Idaho’s largest health care system is projecting a crisis in December, if the spread of COVID-19 continues unabated. Idaho hospitals may be forced to begin choosing which patients receive life-saving medical care.

Dr. Jim Souza of St. Luke’s Health System told CBS This Morning on Thursday that Idaho is headed in the wrong direction. Flu season has begun in Idaho, as hospitals already are approaching their capacity with existing patients and seriously ill COVID-19 patients.

Souza and other health care leaders have warned that holiday travel and gatherings, starting with Thanksgiving next week, would worsen the surge of COVID-19 cases.

“We would be in the unimaginably bad situation of needing to make decisions about who gets (care) and who doesn’t,” Souza told CBS News. “… Our modeling is suggesting we may be facing that scenario in December.”

That situation would be “crisis standards of care,” which is triggered when the need for health care exceeds the resources available for patients — whose care requires beds, nurses, respiratory therapists and other specialized staff, physicians, ventilators, supplies, medication and personal protective equipment.

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The Idaho Department of Health and Welfare, in consultation with the Governor’s Office, other state agencies, local health officials and health care systems, would determine when Idaho has reached that point.

“We do our best, and if one of those COVID patients has a lower chance of survival, we make decisions about who gets the bed,” Souza said.

Already, hospitals such as St. Luke’s Magic Valley Medical Center in Twin Falls have been forced to start diverting patients to other parts of the state because of limited capacity and staffing shortages. St. Luke’s and Saint Alphonsus health systems also have had to delay non-emergency surgeries that require hospital admission, to free up resources during the COVID-19 surge.

His remarks come nearly a week after Idaho Gov. Brad Little pulled Idaho back to a modified Stage 2 order, which limits the size of public and private gatherings to 10 and puts some rules on how restaurants and bars operate. Little did not issue a statewide mask mandate, continuing to leave that up to local governments and regional public health boards.

Souza and other health care leaders have said they will do everything in their power to prevent rationing. They also have expressed hope that Idahoans will voluntarily follow guidelines, such as wearing face coverings in public, maintaining at least 6 feet of distance from others and practicing good hygiene.

“I’m way more interested in cooperation than compliance,” Souza told CBS News.