the leader of an independence party appealed to all communities to get the injections and to reject false information shared online.

While infections may be peaking in French Polynesia, experts fear a long, high plateau instead of a quick recovery. Epidemiologist Jean-Marc Ségualin said “nothing very significant is happening that shows an improvement.”

The territory has one bright spot: Nuku Hiva, in the Marquesas Islands, where French Polynesia’s vaccination campaign began in January and 85% of the population is fully vaccinated.

In a Tahiti rehab center, a 50-year-old man said he had avoided vaccines because of social media posts calling them dangerous. Choking with emotion, he described the fear and regret that consumed him while hospitalized.

One woman described struggling for air while in intensive care and being unable to keep her eyes open. She urged anyone within earshot to get vaccinated.

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Angela Charlton in Paris contributed.

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Follow all AP stories on the coronavirus pandemic at https://apnews.com/hub/coronavirus-pandemic.